Search results for: diagnostic procedures

Authors: Mohamed Edokali, Robert Menzel, David Harbottle, Ali Hassanpour

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Forward osmosis (FO) process has stood out as an energy-efficient technology for water desalination and purification, although the practical application of FO for desalination still relies on RO-based Thin Film Composite (TFC) and Cellulose Triacetate (CTA) polymeric membranes which have a low performance. Recently, graphene oxide (GO) laminated membranes have been considered an ideal selection to overcome the bottleneck of the FO-polymeric membranes owing to their simple fabrication procedures, controllable thickness and pore size and high water permeability rates. However, the low stability of GO laminates in wet and harsh environments is still problematic. The recent developments of modified GO and hydrophobic reduced graphene oxide (rGO) membranes for FO desalination have demonstrated attempts to overcome the ongoing trade-off between desalination performance and stability, which is yet to be achieved prior to the practical implementation. In this study, acid-functionalized GO nanosheets cooperatively reduced and crosslinked by the hyperbranched polyethyleneimine (PEI) and polyethylene glycol (PEG) polymers, respectively, are applied for fabrication of the FO membrane, to enhance the membrane stability and performance, and compared with other functionalized rGO-FO membranes. PEI/PEG doped rGO membrane retained two compacted d-spacings (0.7 and 0.31 nm) compared to the acid-functionalized GO membrane alone (0.82 nm). Besides increasing the hydrophilicity, the coating layer of PEG onto the PEI-doped rGO membrane surface enhanced the structural integrity of the membrane chemically and mechanically. As a result of these synergetic effects, the PEI/PEG doped rGO membrane exhibited a water permeation of 7.7 LMH, salt rejection of 97.9 %, and reverse solute flux of 0.506 gMH at low flow rates in the FO desalination process.

Keywords: desalination, forward osmosis, membrane performance, polyethyleneimine, polyethylene glycol, reduced graphene oxide, stability

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Authors: Ping Jiang, Yunyan Xing, Dian Zhang, Bo Guo

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The reliability qualification test (RQT) is widely used in product development to qualify whether the product meets predetermined reliability requirements, which are mainly described in terms of reliability indices, for example, MTBF (Mean Time Between Failures). It is widely exercised in product development. In engineering practices, RQT plans are mandatorily referred to standards, such as MIL-STD-781 or GJB899A-2009. But these conventional RQT plans in standards are not preferred, as the test plans often require long test times or have high risks for both producer and consumer due to the fact that the methods in the standards only use the test data of the product itself. And the standards usually assume that the product is exponentially distributed, which is not suitable for a complex product other than electronics. So it is desirable to develop an RQT plan derivation method that safely shortens test time while keeping the two risks under control. To meet this end, for the product whose lifetime follows Weibull distribution, an RQT plan derivation method is developed. The merit of the method is that expert judgment is taken into account. This is implemented by applying the Bayesian method, which translates the expert judgment into prior information on product reliability. Then producer’s risk and the consumer’s risk are calculated accordingly. The procedures to derive RQT plans are also proposed in this paper. As extra information and expert judgment are added to the derivation, the derived test plans have the potential to shorten the required test time and have satisfactory low risks for both producer and consumer, compared with conventional test plans. A case study is provided to prove that when using expert judgment in deriving product test plans, the proposed method is capable of finding ideal test plans that not only reduce the two risks but also shorten the required test time as well.

Keywords: expert judgment, reliability qualification test, test plan derivation, producer’s risk, consumer’s risk

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Authors: Luísa P. Cruz-Lopes, Hugo Costa e Silva, Idalina Domingos, José Ferreira, Luís Teixeira de Lemos, Bruno Esteves

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The liquefaction process of cork based tree barks has led to an increase of interest due to its potential innovation in the lumber and wood industries. In this particular study the bark of Quercus cerris (Turkish oak) is used due to its appreciable amount of cork tissue, although of inferior quality when compared to the cork provided by other Quercus trees. This study aims to optimize alkaline catalysis liquefaction conditions, regarding several parameters. To better comprehend the possible chemical characteristics of the bark of Quercus cerris, a complete chemical analysis was performed. The liquefaction process was performed in a double-jacket reactor heated with oil, using glycerol and a mixture of glycerol/ethylene glycol as solvents, potassium hydroxide as a catalyst, and varying the temperature, liquefaction time and granulometry. Due to low liquefaction efficiency resulting from the first experimental procedures a study was made regarding different washing techniques after the filtration process using methanol and methanol/water. The chemical analysis stated that the bark of Quercus cerris is mostly composed by suberin (ca. 30%) and lignin (ca. 24%) as well as insolvent hemicelluloses in hot water (ca. 23%). On the liquefaction stage, the results that led to higher yields were: using a mixture of methanol/ethylene glycol as reagents and a time and temperature of 120 minutes and 200 ºC, respectively. It is concluded that using a granulometry of <80 mesh leads to better results, even if this parameter barely influences the liquefaction efficiency. Regarding the filtration stage, washing the residue with methanol and then distilled water leads to a considerable increase on final liquefaction percentages, which proves that this procedure is effective at liquefying suberin content and lignocellulose fraction.

