Search results for: real time qPCR

Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

Abstract:

In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

Abstract:

In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos.

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Authors: Ebru Cubukcu, Gozde Eksioglu Cetintahra, Burcin Hepguzel Hatip, Mert Cubukcu

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Obesity and overweight cause serious health problems. Public and private organizations aim to encourage walking in various ways in order to cope with the problem of obesity and overweight. This study aims to understand how the spatial characteristics of urban street pattern, connectivity and complexity influence young people’s choice to walk or not. 185 public university students in Izmir, the third largest city in Turkey, participated in the study. Each participant had worn an accelerometer and a global positioning (GPS) device for a week. The accelerometer device records data on the intensity of the participant’s activity at a specified time interval, and the GPS device on the activities’ locations. Combining the two datasets, activity maps are derived. These maps are then used to differentiate the participants’ walk trips and motor vehicle trips. Given that, the frequency of walk and motor vehicle trips are calculated at the street segment level, and the street segments are then categorized into two as ‘preferred by pedestrians’ and ‘preferred by motor vehicles’. Graph Theory-based accessibility indices are calculated to quantify the spatial characteristics of the streets in the sample. Six different indices are used: (I) edge density, (II) edge sinuosity, (III) eta index, (IV) node density, (V) order of a node, and (VI) beta index. T-tests show that the index values for the ‘preferred by pedestrians’ and ‘preferred by motor vehicles’ are significantly different. The findings indicate that the spatial characteristics of the street network have a measurable effect on young people’s choice to walk or not. Policy implications are discussed. This study is funded by the Scientific and Technological Research Council of Turkey, Project No: 116K358.

Keywords: graph theory, walkability, accessibility, street network

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Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

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Authors: T. Iakovleva

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

Keywords: responsible innovation, ICT, healthcare, welfare sector

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Authors: Bong Jae Lee, Jeong Il Lee, Hyo Su Kim

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Both developed and developing countries have adopted the decision to join the Paris agreement to reduce greenhouse gas (GHG) emissions at the Conference of the Parties (COP) 21 meeting in Paris. As a result, the developed and developing countries have to submit the Intended Nationally Determined Contributions (INDC) by 2020, and each country will be assessed for their performance in reducing GHG. After that, they shall propose a reduction target which is higher than the previous target every five years. Therefore, an accurate method for calculating greenhouse gas emissions is essential to be presented as a rational for implementing GHG reduction measures based on the reduction targets. Non-CO2 GHGs (CF4, NF3, N2O, SF6 and so on) are being widely used in fabrication process of semiconductor manufacturing, and etching/deposition process of display manufacturing process. The Global Warming Potential (GWP) value of Non-CO2 is much higher than CO2, which means it will have greater effect on a global warming than CO2. Therefore, GHG calculation methods of the electronics industry are provided by Intergovernmental Panel on climate change (IPCC) and U.S. Environmental Protection Agency (EPA), and it will be discussed at ISO/TC 146 meeting. As discussed earlier, being precise and accurate in calculating Non-CO2 GHG is becoming more important. Thus this study aims to discuss the implications of the calculating methods through comparing the methods of IPCC and EPA. As a conclusion, after analyzing the methods of IPCC & EPA, the method of EPA is more detailed and it also provides the calculation for N2O. In case of the default emission factor (by IPCC & EPA), IPCC provides more conservative results compared to that of EPA; The factor of IPCC was developed for calculating a national GHG emission, while the factor of EPA was specifically developed for the U.S. which means it must have been developed to address the environmental issue of the US. The semiconductor factory ‘A’ measured F gas according to the EPA Destruction and Removal Efficiency (DRE) protocol and estimated their own DRE, and it was observed that their emission factor shows higher DRE compared to default DRE factor of IPCC and EPA Therefore, each country can improve their GHG emission calculation by developing its own emission factor (if possible) at the time of reporting Nationally Determined Contributions (NDC). Acknowledgements: This work was supported by the Korea Evaluation Institute of Industrial Technology (No. 10053589).

Keywords: non-CO2 GHG, GHG emission, electronics industry, measuring method

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Authors: Leo Laine, Morgan Johansson

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To meet the civilizations future needs for safe living and low environmental footprint, the engineers designing the complex systems of tomorrow will need efficient ways to model and optimize these systems for their intended purpose. For example, a civil defence shelter and its subsystem components needs to withstand, e.g. airblast and ground shock from decided design level explosion which detonates with a certain distance from the structure. In addition, the complex civil defence shelter needs to have functioning air filter systems to protect from toxic gases and provide clean air, clean water, heat, and electricity needs to also be available through shock and vibration safe fixtures and connections. Similar complex building systems can be found in any concentrated living or office area. In this paper, the authors use a multidomain modelling language called Modelica to model a concrete wall as a single degree of freedom (SDOF) system with elastoplastic properties with the implemented option of plastic hardening. The elastoplastic model was developed and implemented in the open source tool OpenModelica. The simulation model was tested on the case with a transient equivalent reflected pressure time history representing an airblast from 100 kg TNT detonating 15 meters from the wall. The concrete wall is approximately regarded as a concrete strip of 1.0 m width. This load represents a realistic threat on any building in a city like area. The OpenModelica model results were compared with an Excel implementation of a SDOF model with an elastic-plastic spring using simple fixed timestep central difference solver. The structural displacement results agreed very well with each other when it comes to plastic displacement magnitude, elastic oscillation displacement, and response times.