Keywords: liquefaction, Quercus cerris, polyalcohol liquefaction, temperature

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Authors: Ashana Gupta

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Aim: In the UK, Botulinum Toxin (botox) is authorised for treating chronic myofascial pain secondary to masseter muscle hypertrophy (Fedorowicz et al. 2013). This audit aimed to ensure the Maxillofacial Unit is meeting the trust guidelines for the safe storage and disposal of botox. Method: The trust upholds a strict policy for botox handling. The audit was designed to optimise several elements including Staff awareness of regulations around botox handling A questionnaire was designed to test knowledge of advised storage temperatures, reporting of adverse events, disposal procedures and regulatory authorities. Steps taken to safely delivertoxin and eliminate unused toxin. A checklist was completed. These include marks for storagetemperature, identification checks, disposal of sharps, deactivation of toxin, and disposal. Results: All staff correctly stated storage requirements for toxin. 75% staff (n=8) were unsure about reporting and regulations. Whilst all staff knew how to dispose of vials, 0% staff showed awareness for the crucial step of deactivating toxin. All checklists (n=20) scored 100% for adequate storage, ID checks, and toxin disposal. However, there were no steps taken to deactivate toxin in any cases. Staff training took place with revision to clinical protocols. In line with Trust guidelines, an additional clinical step has been introduced including use of 0.5% sodium hypochlorite to deactivate botox. Conclusion: Deactivation is crucial to ensure residual toxin is not misused. There are cases of stolen botox within South-Tees Hospital (Woodcock, 2014). This audit was successful in increasing compliance to safe handling and disposal of botox by 100% and ensured our hospitalmeets Trust guidance.

Keywords: botulinum toxin, aesthetics, handling, disposal

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Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

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Authors: Dorina Rusu, Emil Ghiocel Ioanid, Marta Ursescu, Ana Maria Vlad, Mihaela Popescu

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During the last decades the cold plasma discharges made the subject of numerous studies concerning the applications in the cultural heritage field, especially concentrated on ecological and non-invasive aspect of these conservation procedures. The conservation treatment using cold plasma is based, on the one hand, on the well-known property of plasma discharges to inactivate the contaminant biological species and, on the other hand, on the surface cleaning effect. Moreover the plasma discharge produces the functionalization of the treated surface, allowing subsequent deposition of protective layers. The paper presents the behavior of printing inks on historical documents treated in cold RF plasma. Two types of printing inks were studied, namely red and black ink, used on a religious book published in 19 century. SEM-EDX analysis results in the identification of the two inks as carbon black ink (C presence in the EDX spectrum) and cinnabar based red ink (Hg and S lines in the spectrum), result confirmed by XRF analysis. The experiments have been performed on paper samples written with laboratory- made inks, of similar composition with the inks identified on historical documents. The samples were subjected to RF plasma discharge, operating in nitrogen gaseous medium, at 1.2 MHz frequency and low-pressure (0.5 mbar), performed in a self-designed equipment for the application of conservation treatments on naturally aged paper supports. The impact of plasma discharge on the inks has been evaluated by SEM, XRD and color analysis. The color analysis revealed a slight discoloration of cinnabar ink on the historical document. SEM and XRD analyses have been carried out in an attempt to elucidate the process responsable for color modification.

Keywords: RF plasma, printing inks, historical documents, surface cleaning effect

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Haithem Elderrat, Huw Davies, Emmanuel Brousseau

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Elastomeric polymer foam has been used widely in the automotive industry, especially for isolating unwanted vibrations. Such material is able to absorb unwanted vibration due to its combination of elastic and viscous properties. However, the ‘creep effect’, poor stress distribution and susceptibility to high temperatures are the main disadvantages of such a system. In this study, improvements in the performance of elastomeric foam as a vibration isolator were investigated using the concept of Foam Filled Fluid (FFFluid). In FFFluid devices, the foam takes the form of capsule shapes, and is mixed with viscous fluid, while the mixture is contained in a closed vessel. When the FFFluid isolator is affected by vibrations, energy is absorbed, due to the elastic strain of the foam. As the foam is compressed, there is also movement of the fluid, which contributes to further energy absorption as the fluid shears. Also, and dependent on the design adopted, the packaging could also attenuate vibration through energy absorption via friction and/or elastic strain. The present study focuses on the advantages of the FFFluid concept over the dry polymeric foam in the role of vibration isolation. This comparative study between the performance of dry foam and the FFFluid was made according to experimental procedures. The paper concludes by evaluating the performance of the FFFluid isolator in the suspension system of a light vehicle. One outcome of this research is that the FFFluid may preferable over elastomer isolators in certain applications, as it enables a reduction in the effects of high temperatures and of ‘creep effects’, thereby increasing the reliability and load distribution. The stiffness coefficient of the system has increased about 60% by using an FFFluid sample. The technology represented by the FFFluid is therefore considered by this research suitable for application in the suspension system of a light vehicle.