Keywords: airblast from explosives, elastoplastic spring model, Modelica modelling language, SDOF, structural response of concrete structure

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Authors: Elen Gasparyan, Naira Hakobyan

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One of the leading factors determining the effectiveness of work in a modern organization is the motivation of its employees. In the scientific psychological literature, this phenomenon is understood mainly as constructive forms of motivation and the search for ways to increase it. At the same time, the motivation of employees can sometimes lead to a decrease in the productivity of the organization, i.e., destructive motivation is usually not considered from the point of view of various motivational theories. This article provides an analysis of various forms of destructive motivation of employees. These forms include formalism in labor behavior, inadequate assessment of the work done, and an imbalance of personal and organizational interests. The destructive motivation of personnel has certain negative consequences both for the employees themselves and for the entire organization - it leads to a decrease in the rate of production and the quality of products or services, increased conflict in the behavior of employees, etc. Currently, there is an increase in scientific interest in the study of destructive motivation. The subject of psychological research is not only modern socio-psychological processes but also the achievements of scientific thought in the field of theories of motivation and management. This article examines the theoretical approaches of J. S. Adams and Porter-Lawler, provides an analysis of theoretical concepts, and emphasizes the main characteristics of the destructiveness of motivation. Destructive work motivation is presented at the macro, meso, and micro levels. These levels express various directions of development of motivation stimuli, such as social, organizational, and personal ones. At the macro level, the most important characteristics of destructive motivation are the high-income gap between employers and employees, а high degree of unemployment, weak social protection of workers, non-compliance by employers with labor legislation, and emergencies. At the organizational level, the main characteristics are decreasing the diversity of work and insufficient work conditions. At the personal level, the main characteristic of destructive motivation is a discrepancy between personal and organizational interests. A comparative analysis of the theoretical and methodological foundations of the study of motivation makes it possible to identify not only the main characteristics of destructive motivation but also to determine the contours of psychological counseling to reduce destructiveness in the behavior of employees.

Keywords: destructive, motivation, organization, behavior

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Authors: Bin Feng, Zhulin Zong

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Radar systems are critical in the modern military, aviation, and maritime operations, and their proper functioning is essential for the success of these operations. However, due to the complexity and sensitivity of radar systems, they are susceptible to various faults that can significantly affect their performance. Traditional radar fault diagnosis strategies rely on expert knowledge and rule-based approaches, which are often limited in effectiveness and require a lot of time and resources. Deep learning has recently emerged as a promising approach for fault diagnosis due to its ability to learn features and patterns from large amounts of data automatically. In this paper, we propose a radar fault diagnosis strategy based on deep learning that can accurately identify and classify faults in radar systems. Our approach uses convolutional neural networks (CNN) to extract features from radar signals and fault classify the features. The proposed strategy is trained and validated on a dataset of measured radar signals with various types of faults. The results show that it achieves high accuracy in fault diagnosis. To further evaluate the effectiveness of the proposed strategy, we compare it with traditional rule-based approaches and other machine learning-based methods, including decision trees, support vector machines (SVMs), and random forests. The results demonstrate that our deep learning-based approach outperforms the traditional approaches in terms of accuracy and efficiency. Finally, we discuss the potential applications and limitations of the proposed strategy, as well as future research directions. Our study highlights the importance and potential of deep learning for radar fault diagnosis. It suggests that it can be a valuable tool for improving the performance and reliability of radar systems. In summary, this paper presents a radar fault diagnosis strategy based on deep learning that achieves high accuracy and efficiency in identifying and classifying faults in radar systems. The proposed strategy has significant potential for practical applications and can pave the way for further research.

Keywords: radar system, fault diagnosis, deep learning, radar fault

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Authors: Maryam Memarian, Mahmood Naghizadeh

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Deconstruction is an approach that is entirely incompatible with the traditional prevalent architecture. Considering the fact that this approach attempts to put architecture in sharp contrast with its opposite events and transpires with attending to the neglected and missing aspects of architecture and deconstructing its stable structures. It also recklessly proceeds beyond the existing frameworks and intends to create a different and more efficient prospect for space. The aim of deconstruction architecture is to satisfy both the prospective and retrospective visions as well as takes into account all tastes of the present in order to transcend time. Likewise, it ventures to fragment the facts and symbols of the past and extract new concepts from within their heart, which coincide with today’s circumstances. Since this approach is an attempt to surpass the limits of the prevalent architecture, it can be employed to design places in which creative events occur and imagination and ambition flourish. Thought-provoking artistic events can grow and mature in such places and be represented in the best way possible to all people. The concept of event proposed in the plan grows out of the interaction between space and creation. In addition to triggering surprise and high impressions, it is also considered as a bold journey into the suspended realms of the traditional conflicts in architecture such as architecture-landscape, interior-exterior, center-margin, product-process, and stability-instability. In this project, at first, through interpretive-historical research method and examining the inputs and data collection, recognition and organizing takes place. After evaluating the obtained data using deductive reasoning, the data is eventually interpreted. Given the fact that the research topic is in its infancy and there is not a similar case in Iran with limited number of corresponding instances across the world, the selected topic helps to shed lights on the unrevealed and neglected parts in architecture. Similarly, criticizing, investigating and comparing specific and highly prized cases in other countries with the project under study can serve as an introduction into this architecture style.

Keywords: anti-architecture, creativity, deconstruction, event

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Authors: Esther Mafunda, Simbarashe Muparangi

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The present paper tests the applicability of the Regression Hypothesis on the pathological language dissolution of a Shona male adult with Broca’s aphasia. It particularly assesses the prediction of the Regression Hypothesis, which states that the process according to which language is forgotten will be the reversal of the process according to which it will be acquired. The main aim of the paper is to find out whether mirror symmetries between L1 acquisition and L1 dissolution of tense in Shona and, if so, what might cause these regression patterns. The paper also sought to highlight the practical contributions that Linguistic theory can make to solving language-related problems. Data was collected from a 46-year-old male adult with Broca’s aphasia who was receiving speech therapy at St Giles Rehabilitation Centre in Harare, Zimbabwe. The primary data elicitation method was experimental, using the probe technique. The TART (Test for Assessing Reference Time) Shona version in the form of sequencing pictures was used to access tense by Broca’s aphasic and 3.5-year-old child. Using the SPSS (Statistical Package for Social Studies) and Excel analysis, it was established that the use of the future tense was impaired in Shona Broca’s aphasic whilst the present and past tense was intact. However, though the past tense was intact in the male adult with Broca’s aphasic, a reference to the remote past was made. The use of the future tense was also found to be difficult for the 3,5-year-old speaking child. No difficulties were encountered in using the present and past tenses. This means that mirror symmetries were found between L1 acquisition and L1 dissolution of tense in Shona. On the basis of the results of this research, it can be concluded that the use of tense in a Shona adult with Broca’s aphasia supports the Regression Hypothesis. The findings of this study are important in terms of speech therapy in the context of Zimbabwe. The study also contributes to Bantu linguistics in general and to Shona linguistics in particular. Further studies could also be done focusing on the rest of the Bantu language varieties in terms of aphasia.

Keywords: Broca’s Aphasia, regression hypothesis, Shona, language dissolution

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Authors: Osayomwanbor E. Oghama, John O. Olomukoro

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The school environment, apart from home, is probably the most important indoor environment for children. Children spend as much as 80-90% of their indoor time either at school or at home; an average of 35 - 40 hours per week in schools, hence are at the risk of indoor air pollutants such as volatile organic compounds (VOCs). Concentrations of VOCs vary widely but are generally higher indoors than outdoors. This research was, therefore, carried out to evaluate the levels of VOCs in secondary school classrooms in Benin City, Edo State. Samples were obtained from a total of 18 classrooms in 6 secondary schools. Samples were collected 3 times from each school and from 3 different classrooms in each school using Draeger ORSA 5 tubes. Samplers were left to stay for a school-week (5 days). The VOCs detected and analyzed were benzene, ethlybenzene, isopropylbenzene, naphthalene, n-butylbenzene, n-propylbenzene, toluene, m-xylene, p-xylene, o-xylene, styrene, chlorobenzene, chloroform, 1,2-dichloropropane, 2,2-dichloropropane, tetrachloroethane, tetrahydrofuran, isopropyl acetate, α-pinene, and camphene. The results showed that chloroform, o-xylene, and styrene were the most abundant while α-pinene and camphene were the least abundant. The health risk assessment was done in terms of carcinogenic (CRI) and non-carcinogenic risks (THR). The CRI values of the schools ranged from 1.03 × 10-5 to 1.36 × 10-5 μg/m³ (a mean of 1.16 × 10-5 μg/m³) with School 6 and School 3 having the highest and lowest values respectively. The THR values of the study schools ranged from 0.071-0.086 μg/m³ (a mean of 0.078 μg/m³) with School 3 and School 2 having the highest and lowest values respectively. The results show that all the schools pose a potential carcinogenic risks having CRI values greater than the recommended limit of 1 × 10-6 µg/m³ and no non-carcinogenic risk having THR values less than the USEPA hazard quotient of 1 µg/m³. It is recommended that school authorities should ensure adequate ventilation in their schools, supplementing natural ventilation with mechanical sources, where necessary. In addition, indoor air quality should be taken into consideration in the design and construction of classrooms.

Keywords: carcinogenic risk indicator, health risk, indoor air, non-carcinogenic risk indicator, secondary schools, volatile organic compounds

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Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

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Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

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Authors: Virginie Hergault, Siham Chebbah, Bertrand Frere

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Following in-house objectives, Central laboratory of Paris police Prefecture conducted a general review on models and Computational Fluid Dynamics (CFD) codes used to simulate pollutant dispersion in the atmosphere. Starting from that review and considering main features of Large Eddy Simulation, Central Laboratory Of Paris Police Prefecture (LCPP) postulates that the Fire Dynamics Simulator (FDS) model, from National Institute of Standards and Technology (NIST), should be well suited for air pollutant dispersion modeling. This paper focuses on the implementation and the evaluation of FDS in the frame of the European COST ES1006 Action. This action aimed at quantifying the performance of modeling approaches. In this paper, the CUTE dataset carried out in the city of Hamburg, and its mock-up has been used. We have performed a comparison of FDS results with wind tunnel measurements from CUTE trials on the one hand, and, on the other, with the models results involved in the COST Action. The most time-consuming part of creating input data for simulations is the transfer of obstacle geometry information to the format required by SDS. Thus, we have developed Python codes to convert automatically building and topographic data to the FDS input file. In order to evaluate the predictions of FDS with observations, statistical performance measures have been used. These metrics include the fractional bias (FB), the normalized mean square error (NMSE) and the fraction of predictions within a factor of two of observations (FAC2). As well as the CFD models tested in the COST Action, FDS results demonstrate a good agreement with measured concentrations. Furthermore, the metrics assessment indicate that FB and NMSE meet the tolerance acceptable.