Keywords: FFFluid, dry foam, anti-vibration devices, elastomeric polymer foam

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Authors: Zubair Ahmad

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The aim of this study is to analyze the risks factors and issues with waste management in developing nations as barriers. Depending on their content and categorization, wastes are managed differently. Waste management strategies differ for liquid, solid, and organic wastes. The final stage of trash disposal entails procedures like burning, interment, recycling, and treatment. Due to the rising creation of solid waste, the growing urban population has a magnified impact on the environment and public health. All regions, but especially informal urban neighborhoods, tribal villages, and official rural settlements have a protracted backlog in waste services. Another significant impediment seen in the developing world is a lack of education and awareness of effective waste-management practices. Unauthorized dumpsites pose a serious risk to the environment since they could contain dangerous elements like radioactive, infectious, and toxic waste. Wealthier individuals are more inclined to think that their actions will have an impact on environmental problems and to act to address them. Waste managers need to take action to make sure the public is given information that is consistent with what they currently know. The results of the data analysis conducted with the aid of the various methodologies discussed in the preceding chapter are presented in this chapter by the researcher. Descriptive analysis has been used in research to determine whether or not there are relationships between variables and to determine the importance of the variables. According to a survey, there are no efforts being made to lessen the odor that garbage dump sites emit (in terms of treating or recycling the material placed at dumpsite) This might be the case since respondents only commented on the waste management conditions in their immediate surroundings and may not have fully understood the steps taken to resolve this issue.

Keywords: risk factor of waste material, lack of awareness, developing countries struggles, waste management

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Authors: Mohammed Al-Zubaidi, Katherine Ong, Pravin Viswambaram, Steve McCombie, Oliver Oey, Jeremy Ong, Richard Gauci, Ronny Low, Dickon Hayne

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Objective: Lymph node involvement along with distant metastasis in a patient with invasive bladder cancer determines the disease survival, therefeor, it is an essential determinant of the therapeutic management and outcome. This retrospective study aims to determine the accuracy of FDG PET scan in detecting lymphatic involvement and distant metastatic urothelial cancer compared to conventional CT staging. Method: A retrospective review of 76 patients with UC or BC who underwent surgery or confirmatory biopsy that was staged with both CT and 18F-FDG-PET (up to 8 weeks apart) between 2015 and 2020. Fifty-sevenpatients (75%) had formal pelvic LN dissection or biopsy of suspicious metastasis. 18F-FDG-PET reports for positive sites were qualitative depending on SUV Max. On the other hand, enlarged LN by RECIST criteria 1.1 (>10 mm) and other qualitative findings suggesting metastasis were considered positive in CT scan. Histopathological findings from surgical specimens or image-guided biopsies were considered the gold standard in comparison to imaging reports. 18F-FDG-avid or enlarged pelvic LNs with surgically proven nodal metastasis were considered true positives. Performance characteristics of 18F-FDG-PET and CT, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (PPV), were calculated. Results: Pelvic LN involvement was confirmed histologically in 10/57 (17.5%) patients. Sensitivity, specificity, PPV and NPV of CT for detecting pelvic LN metastases were 41.17% (95% CI:18-67%), 100% (95% CI:90-100%) 100% (95% CI:59-100%) and 78.26% (95% CI:64-89%) respectively. Sensitivity, specificity, PPV and NPV of 18F-FDG-PET for detecting pelvic LN metastases were 62.5% (95% CI:35-85%), 83.78% (95% CI:68-94%), 62.5% (95% CI:35-85%), and 83.78% (95% CI:68-94%) respectively. Pre-operative staging with 18F-FDG-PET identified the distant metastatic disease in 9/76 (11.8%) patients who were occult on CT. This retrospective study suggested that 18F-FDG-PET may be more sensitive than CT for detecting pelvic LN metastases. 7/76 (9.2%) patients avoided cystectomy due to 18F-FDG-PET diagnosed metastases that were not reported on CT. Conclusion: 18F-FDG-PET is more sensitive than CT for pelvic LN metastases, which can be used as the standard modality of bladder cancer staging, as it may change the treatment by detecting lymph node metastasis that was occult in CT. Further research involving randomised controlled trials comparing the diagnostic yield of 18F-FDG-PET and CT in detecting nodal and distant metastasis in UC or BC is warranted to confirm our findings.

Keywords: FDG PET, CT scan, urothelial cancer, bladder cancer

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Authors: Shraddha Acharya, Sharad Kumar Sharma, Ratna Bhattarai, Bhagwan Maharjan, Deepak Dahal, Serpahine Kaminsa

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Background: Drug-resistant (DR) tuberculosis (TB) continues to be a threat in Nepal, with an estimated 2800 new cases every year. The treatment of DR-TB with second line TB drugs is complex and takes longer time with comparatively lower treatment success rate than drug-susceptible TB. Delay in treatment initiation for DR-TB patients might further result in unfavorable treatment outcomes and increased transmission. This study thus aims to determine median time taken to initiate second-line treatment among Rifampicin Resistant (RR) diagnosed TB patients and to assess the proportion of treatment delays among various type of DR-TB cases. Method: A retrospective cohort study was done using national routine electronic data (DRTB and TB Laboratory Patient Tracking System-DHIS2) on drug resistant tuberculosis patients between January 2020 and December 2022. The time taken for treatment initiation was computed as– days from first diagnosis as RR TB through Xpert MTB/Rif test to enrollment on second-line treatment. The treatment delay (>7 days after diagnosis) was calculated. Results: Among total RR TB cases (N=954) diagnosed via Xpert nationwide, 61.4% were enrolled under shorter-treatment regimen (STR), 33.0% under longer treatment regimen (LTR), 5.1% for Pre-extensively drug resistant TB (Pre-XDR) and 0.4% for Extensively drug resistant TB (XDR) treatment. Among these cases, it was found that the median time from diagnosis to treatment initiation was 6 days (IQR:2-15.8). The median time was 5 days (IQR:2.0-13.3) among STR, 6 days (IQR:3.0-15.0) among LTR, 30 days (IQR:5.5-66.8) among Pre-XDR and 4 days (IQR:2.5-9.0) among XDR TB cases. The overall treatment delay (>7 days after diagnosis) was observed in 42.4% of the patients, among which, cases enrolled under Pre-XDR contributed substantially to treatment delay (72.0%), followed by LTR (43.6%), STR (39.1%) and XDR (33.3%). Conclusion: Timely diagnosis and prompt treatment initiation remain fundamental focus of the National TB program. The findings of the study, however suggest gaps in timeliness of treatment initiation for the drug-resistant TB patients, which could bring adverse treatment outcomes. Moreover, there is an alarming delay in second line treatment initiation for the Pre-XDR TB patients. Therefore, this study generates evidence to identify existing gaps in treatment initiation and highlights need for formulating specific policies and intervention in creating effective linkage between the RR TB diagnosis and enrollment on second line TB treatment with intensified efforts from health providers for follow-ups and expansion of more decentralized, adequate, and accessible diagnostic and treatment services for DR-TB, especially Pre-XDR TB cases, due to the observed long treatment delays.