Keywords: numerical simulations, atmospheric dispersion, cost ES1006 action, CFD model, cute experiments, wind tunnel data, numerical results

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Authors: Marcel Schneider, Nils Nießen

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Microscopic simulation programs enable the description of the two processes of railway operation and the previous timetabling. Occupation conflicts are often solved based on defined train priorities on both process levels. These conflict resolutions produce knock-on delays for the involved trains. The sum of knock-on delays is commonly used to evaluate the quality of railway operations. It is either compared to an acceptable level-of-service or the delays are evaluated economically by linearly monetary functions. It is impossible to properly evaluate dispatching decisions without a well-founded objective function. This paper presents a new approach for evaluation of dispatching decisions. It uses models of choice of transport and considers the behaviour of the end-costumers. These models evaluate the knock-on delays in more detail than linearly monetary functions and consider other competing modes of transport. The new approach pursues the coupling of a microscopic model of railway operation with the macroscopic model of choice of transport. First it will be implemented for the railway operations process, but it can also be used for timetabling. The evaluation considers the possibility to change over to other transport modes by the end-costumers. The new approach first looks at the rail-mounted and road transport, but it can also be extended to air transport. The split of the end-costumers is described by the modal-split. The reactions by the end-costumers have an effect on the revenues of the railway undertakings. Various travel purposes has different pavement reserves and tolerances towards delays. Longer journey times affect besides revenue changes also additional costs. The costs depend either on time or track and arise from circulation of workers and vehicles. Only the variable values are summarised in the contribution margin, which is the base for the monetary evaluation of the delays. The contribution margin is calculated for different resolution decisions of the same conflict. The conflict resolution is improved until the monetary loss becomes minimised. The iterative process therefore determines an optimum conflict resolution by observing the change of the contribution margin. Furthermore, a monetary value of each dispatching decision can also be determined.

Keywords: choice of transport, knock-on delays, monetary evaluation, railway operations

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Authors: Nahid Hassanshahi, Ayoub Karimi-Jashni, Nasser Talebbeydokhti

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Due to the economic and environmental benefits of producing less waste, the US Environmental Protection Agency (EPA) introduces source reduction as one of the most important means to deal with the problems caused by increased landfills and pollution. Waste reduction involves all waste management methods, including source reduction, recycling, and composting, which reduce waste flow to landfills or other disposal facilities. Source reduction of waste can be studied from two perspectives: avoiding waste production, or reducing per capita waste production, and waste deviation that indicates the reduction of waste transfer to landfills. The present paper has investigated home composting as a managerial solution for reduction of waste transfer to landfills. Home composting has many benefits. The use of household waste for the production of compost will result in a much smaller amount of waste being sent to landfills, which in turn will reduce the costs of waste collection, transportation and burial. Reducing the volume of waste for disposal and using them for the production of compost and plant fertilizer might help to recycle the material in a shorter time and to use them effectively in order to preserve the environment and reduce contamination. Producing compost in a home-based manner requires very small piece of land for preparation and recycling compared with other methods. The final product of home-made compost is valuable and helps to grow crops and garden plants. It is also used for modifying the soil structure and maintaining its moisture. The food that is transferred to landfills will spoil and produce leachate after a while. It will also release methane and greenhouse gases. But, composting these materials at home is the best way to manage degradable materials, use them efficiently and reduce environmental pollution. Studies have shown that the benefits of the sale of produced compost and the reduced costs of collecting, transporting, and burying waste can well be responsive to the costs of purchasing home compost machine and the cost of related trainings. Moreover, the process of producing home compost may be profitable within 4 to 5 years and as a result, it will have a major role in reducing waste management.

Keywords: compost, home compost, reducing waste, waste management

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Authors: Tasneem Imam, Justine S. Gibson, Mohammad Foysal, Shetu B. Das, Rashed Mahmud, Suman D. Gupta, Ahasanul Hoque, Guillaume Fournie, Joerg Henning

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Commercial chicken production is an import livestock industry in Bangladesh. Antimicrobials are commonly used to control and prevent infectious diseases. It was hypothesized that inadequate biosecurity practices might promote antimicrobial usage on commercial chicken farms. A cross-sectional study was carried out to evaluate antimicrobial usage and farm biosecurity practices implemented on 57 layer and 83 broiler farms in eight sub-districts of the Chattogram district in Bangladesh. A questionnaire was used to collect data on antimicrobial usage and biosecurity practices on these farms. A causal framework was used to guide the development of a multi-level mixed-effects logistic regression analysis to evaluate the total and direct effects of practiced biosecurity management on prophylactic and therapeutic administration of antimicrobials. A total of 24 antimicrobials were administered in the current production cycle at the time of the survey. The most administered antimicrobials on layer farms were ciprofloxacin (37.0% of farms), amoxicillin (33.3%), and tiamulin (31.5%); however, on broiler farms, colistin (56.6% of farms), doxycycline (50.6%), and neomycin (38.6%) were most used. Only 15.3% of commercial farmers used antimicrobials entirely for therapeutic purposes, whereas 84.7% administered antimicrobials prophylactically. Inadequate biosecurity practices were more common among commercial broiler farmers compared to layer farmers. For example, only 2.4% of broiler farmers used footbaths before entering sheds compared to 22.2% of the layer farmers (p < 0.001). Farms that used antimicrobials only for therapeutic purposes (vs prophylactic) implemented more frequently adequate disease control measures, such as separating sick birds from healthy birds. This research highlighted that the prophylactic application of antimicrobials is often conducted to substitute poor biosecurity practices on commercial chicken farms. Awareness programs for farmers are crucial to inform them about the risk associated with antimicrobial usage and to highlight the economic benefits of implementing cost-effective biosecurity measures to control infectious poultry diseases.

Keywords: antimicrobial, biosecurity, broiler, layer

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Authors: Miroslava Markovic, Snezana Rajkovic, Ljubinko Rakonjac, Aleksandar Lucic

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Oak powdery mildew is a serious problem on seedlings in nurseries as well as on naturally and artificially introduced progeny. The experiments were set on oak seedlings in two nurseries located in Central Serbia, where control of oak powdery mildew Microsphaera alphitoides Griff. et Maubl. had been conducted through alternative protection measures by means of various dosages of AQ-10 biofungicide, with and without added polymer (which has so far never been used in this country for control of oak powdery mildew). Simultaneous testing was conducted on the efficiency of a chemical sulphur-based preparation (used in this area for many years as a measure of suppression of powdery mildews, without the possibility of developing resistance of the pathogen to the active matter). To date, the Republic of Serbia has registered no fungicides for suppression of pathogens in the forest ecosystems. In order to introduce proper use of new disease-fighting agents into a country, certain relevant principles, requirements and criteria prescribed by the Forest Stewardship Council (FSC) must be observed, primarily with respect to measures of assessment and mitigation of risks, the list of dangerous and highly dangerous pesticides with the possibility of alternative protection. One of the main goals of the research was adjustment of the protective measures to the FSC policy through selection of eco-toxicologically favourable fungicides, given the fact that only preparations named on the list of permitted active matters are approved for use in certified forests. The results of the research have demonstrated that AQ-10 biofungicide can be used as a part of integrated disease management programmes as an alternative, through application of several treatments during vegetation and combination with other active matters registered for these purposes, so as to curtail the use of standard fungicides for control of powdery mildews on oak seedlings in nurseries. The best results in suppression of oak powdery mildew were attained through use of AQ-10 biofungicide (dose 50 or 70g/ha) with added polymer Nu Film-17 (dose 1.0 or 1.5 l/ha). If the treatment is applied at the appropriate time, even fewer number of treatments and smaller doses will be just as efficient.

Keywords: oak powdery mildew, biofungicides, polymers, Microsphaera alphitoides

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Authors: Charu Sharma

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San Francisco Public Utilities Commission’s Headquarters was listed in the 2013-American Institute of Architects Committee of the Environment (AIA COTE) Top Ten Green Projects. This 13-story, 277,000-square-foot building, housing more than 900 of the agency’s employees was completed in June 2012. It was designed to achieve LEED Platinum Certification and boasts a plethora of green features to significantly reduce the use of energy and water consumption, and provide a healthy office work environment with high interior air quality and natural daylight. Key sustainability features include on-site clean energy generation through renewable photovoltaic and wind sources providing $118 million in energy cost savings over 75 years; 45 percent daylight harvesting; and the consumption of 55 percent less energy and a 32 percent less electricity demand from the main power grid. It uses 60 percent less water usage than an average 13-story office building as most of that water will be recycled for non-potable uses at the site, running through a system of underground tanks and artificial wetlands that cleans and clarifies whatever is flushed down toilets or washed down drains. This is one of the first buildings in the nation with treatment of gray and black water. The building utilizes an innovative structural system with post tensioned cores that will provide the highest asset preservation for the building. In addition, the building uses a “green” concrete mixture that releases less carbon gases. As a public utility commission this building has set a good example for resource conservation-the building is expected to be cheaper to operate and maintain as time goes on and will have saved rate-payers $500 million in energy and water savings. Within the anticipated 100-year lifespan of the building, our ratepayers will save approximately $3.7 billion through the combination of rental savings, energy efficiencies, and asset ownership.

Keywords: energy efficiency, sustainability, resource conservation, asset ownership, rental savings

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Authors: E. N. Vetrova, L.V. Lapochkina, N. V. Nikulina

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In the national economy, entrepreneurship plays the role of a buffer between economy and policy for it contributes to improving budget effectiveness and decreasing dependence of economy on the state. Entrepreneurship in industry makes it possible to increase the added value that is formed in production chains and to decrease dependence on import. Under the current circumstances, when sanctions are being imposed, this is especially relevant for Russia and for the realization of projects in the Russian Arctic. However, development of entrepreneurship in industry requires an enlightened state policy. The purpose of the research is elaboration of recommendations for improving economic effectiveness of the realization of the Arctic projects on the basis of conceptual proposals for the development of entrepreneurship in industry. The paper presents the studies of the extractive industry role in the Russian economy and proves its raw material character. The analysis of production chains in industry on the basis of the conception of the added value global chains demonstrated a low added value formed by Russian companies. The study of changes in the structure of economy based on systemic, statistical and comparative analyses revealed no positive changes in the structure of economy over the period under consideration. This is a manifestation of ineffectiveness of the Russian industrial policy in general and within the Arctic region in particular. The authors identified the problems information and implementation of the state industrial policy in the Arctic region and in the development of national entrepreneurship, analyzed the shortcomings of the current state policy in the sphere of the Russian industry. On the basis of the conducted studies, the authors formulated conceptual approaches to change the state policy in the Arctic. The basic idea of the authors is to substantiate the focus of the state regulation on the development of entrepreneurship in industry in the process of the Russian Arctic exploration. At the same time another problem is solved–that of the development of the manufacturing industry in the southern regions of the northwestern part of Russia. The criterion of effectiveness in this case is the economic effectiveness.