Keywords: drug-resistant, tuberculosis, treatment initiation, Nepal, treatment delay

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Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

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Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

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Authors: Mohamed Zakareia Ghazy Aly Belal

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Commercial law is the set of legal rules that apply to business and regulates the trade of trade. The meaning of this is that the commercial law regulates certain relations only that arises as a result of carrying out certain businesses. which are business, as it regulates the activity of a specific sect, the sect of merchants, and the commercial law as other branches of the law has characteristics that distinguish it from other laws and various, and various sources from which its basis is derived from It is the objective or material source. the historical source, the official source and the interpretative source, and we are limited to official sources and explanatory sources. so what do you see what these sources are, and what is their degree and strength in taking it in commercial disputes. The first topic / characteristics of commercial law. Commercial law has become necessary for the world of trade and economics, which cannot be dispensed with, given the reasons that have been set as legal rules for commercial field. In fact, it is sufficient to refer to the stability and stability of the environment, and in exchange for the movement and the speed in which the commercial environment is in addition to confidence and credit. the characteristic of speed and the characteristic of trust, and credit are the ones that justify the existence of commercial law. Business is fast, while civil business is slow, stable and stability. The person concludes civil transactions in his life only a little. And before doing any civil action. he must have a period of thinking and scrutiny, and the investigation is the person who wants the husband, he must have a period of thinking and scrutiny. as if the person who wants to acquire a house to live with with his family, he must search and investigate Discuss the price before the conclusion of a purchase contract. In the commercial field, transactions take place very quickly because the time factor has an important role in concluding deals and achieving profits. This is because the merchant in contracting about a specific deal would cause a loss to the merchant due to the linkage of the commercial law with the fluctuations of the economy and the market. The merchant may also conclude more than one deal in one and short time. And that is due to the absence of commercial law from the formalities and procedures that hinder commercial transactions.

Keywords: law, commercial law, business, commercial field

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Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Samuel Francisco Ngovene

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Mozambique is a country with cultural segregation along its rivers, dividing the main ethnic groups of Machangana, Macena, and Macua, inter alia South, Centre, and North. This division has led to internal conflicts, seemingly rooted in ethnicity. The aim of this study is to analyze the tolerance of the main ethnic groups in Mozambique in terms of cohabitation, sharing opportunities, and political power. The study utilizes participant observation in the field, group discussions, and a questionnaire targeting 150 respondents split into 50 for each ethnic group. The study finds that people in Mozambique are generally tolerant of cohabiting or marrying individuals from different ethnic groups. However, when it comes to sharing opportunities such as employment or business, there is a perception that individuals from different ethnic groups may be taking away opportunities. Similarly, each ethnic group believes that having a president from their own group would lead to better opportunities for their community. The study highlights the importance of addressing this intolerance, as it can be a source of internal political conflicts. The anthropological approach provides a valuable tool for diplomacy channels to ensure long-lasting peace. Analysis procedures: The data collected through participant observation, group discussions are analytically crosschecked, comparing the opinions of people from different ethnic groups, while the data from the questionnaire are analyzed statistically to understand the level of tolerance among the ethnic groups and their perceptions of sharing opportunities and political power. The study addresses the question of whether the main ethnic groups in Mozambique are tolerant of cohabitation, sharing opportunities, and political power among themselves. The study concludes that while there is overall tolerance for cohabitation and marriage across ethnic groups, there is also a perception that individuals from different ethnic groups may take away opportunities. The study suggests that cultural education from a young age may be an effective way to promote tolerance.

Keywords: cohabitation, ethnicities, Mozambique, political conflicts, tolerance

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Authors: Charles Amoo, Joshua New, Bill Eckman

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Buildings in the United States account for a significant proportion of energy consumption and greenhouse gas (GHG) emissions, and this trend is expected to continue as well as rise in the near future. Low-income households, in particular, bear a disproportionate burden of high building energy consumption and spending due to high energy costs. Energy efficiency improvements need to reach an average of 4% per year in this decade in order to meet global net zero emissions target by 2050, but less than 1 % of U.S. buildings are improved each year. The government has recognized the importance of technology in addressing this issue, and energy efficiency programs have been developed to tackle the problem. The Weatherization Assistance Program (WAP), the largest residential whole-house energy efficiency program in the U.S., is specifically designed to reduce energy costs for low-income households. Under the WAP, energy auditors must follow specific audit procedures and use Department of Energy (DOE) approved energy audit tools or software. This article proposes an expanded framework of factors that should be considered in energy audit software that is approved for use in energy efficiency programs, particularly for low-income households. The framework includes more than 50 factors organized under 14 assessment criteria and can be used to qualitatively and quantitatively score different energy audit software to determine their suitability for specific energy efficiency programs. While the tool can be useful for developers to build new tools and improve existing software, as well as for energy efficiency program administrators to approve or certify tools for use, there are limitations to the model, such as the lack of flexibility that allows continuous scoring to accommodate variability and subjectivity. These limitations can be addressed by using aggregate scores of each criterion as weights that could be combined with value function and direct rating scores in a multicriteria decision analysis for a more flexible scoring.