Keywords: entrepreneurship in industry, global chains of the added value, government regulation, industrial policies, production chains in the arctic region, economic effectiveness

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Authors: Abbas Ali Husseini, Ali Mohammad Yazdani, Fatemeh Ghadiri, Alper Şişman

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We developed a microchip device that uses surface acoustic waves for rapid lysis of low level of cell samples. The device incorporates sharp-edge glass microparticles for improved performance. We optimized the lysis conditions for high efficiency and evaluated the device's feasibility for point-of-care applications. The microchip contains a 13-finger pair interdigital transducer with a 30-degree focused angle. It generates high-intensity acoustic beams that converge 6 mm away. The microchip operates at a frequency of 16 MHz, exciting Rayleigh waves with a 250 µm wavelength on the LiNbO3 substrate. Cell lysis occurs when Candida albicans cells and glass particles are placed within the focal area. The high-intensity surface acoustic waves induce centrifugal forces on the cells and glass particles, resulting in cell lysis through lateral forces from the sharp-edge glass particles. We conducted 42 pilot cell lysis experiments to optimize the surface acoustic wave-induced streaming. We varied electrical power, droplet volume, glass particle size, concentration, and lysis time. A regression machine-learning model determined the impact of each parameter on lysis efficiency. Based on these findings, we predicted optimal conditions: electrical signal of 2.5 W, sample volume of 20 µl, glass particle size below 10 µm, concentration of 0.2 µg, and a 5-minute lysis period. Downstream analysis successfully amplified a DNA target fragment directly from the lysate. The study presents an efficient microchip-based cell lysis method employing acoustic streaming and microparticle collisions within microdroplets. Integration of a surface acoustic wave-based lysis chip with an isothermal amplification method enables swift point-of-care applications.

Keywords: cell lysis, surface acoustic wave, micro-glass particle, droplet

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Authors: Sheng Yu Chen, Shi-Heng Wang

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

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

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Authors: Aliya Sekenova, Vyacheslav Ogay

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The derivation of human induced pluripotent stem cells (iPSCs) from somatic cells by direct reprogramming opens wide perspectives in the regenerative medicine. It means the possibility to develop the personal and, consequently, any immunologically compatible cells for applications in cell-based therapy. The purpose of our study was to develop the technology for the production of NK cells from T cell-derived induced pluripotent stem cells (TiPSCs) for subsequent application in adoptive cancer immunotherapy. Methods: In this study iPSCs were derived from peripheral blood T cells using Sendai virus vectors expressing Oct4, Sox2, Klf4 and c-Myc. Pluripotent characteristics of TiPSCs were examined and confirmed with alkaline phosphatase staining, immunocytochemistry and RT-PCR analysis. For NK cell differentiation, embryoid bodies (EB) formed from (TiPSCs) were cultured in xenogeneic serum-free medium containing human serum, IL-3, IL-7, IL-15, SCF, FLT3L without using M210-B4 and AFT-024 stromal feeder cells. After differentiation, NK cells were characterized with immunofluorescence analysis, flow cytometry and cytotoxicity assay. Results: Here, we for the first time demonstrate that TiPSCs can effectively differentiate into functionally active NK cells without M210-B4 and AFT-024 xenogeneic stroma cells. Immunofluorescence and flow cytometry analysis showed that EB-derived cells can differentiate into a homogeneous population of NK cell expressing high levels of CD56, CD45 and CD16 specific markers. Moreover, these cells significantly express killing activation receptors such as NKp44 and NKp46. In the comparative analysis, we observed that NK cells derived using feeder-free culture system have more high killing activity against K-562 tumor cells, than NK cells derived by feeder-dependent method. Thus, we think that our obtained data will be useful for the development of large-scale production of NK cells for translation into cancer immunotherapy.

Keywords: induced pluripotent stem cells, NK cells, T cells, cell diffentiation, feeder cell-free culture system

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Authors: Sarah Nasser, Anne Moreau, Alain Hedoux, Romain Jeantet, Guillaume Delaplace

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Background: Spray dryed powders containing some caseins are commonly produced in dairy industry. It is widely admitted that the structure of casein evolves during powder storage, inducing a loss of solubility. However few studies evaluate accurately the destabilization mechanisms at molecular and mesoscopic level, in particular for Native Phospho Casein powder (NPC). Consequently, at the state of the art, it is very difficult to assess which secondary structure change or crosslinks initiate insolubility during storage. To address this issue, controlled ageing conditions have been applied to a NPC powder (which was obtained by spray drying a concentrate containing a higher content of casein (90%), whey protein (8%) and lactose (few %)). Evolution of structure and loss of solubility, with the effects of temperature and time of storage were systematically reported. Methods: FTIR spectroscopy, Raman and Circular Dichroism were used to monitor changes of secondary structure in dry powder and in solution after rehydration. Besides, proteomic tools and electrophoresis have been performed after varying storage conditions for evaluating aggregation and post translational modifications, like lactosylation or phosphorylation. Finally, Tof Sims and MEB were used to follow in parallel evolution of structure in surface and skin formation due to storage. Results + conclusion: These results highlight the important role of storage temperature in the stability of NPC. It is shown that this is not lactosylation at the heart of formation of aggregates, as advanced in others publications This is almost the rise of multitude post translational modifications (chemical cross link), added to disulphide bridges (physical cross link) wich contribute to the destabilisation of structure and aggregation of casein. A relative quantification of each kind of cross link, source of aggregates, is proposed. In addition, it has been proved that migration of lipids and formation of skin in surface during the ageing also explains the evolution of structure casein and thus the alterations of functional properties of NPC powder.