Keywords: buildings, energy efficiency, energy audit, software

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Authors: Sajan Antony Mathew, Bhukya Ramdas

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Abstract—The impetus of wind energy deployment over the last few decades has seen potential sites being harvested very actively for wind farm development. Due to the scarce availability of highly potential sites, the turbines are getting more optimized in its location wherein minimum spacing between the turbines are resorted without comprising on the optimization of its energy yield. The optimization of the energy yield from a wind turbine is achieved by effective micrositing techniques. These time-tested techniques which are applied from site to site on terrain conditions that meet the requirements of the International standard for power performance measurements of wind turbines result in the positioning of wind turbines for optimized energy yields. The international standard for Power Curve Measurements has rules of procedure and methodology to evaluate the terrain, obstacles and sector for measurements. There are many challenges at the sites for complying with the requirements for terrain, obstacles and sector for measurements. Studies are being attempted to carry out these measurements within the scope of the international standard as various other procedures specified in alternate standards or the integration of LIDAR for Power Curve Measurements are in the nascent stage. The paper strives to assist in the understanding of the fact that if positioning of a wind turbine at a site is based on an optimized output, then there are no wake effects seen on the power curve of an adjacent wind turbine. The paper also demonstrates that an invalid sector for measurements could be used in the analysis in alteration to the requirement as per the international standard for power performance measurements. Therefore the paper strives firstly to demonstrate that if a wind turbine is optimally positioned, no wake effects are seen and secondly the sector for measurements in such a case could include sectors which otherwise would have to be excluded as per the requirements of International standard for power performance measurements.

Keywords: micrositing, optimization, power performance, wake effects

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Authors: Simon B. N. Thompson

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Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: cortisol, electromyography, neurology, yawning

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Authors: Aliyaa Zaidan, Rayan Bahabri

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The twenty-first century revealed an accelerating change and intensifying complexity of communication technology. Online social networking engines have gained astounding recognition worldwide. The influence of those social media platforms on dentistry and dental students is not well established. Therefore, this study aimed to evaluate the impact of using social media on professional and profile level among dental students in Saudi Arabia. A cross-sectional study developed via online questionnaire concerning on social media usage and its effect on professional and profile level of dental students and dental interns from several universities in Saudi Arabia. A total of 296 dental students and dental interns in Saudi Arabia responded to the questionnaire. Ninety-eight percent of the participants usually use the social media on a regular basis. Most social media sites used among the participants were Snapchat, Instagram, and YouTube by 85%, 81%, 77% respectively. Forty-one percent of the participants agreed that using social media in the dental field is a necessity nowadays. Thirty-eight percent of participants agreed that using social media is an easy way to gain a reliable knowledge, while 43% agreed that social media will improve the quality of healthcare. Furthermore, 65% of the students deemed using social media for academic purposes will improve their performance. Fifty-five percent of the respondents often use social media tools to obtain information about subject or procedures related to the dental field. Regarding profile reputation of dental students, 40% of the respondents agreed that their profile information published on social networking websites, could be used by others to judge their level of professionalism. Male and female dental students both agreed that their reputation would be adversely affected by 37%,63%, respectively, if their social networking activity were viewed by members of the public. The discrepancy among student levels reveals that social media profile positively influence the acceptance to postgraduate programs (P= 0.01).

Keywords: dental students, professional, reputation, social media

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Authors: Pius Marthin, Nihal Ata Tutkun

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Survival analysis has become one of the paramount procedures in the modeling of time-to-event data. When we encounter complex survival problems, the traditional approach remains limited in accounting for the complex correlational structure between the covariates and the outcome due to the strong assumptions that limit the inference and prediction ability of the resulting models. Several studies exist on the deep learning approach to survival modeling; moreover, the application for the case of complex survival problems still needs to be improved. In addition, the existing models need to address the data structure's complexity fully and are subject to noise and redundant information. In this study, we design a deep learning technique (CmpXRnnSurv_AE) that obliterates the limitations imposed by traditional approaches and addresses the above issues to jointly predict the risk-specific probabilities and survival function for recurrent events with competing risks. We introduce the component termed Risks Information Weights (RIW) as an attention mechanism to compute the weighted cumulative incidence function (WCIF) and an external auto-encoder (ExternalAE) as a feature selector to extract complex characteristics among the set of covariates responsible for the cause-specific events. We train our model using synthetic and real data sets and employ the appropriate metrics for complex survival models for evaluation. As benchmarks, we selected both traditional and machine learning models and our model demonstrates better performance across all datasets.