Keywords: casein, cross link, powder, storage

Procedia PDF Downloads 363

Authors: Davod Ahmadi, Narges Ebadi, Ethan Wang, Hugo Melgar-Quiñonez

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Compared to the other Least Developed Countries (LDCs), major countries in sub-Saharan Africa (SSA) have limited access to the clean water. People in this region, and more specifically females, suffer from acute water scarcity problems. They are compelled to spend too much of their time bringing water for domestic use like drinking and washing. Apart from domestic use, water through affecting agriculture and livestock contributes to the food security status of people in vulnerable regions like SSA. Livestock needs water to grow, and agriculture requires enormous quantities of water for irrigation. The main objective of this study is to explore the association between access to water and individuals’ food security status. Data from 2017 Gallup World Poll (GWP) for SSA were analyzed (n=35,000). The target population in GWP is the entire civilian, non-institutionalized, aged 15 and older population. All samples selection is probability based and nationally representative. The Gallup surveys an average of 1,000 samples of individuals per country. Three questions related to water (i.e., water quality, availability of water for crops and availability of water for livestock) were used as the exposure variables. Food Insecurity Experience Scale (FIES) was used as the outcome variable. FIES measures individuals’ food security status, and it is composed of eight questions with simple dichotomous responses (1=Yes and 0=No). Different statistical analyses such as descriptive, crosstabs and binary logistic regression, form the basis of this study. Results from descriptive analyses showed that more than 50% of the respondents had no access to enough water for crops and livestock. More than 85% of respondents were categorized as “food insecure”. Findings from cross-tabulation analyses showed that food security status was significantly associated with water quality (0.135; P=0.000), water for crops (0.106; P=0.000) and water for livestock (0.112; P=0.000). In regression analyses, the probability of being food insecure increased among people who expressed no satisfaction with water quality (OR=1.884 (OR=1.768-2.008)), not enough water for crops (OR=1.721 (1.616-1.834)) and not enough water for livestock (OR=1.706 (1.819)). In conclusion, it should note that water access affects food security status in SSA.

Keywords: water access, agriculture, livestock, FIES

Procedia PDF Downloads 131

Authors: T. H. Huang, C. Y. Gao, C. H. Lin, J. L. Kwo, Y. K. Tseng

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The design and reliability of solar photovoltaic modules are crucial to the development of solar energy, and efforts are still being made to extend the life of photovoltaic modules to improve their efficiency because natural aging is time-consuming and does not provide manufacturers and investors with timely information, accelerated aging is currently the best way to estimate the life of photovoltaic modules. In this study, the accelerated aging of different light sources was combined with spectral response measurements to understand the effect of light sources on aging tests. In this study, there are two types of experimental samples: packaged and unpackaged and then irradiated with full-spectrum and UVC light sources for accelerated aging, as well as a control group without aging. The full-spectrum aging was performed by irradiating the solar cell with a xenon lamp like the solar spectrum for two weeks, while the accelerated aging was performed by irradiating the solar cell with a UVC lamp for two weeks. The samples were first visually observed, and infrared thermal images were taken, and then the electrical (IV) and Spectral Responsivity (SR) data were obtained by measuring the spectral response of the samples, followed by Scanning Electron Microscopy (SEM), Raman spectroscopy (Raman), and X-ray Diffraction (XRD) analysis. The results of electrical (IV) and Spectral Responsivity (SR) and material analyses were used to compare the differences between packaged and unpackaged solar cells with full spectral aging, accelerated UVC aging, and unaged solar cells. The main objective of this study is to compare the difference in the aging of packaged and unpackaged solar cells by irradiating different light sources. We determined by infrared thermal imaging that both full-spectrum aging and UVC accelerated aging increase the defects of solar cells, and IV measurements demonstrated that the conversion efficiency of solar cells decreases after full-spectrum aging and UVC accelerated aging. SEM observed some scorch marks on both unpackaged UVC accelerated aging solar cells and unpackaged full-spectrum aging solar cells. Raman spectroscopy examines the Si intensity of solar cells, and XRD confirms the crystallinity of solar cells by the intensity of Si and Ag winding peaks.

Keywords: solar cell, aging, spectral response measurement

Procedia PDF Downloads 82

Authors: Kayvan Khoramipour, Abbas Ali Gaeini, Elham Shirzad, Øyvind Sandbakk

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Basketball has different positions with individual movement profiles, which may influence metabolic demands. Accordingly, the present study aimed to compare the movement and metabolic load between different positions during elite male basketball games. Five main players of 14 teams (n = 70), who participated in the 2017-18 Iranian national basketball leagues, were selected as participants. The players were defined as backcourt (Posts 1-3) and frontcourt (Posts 4-5). Video based time motion analysis (VBTMA) was performed based on players’ individual running and shuffling speed using Dartfish software. Movements were classified into high and low intensity running with and without having the ball, as well as high and low-intensity shuffling and static movements. Mean frequency, duration, and distance were calculated for each class, except for static movements where only frequency was calculated. Saliva samples were collected from each player before and after 40-minute basketball games and analyzed using metabolomics. Principal component analysis (PCA) and Partial least square discriminant analysis (PLSDA) (for metabolomics data) and independent T-tests (for VBTMA) were used as statistical tests. Movement frequency, duration, and distance were higher in backcourt players (all p ≤ 0.05), while static movement frequency did not differ. Saliva samples showed that the levels of Taurine, Succinic acid, Citric acid, Pyruvate, Glycerol, Acetoacetic acid, Acetone, and Hypoxanthine were all higher in backcourt players, whereas Lactate, Alanine, 3-Metyl Histidine, and Methionine were higher in frontcourt players Based on metabolomics, we demonstrate that backcourt and frontcourt players have different metabolic profiles during games, where backcourt players move clearly more during games and therefore rely more on aerobic energy, whereas frontcourt players rely more on anaerobic energy systems in line with less dynamic but more static movement patterns.