Keywords: cumulative incidence function (CIF), risk information weight (RIW), autoencoders (AE), survival analysis, recurrent events with competing risks, recurrent neural networks (RNN), long short-term memory (LSTM), self-attention, multilayers perceptrons (MLPs)

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Authors: Pegah Ebrahimi, Farshad Oveissi, Iman Manavi-Tehrani, Sina Naficy, David F. Fletcher, Fariba Dehghani, David S. Winlaw

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Despite advances in modern surgery, congenital heart disease remains a medical challenge and a major cause of infant mortality. Cardiovascular prostheses are routinely used in surgical procedures to address congenital malformations, for example establishing a pathway from the right ventricle to the pulmonary arteries in pulmonary valvar atresia. Current off-the-shelf options including human and adult products have limited biocompatibility and durability, and their fixed size necessitates multiple subsequent operations to upsize the conduit to match with patients’ growth over their lifetime. Non-physiological blood flow is another major problem, reducing the longevity of these prostheses. These limitations call for better designs that take into account the hemodynamical and anatomical characteristics of different patients. We have integrated tissue engineering techniques with modern medical imaging and image processing tools along with mathematical modeling to optimize the design of cardiovascular grafts in a patient-specific manner. Computational Fluid Dynamics (CFD) analysis is done according to models constructed from each individual patient’s data. This allows for improved geometrical design and achieving better hemodynamic performance. Tissue engineering strives to provide a material that grows with the patient and mimic the durability and elasticity of the native tissue. Simulations also give insight on the performance of the tissues produced in our lab and reduce the need for costly and time-consuming methods of evaluation of the grafts. We are also developing a methodology for the fabrication of the optimized designs.

Keywords: computational fluid dynamics, cardiovascular grafts, design optimization, tissue engineering

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Authors: Jean Paul M. Milambo

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Purpose: Aromatase inhibitors (AIs) are indicated in the treatment of hormone-receptive breast cancer in postmenopausal women in various settings. Studies have shown cardiovascular events in some developed countries. To date the data is sparce for evidence-based recommendations in African clinical settings due to lack of cancer registries, capacity building and surveillance systems. Therefore, this study was conducted to assess the feasibility of HyBeacon® probe genotyping adjunctive to standard care for timely prediction and diagnosis of Aromatase inhibitors (AIs) associated adverse events in breast cancer survivors in Africa. Methods: Cross sectional study was conducted to assess the knowledge of POCT among six African countries using online survey and telephonically contacted. Incremental cost effectiveness ratio (ICER) was calculated, using diagnostic accuracy study. This was based on mathematical modeling. Results: One hundred twenty-six participants were considered for analysis (mean age = 61 years; SD = 7.11 years; 95%CI: 60-62 years). Comparison of genotyping from HyBeacon® probe technology to Sanger sequencing showed that sensitivity was reported at 99% (95% CI: 94.55% to 99.97%), specificity at 89.44% (95% CI: 87.25 to 91.38%), PPV at 51% (95%: 43.77 to 58.26%), and NPV at 99.88% (95% CI: 99.31 to 100.00%). Based on the mathematical model, the assumptions revealed that ICER was R7 044.55. Conclusion: POCT using HyBeacon® probe genotyping for AI-associated adverse events maybe cost effective in many African clinical settings. Integration of preventive measures for early detection and prevention guided by different subtype of breast cancer diagnosis with specific clinical, biomedical and genetic screenings may improve cancer survivorship. Feasibility of POCT was demonstrated but the implementation could be achieved by improving the integration of POCT within primary health cares, referral cancer hospitals with capacity building activities at different level of health systems. This finding is pertinent for a future envisioned implementation and global scale-up of POCT-based initiative as part of risk communication strategies with clear management pathways.

Keywords: breast cancer, diagnosis, point of care, South Africa, aromatase inhibitors

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Authors: Lanre Oluwafemi Akinyemi

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The reduction of limestone to cement in Nigeria is expensive and requires huge amounts of energy. This significantly affects the cost of cement. Concrete is heavy: a cubic foot of it weighs about 150 lbs. and a cubic yard is about 4000 lbs. Thus a ready-mix truck with 9 cubic yards is carrying 36,000 lbs excluding the weight of the truck itself, thereby accumulating cost for also manufacturers. Therein lies the need to find a substitute for cement by using the polystyrene paste that benefits both the manufactures and the consumers. Polystyrene Paste Constructional Cement (PPCC), a patented material obtained by dissolving Waste EPS in volatile organic solvent, has recently been identified as a suitable binder/cement for construction and building material production. This paper illustrates the procedures of a test experiment undertaken to determine the splitting tensile strength of PPCC mortar compared to that of OPC (Ordinary Portland Cement). Expanded polystyrene was dissolved in gasoline to form a paste referred to as Polystyrene Paste Constructional Cement (PPCC). Mortars of mix ratios 1:4, 1:5, 1:6, 1:7 (PPCC: fine aggregate) batched by volume were used to produce 50mm x 100mm cylindrical PPCC mortar splitting tensile strength specimens. The control experiment was done by creating another series of cylindrical OPC mortar splitting tensile strength specimens following the same mix ratio used earlier. The PPCC cylindrical splitting tensile strength specimens were left to air-set, and the ones made with Ordinary Portland Cement (OPC) were demoded after 24 hours and cured in water. The cylindrical PPCC splitting tensile strength specimens were tested at 28 days and compared with those of the Ordinary Portland cement splitting tensile strength specimens. The result shows that hence for this two mixes, PPCC exhibits a better binding property than the OPC. With this my new invention I recommend the use of PPCC as a substitute for a Portland cement.