Keywords: basketball, metabolomics, saliva, sport loadomics

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Authors: Floyd Misheck Mwanza, Paul Boniface Majura

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The paper looked at highways/ roadside waste generation, disposal and the consequent environmental impacts. The dramatic increase in vehicular and paved roads in the recent past in Zambia, has given rise to the indiscriminate disposal of litter that now poses a threat to health and the environment. Primary data was generated by carrying out oral interviews and field observations for holistic and in–depth assessment of the environment and the secondary data was obtained from desk review method, information on effects of roadside wastes on environment were obtained from relevant literatures. The interviews were semi structured and a purposive sampling method was adopted and analyzed descriptively. The results of the findings showed that population growth and unplanned road expansion has exceeded the expected limit in recent time with resultant poor system of roadside wastes disposal. Roadside wastes which contain both biodegradable and non-biodegradable roadside wastes are disposed at the shoulders of major highways in temporary dumpsites and are never collected by a road development agency (RDA). There is no organized highway to highway or street to street collection of the wastes in Zambia by the key organization the RDA. The study revealed that roadside disposal of roadside wastes has serious impacts on the environment. Some of these impacts include physical nuisance of the wastes to the environment, the waste dumps also serve as hideouts for rodents and snakes which are dangerous. Waste are blown around by wind making the environment filthy, most of the wastes are also been washed by overland flow during heavy downpour to block drainage channels and subsequently lead to flooding of the environment. Most of the non- biodegradable wastes contain toxic chemicals which have serious implications on the environmental sustainability and human health. The paper therefore recommends that Government/ RDA should come up with proper orientation and environmental laws should be put in place for the general public and also to provide necessary facilities and arrange for better methods of collection of wastes.

Keywords: biodegradable, disposal, environment, impacts

Procedia PDF Downloads 319

Authors: M. Miljkovic, A. Urakpo, M. Simic-Koumoutsaris

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Benefit-risk assessment (BRA) is a valuable tool that takes place in multiple stages during a medicine's lifecycle, and this assessment can be conducted in a variety of ways. The aim was to summarize current BRA methods used during approval decisions and in post-approval settings and to see possible future directions. Relevant reviews, recommendations, and guidelines published in medical literature and through regulatory agencies over the past five years have been examined. BRA implies the review of two dimensions: the dimension of benefits (determined mainly by the therapeutic efficacy) and the dimension of risks (comprises the safety profile of a drug). Regulators, industry, and academia have developed various approaches, ranging from descriptive textual (qualitative) to decision-analytic (quantitative) models, to facilitate the BRA of medicines during the product lifecycle (from Phase I trials, to authorization procedure, post-marketing surveillance and health technology assessment for inclusion in public formularies). These approaches can be classified into the following categories: stepwise structured approaches (frameworks); measures for benefits and risks that are usually endpoint specific (metrics), simulation techniques and meta-analysis (estimation techniques), and utility survey techniques to elicit stakeholders’ preferences (utilities). All these approaches share the following two common goals: to assist this analysis and to improve the communication of decisions, but each is subject to its own specific strengths and limitations. Before using any method, its utility, complexity, the extent to which it is established, and the ease of results interpretation should be considered. Despite widespread and long-time use, BRA is subject to debate, suffers from a number of limitations, and currently is still under development. The use of formal, systematic structured approaches to BRA for regulatory decision-making and quantitative methods to support BRA during the product lifecycle is a standard practice in medicine that is subject to continuous improvement and modernization, not only in methodology but also in cooperation between organizations.

Keywords: benefit-risk assessment, benefit-risk profile, product lifecycle, quantitative methods, structured approaches

Procedia PDF Downloads 131

Authors: Oktavian Prasetia Wardana, Martono Tri Utomo, Risa Etika, Kartika Darma Handayani, Dina Angelika, Wurry Ayuningtyas

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Background: Critically ill neonates are newborn babies with high-risk factors that potentially cause disability and/or death. Scoring systems for determining the severity of the disease have been widely developed as well as some designs for use in neonates. The SNAPPE-II method, which has been used as a mortality predictor scoring system in several referral centers, was found to be slow in assessing the outcome of critically ill neonates in the Neonatal Intensive Care Unit (NICU). Objective: To analyze the predictive value of MSNS on the outcome of critically ill neonates at the time of arrival up to 24 hours after being admitted to the NICU. Methods: A longitudinal observational analytic study based on medical record data was conducted from January to August 2022. Each sample was recorded from medical record data, including data on gestational age, mode of delivery, APGAR score at birth, resuscitation measures at birth, duration of resuscitation, post-resuscitation ventilation, physical examination at birth (including vital signs and any congenital abnormalities), the results of routine laboratory examinations, as well as the neonatal outcomes. Results: This study involved 105 critically ill neonates who were admitted to the NICU. The outcome of critically ill neonates was 50 (47.6%) neonates died, and 55 (52.4%) neonates lived. There were more males than females (61% vs. 39%). The mean gestational age of the subjects in this study was 33.8 ± 4.28 weeks, with the mean birth weight of the subjects being 1820.31 ± 33.18 g. The mean MSNS score of neonates with a deadly outcome was lower than that of the lived outcome. ROC curve with a cut point MSNS score <10.5 obtained an AUC of 93.5% (95% CI: 88.3-98.6) with a sensitivity value of 84% (95% CI: 80.5-94.9), specificity 80 % (CI 95%: 88.3-98.6), Positive Predictive Value (PPV) 79.2%, Negative Predictive Value (NPV) 84.6%, Risk Ratio (RR) 5.14 with Hosmer & Lemeshow test results p>0.05. Conclusion: The MSNS score has a good predictive value and good calibration of the outcomes of critically ill neonates admitted to the NICU.

Keywords: critically ill neonate, outcome, MSNS, NICU, predictive value

Procedia PDF Downloads 49