Keywords: polystyrene paste, Portland cement, construction, mortar

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Authors: Renata Kurpiewska-Korbut

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Making an assumption that the use and sharing of data generated in humanitarian action constitute a core function of humanitarian organizations, the paper analyzes the position of the largest Polish humanitarian non-governmental organizations in the humanitarian data ecosystem in Ukraine and their approach to non-personal and personal data management since February of 2022. Both expert interviews and document analysis of non-profit organizations providing a direct response in the Ukrainian crisis context, i.e., the Polish Humanitarian Action, Caritas, Polish Medical Mission, Polish Red Cross, and the Polish Center for International Aid and the applicability of theoretical perspective of contingency theory – with its central point that the context or specific set of conditions determining the way of behavior and the choice of methods of action – help to examine the significance of data complexity and adaptive approach to data management by relief organizations in the humanitarian supply chain network. The purpose of this study is to determine how the existence of well-established and accurate internal procedures and good practices of using and sharing data (including safeguards for sensitive data) by the surveyed organizations with comparable human and technological capabilities are implemented and adjusted to Ukrainian humanitarian settings and data infrastructure. The study also poses a fundamental question of whether this crisis experience will have a determining effect on their future performance. The obtained finding indicate that Polish humanitarian organizations in Ukraine, which have their own unique code of conduct and effective managerial data practices determined by contingencies, have limited influence on improving the situational awareness of other assistance providers in the data ecosystem despite their attempts to undertake interagency work in the area of data sharing.

Keywords: humanitarian data ecosystem, humanitarian data management, polish NGOs, Ukraine

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Authors: Lakmali Anthony, Madeline Gillies

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Background: Incisional and ventral hernias are highly prevalent, with primary ventral hernias occurring in approximately 20% of adults and incisional hernias developing in up to 30% of midline abdominal incisions. Recent data from the United States have shown an increasing incidence of elective incisional and ventral hernia repair (IVHR) and emergency repair of complicated hernias. This study examines Australian population trends in IVHR over a two-decade study period. Methods: This retrospective study was performed using procedure data from the Australian Institute of Health and Welfare, and population data from the Australian Bureau of Statistics captured between 2000 and 2021 to calculate incidence rates per 100,000 population by age and sex for selected subcategories of IVHR operations. Trends over time were evaluated using simple linear regression. Results: There were 809,308 IVHR operations performed in Australia during the study period. The cumulative incidence adjusted for the population was 182 per 100,000; this increased by 9.578 per year during the study period (95% CI = 8.431- 10.726, p<.001). IVHR for primary umbilical hernias experienced the most significant increase in population-adjusted incidence, 1.177 per year. (95% CI = 0.654- 1.701, p<.001). Emergency IVHR for incarcerated, obstructed, and strangulated hernias increased by 0.576 per year (95% CI = 0.510 -0.642, p<.001). Only 20.2% of IVHR procedures were performed as day surgery. Conclusions: Australia has seen a significant increase in IVHR operations performed in the last 20 years, particularly those for primary ventral hernias. IVHR for hernias complicated by incarceration, obstruction, and strangulation also increased significantly. The proportion of IVHR operations performed as day surgery is well below the target set by the Royal Australasian College of Surgeons. With the increasing incidence of IVHR operations and an increasing proportion of these being emergent, elective IVHR should be performed as day surgery when it is safe.

Keywords: ventral, incisional, hernia, trends

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Authors: Sung Jong Lee, Hong Joo Ha, Chun Sang Hong

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In recent years, the interests on the impacts of industrial wastewater on aquatic ecosystem have increased with concern about ecosystem protection and human health. Whole effluent toxicity tests are used to monitor toxicity by unknown toxic chemicals as well as conventional pollutants from industrial effluent discharges. This study describes the application of TIE (toxicity identification evaluation) procedures to an acutely toxic effluent from a Seawater desalination facility in industrial complex which was toxic to Daphnia magna. In TIE phase I (characterization step), the toxic effects by heavy metals, organic compounds, oxidants, volatile organic compounds, suspended solids and ammonia were screened and revealed that the source of toxicity is far from these toxicants group. Chemical analysis (TIE phase II) on TDS showed that the concentration of chloride ion (24,215 ~ 29,562 mg/L) was substantially higher than that predicted from EC50 for D. magna. In confirmation step (TIE phase III), chloride ion was demonstrated to be main toxicant in this effluent by the spiking approach, species sensitivity approach, and deletion approach. Calcium, potassium, magnesium, sodium, fluorine, sulfate ion concentration was not shown toxicity from D. magna. Finally, we concluded that chloride was the most contributing toxicant in the waste water treatment plant. Further research activities are needed for technical support of toxicity identification and evaluation on the various types of wastewater treatment plant discharge in Korea. Acknowledgement: This research was supported by a grant (16IFIP-B089911-03) from Plant Research Program funded by Ministry of Land, Infrastructure and Transport of Korean government.

Keywords: TIE, D. magna, V. fischeri, seawater desalination facility

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Authors: Gerhard Grebe, Johan Marx

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The aim of the study is to assess the state of operational risk management and the adoption of an appropriate risk culture in Ghanaian banks. The Bank of Ghana (BoG) joined the Basel Consultative Group (BCG) of the Basel Committee on Bank Supervision (BCBS) in 2021 and is proceeding with the implementation of the Basel III international regulatory framework for banks. The BoG’s Directive about risk management encourages, inter alia, the creation of an appropriate risk culture by Ghanaian banks. However, it is not evident how the risk management staff of Ghanaian banks experience the risk culture and the implementation of operational risk management in the banks where they are employed. Ghana is a developing economy, and it is addressing challenges with its organisational culture. According to Transparency International, successive Ghanaian governments claim to be fighting corruption, but little success has been achieved so far. This points to a possible lack of accountability, transparency, and integrity in the environment in which Ghanaian banks operate and which could influence their risk culture negatively. Purposive sampling was used for the survey, and the questionnaire was completed byGhanaian bank personnel who specializesin operational risk management, risk governance, and compliance, bank supervision, risk analyses, as well as the implementation of the operational risk management requirements of the Basel regulatory frameworks. The respondents indicated that they are fostering a risk culture and implementing monitoring and reporting procedures; the three lines of defence (3LOD); compliance; internal auditing; disclosure of operational risk information; and receiving guidance from the bank supervisor in an attempt to improve their operational risk management practices. However, the respondents reported the following challenges with staff members who are not inside the risk management departments(in order of priority), namelydemonstrating a risk culture, training and development; communication; reporting and disclosure; roles and responsibilities; performance appraisal; and technological and environmental barriers. Recommendations to address these challenges are provided

Keywords: ghana, operational risk, risk culture, risk management

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Authors: Madhur Verma, Meena Rajput, Kamal Kishore

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Background: The general view that obesity is a problem of prosperous Western countries has been repealed with substantial evidence showing that middle-income countries like India are now at the heart of a fat explosion. Neck circumference has evolved as a promising index to measure obesity, because of the convenience of its use, even in culture sensitive population. Objectives: To determine whether neck circumference (NC) was associated with overweight and obesity and contributed to the prediction like other classical anthropometric indices. Methodology: Cross-sectional study consisting of 1080 adults (> 19 years) selected through Multi-stage random sampling between August 2013 and September 2014 using the pretested semi-structured questionnaire. After recruitment, the demographic and anthropometric parameters [BMI, Waist & Hip Circumference (WC, HC), Waist to hip ratio (WHR), waist to height ratio (WHtR), body fat percentage (BF %), neck circumference (NC)] were recorded & calculated as per standard procedures. Analysis was done using appropriate statistical tests. (SPSS, version 21.) Results: Mean age of study participants was 44.55+15.65 years. Overall prevalence of overweight & obesity as per modified criteria for Asian Indians (BMI ≥ 23 kg/m2) was 49.62% (Females-51.48%; Males-47.77%). Also, number of participants having high WHR, WHtR, BF%, WC & NC was 827(76.57%), 530(49.07%), 513(47.5%), 537(49.72%) & 376(34.81%) respectively. Variation of NC, BMI & BF% with age was non- significant. In both the genders, as per the Pearson’s correlational analysis, neck circumference was positively correlated with BMI (men, r=0.670 {p < 0.05}; women, r=0.564 {p < 0.05}), BF% (men, r=0.407 {p < 0.05}; women, r= 0.283 {p < 0.05}), WC (men, r=0.598{p < 0.05}; women, r=0.615 {p < 0.05}), HC (men, r=0.512{p < 0.05}; women, r=0.523{p < 0.05}), WHR (men, r= 0.380{p > 0.05}; women, r=0.022{p > 0.05}) & WHtR (men, r=0.318 {p < 0.05}; women, r=0.396{p < 0.05}). On ROC analysis, NC showed good discriminatory power to identify obesity with AUC (AUC for males: 0.822 & females: 0.873; p- value < 0.001) with maximum sensitivity and specificity at a cut-off value of 36.55 cms for males & 34.05cms for females. Conclusion: NC has fair validity as a community-based screener for overweight and obese individuals in the study context and has also correlated well with other classical indices.

Keywords: neck circumference, obesity, anthropometric indices, body fat percentage

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Authors: Anthony D. Rhodes, Manan Goel

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We provide a high fidelity deep learning algorithm (HyperSeg) for interactive video segmentation tasks using a dense convolutional network with context-aware skip connections and compressed, 'hypercolumn' image features combined with a convolutional tessellation procedure. In order to maintain high output fidelity, our model crucially processes and renders all image features in high resolution, without utilizing downsampling or pooling procedures. We maintain this consistent, high grade fidelity efficiently in our model chiefly through two means: (1) we use a statistically-principled, tensor decomposition procedure to modulate the number of hypercolumn features and (2) we render these features in their native resolution using a convolutional tessellation technique. For improved pixel-level segmentation results, we introduce a boundary loss function; for improved temporal coherence in video data, we include temporal image information in our model. Through experiments, we demonstrate the improved accuracy of our model against baseline models for interactive segmentation tasks using high resolution video data. We also introduce a benchmark video segmentation dataset, the VFX Segmentation Dataset, which contains over 27,046 high resolution video frames, including green screen and various composited scenes with corresponding, hand-crafted, pixel-level segmentations. Our work presents a improves state of the art segmentation fidelity with high resolution data and can be used across a broad range of application domains, including VFX pipelines and medical imaging disciplines.

Keywords: computer vision, object segmentation, interactive segmentation, model compression

Procedia PDF Downloads 117