Search results for: environmental review

Authors: Anagha Pavithran Vattamparambil, Niranjana Regimon

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Dalit and tribal communities in India have the largest suicide rate; however, the current literature does not reflect this reality. While existing research acknowledges socio-cultural risk factors, it fails to discuss structural issues pertaining to marginalized communities in India. Furthermore, the language is framed in an individualistic manner which denies room for recognizing systemic violence and injustice among causative agents of suicide. We aim to examine the representation of Dalit and tribal identities and their experiences of marginalisation as a contributive factor of suicide, as well as discuss the epistemic injustice involved in its exclusion. Electronic searches of PubMed, PsychInfo, and Web of Science databases will be carried out from inception till January 2023 to conduct a systematic scoping review of peer-reviewed articles; it will include all studies involving psychological autopsy in India. A narrative synthesis will be performed to gain insight into the inclusion of the experiences of Dalits and Tribals, the absence of which indicates a lacking understanding of suicide in India. It is also expected to highlight the alienation of lived experiences and narratives of marginalisation from mainstream discourse on suicide that constitutes epistemic injustice. There is a complex interplay of psychological, socio-cultural, economic, and political factors for suicide in the Indian setting. But, political and systemic issues are often downplayed in suicide etiology, including casteist assault, rape, violence, public humiliation, and discrimination which deserves more research attention.

Keywords: dalits, marginalisation, psychological autopsy, suicide, tribals

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Authors: Gustavo Menezes De Souza Melo, Arnaud Heitz, Johannes Henrich Schleifenbaum

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Additive manufacturing is a growing market that is taking over in many industries as it offers numerous advantages like new design possibilities, weight-saving solutions, ease of manufacture, and simplification of assemblies. These are all unquestionable technical or financial assets. As to the environmental aspect, additive manufacturing is often discussed whether it is the best solution to decarbonize our industries or if conventional manufacturing remains cleaner. This work presents a life cycle assessment (LCA) comparison based on the technological case of a motorbike swing-arm. We compare the original equipment manufacturer part made with conventional manufacturing (CM) methods to an additive manufacturing (AM) version printed using the laser powder bed fusion process. The AM version has been modified and optimized to achieve better dynamic performance without any regard to weight saving. Lightweight not being a priority in the creation of the 3D printed part brings us a unique perspective in this study. To achieve the LCA, we are using the open-source life cycle, and sustainability software OpenLCA combined with the ReCiPe 2016 at midpoint and endpoint level method. This allows the calculation and the presentation of the results through indicators such as global warming, water use, resource scarcity, etc. The results are then showing the relative impact of the AM version compared to the CM one and give us a key to understand and answer questions about the environmental sustainability of additive manufacturing.

Keywords: additive manufacturing, environmental impact, life cycle assessment, laser powder bed fusion

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Authors: Bashistha Kumar Kanth, Seung Pil Pack

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Carbonic anhydrase is ubiquitously distributed in organisms, and is fundamental to many eukaryotic biological processes such as photosynthesis, respiration, CO2 and ion transport, calcification and acid–base balance. However, CA occurs across the spectrum of prokaryotic metabolism in both the archaea and bacteria domains and many individual species contain more than one class. In this review, various roles of CA involved in cellular mechanism are presented to find out the CA functions applicable for industrial use.

Keywords: carbonic anhydrase, mechanism, CO2 sequestration, respiration

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Authors: K. Doi, T. Nishimura, H. Fujimoto, Y. Hoshikawa, T. Wada

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Japanese industrial standard (JIS) association established one JIS (JIS S 0021) regarding packaging accessible design for people with visual impairments and elderly people in 2000. Recently, tactile symbol on shampoo bottle has been known as one of package accessible design and more effectively used. However, it has been said that people with visual impairment have been not been in trouble with difficulty of identifying body soap bottle between three bottles such as body soap bottle, shampoo bottle, and conditioner bottle. Japanese low vision association asked JIS association to solve this problem. JIS association and Japan cosmetic industry association constituted one review team for solving the problem. The review team asked our research team to make a proposal regarding new tactile symbol on body soap bottle. We conducted user survey and maker survey regarding tactile symbol on body soap bottle with easily identification. Seven test tactile symbol marks were elected in our proposed tactile symbols. In this study, we evaluate easily identification of tactile symbol on body soap bottle. Six visual impaired subjects were participated in our experiment. These subjects were asked to identify body soap bottle between three bottles such as body soap bottle, shampoo bottle, and conditioner bottle. The test tactile symbol on body soap were presented in random order. The test tactile symbols were produced by use of our originally developed 3D raised equipment. From our study, test tactile symbol marks with easily identification were made a short list of our proposed tactile symbols. This knowledge will be helpful in revision of ISO 11156.

Keywords: tactile symbol, easily identification, body soap, people with visual impairments

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Authors: Francis Kwesi Bondinuba, Seidu Abdullah, Nelly Bondinuba

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Purpose: The study proposes a theoretical framework for integrating sustainable project management in the construction sector, addressing the need for sustainable development practices. Methodology: The study adopts a theoretical approach by reviewing existing literature on sustainable development and project management in the construction industry. It analyses various concepts, theories, and frameworks to develop a comprehensive theoretical framework for integrating sustainable project management. Findings: The study emphasizes the importance of incorporating sustainable development practices into construction project management, focusing on collaboration, stakeholder engagement, and continuous improvement to achieve environmental conservation, social responsibility, and economic viability. Conclusion: Sustainable Project Management (SPM) in Ghana's construction industry is challenging due to lack of awareness, regulatory frameworks, financial constraints, and skill shortages, despite its benefits in promoting social inclusivity, job creation, and environmental resilience. Recommendation: The construction industry in Ghana should adopt a comprehensive approach involving local communities, government bodies, and environmental organizations. It should utilize green materials and technologies and effectively manage waste. Originality: This study presents a theoretical framework for sustainable project management in construction. It emphasizes collaboration and stakeholder engagement for long-term sustainable outcomes and considers environmental, social, and economic aspects.

Keywords: construction industry, theoretical framework, integration, project management, sustainable development

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Authors: E. Feizi Ashtiani, S. Jamshidi, M.H Niksokhan, A. Feizi Ashtiani

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Waste load allocation (WLA) policies may use multi-objective optimization methods to find the most appropriate and sustainable solutions. These usually intend to simultaneously minimize two criteria, total abatement costs (TC) and environmental violations (EV). If other criteria, such as inequity, need for minimization as well, it requires introducing more binary optimizations through different scenarios. In order to reduce the calculation steps, this study presents value index as an innovative decision making approach. Since the value index contains both the environmental violation and treatment costs, it can be maximized simultaneously with the equity index. It implies that the definition of different scenarios for environmental violations is no longer required. Furthermore, the solution is not necessarily the point with minimized total costs or environmental violations. This idea is testified for Haraz River, in north of Iran. Here, the dissolved oxygen (DO) level of river is simulated by Streeter-Phelps equation in MATLAB software. The WLA is determined for fish farms using multi-objective particle swarm optimization (MOPSO) in two scenarios. At first, the trade-off curves of TC-EV and TC-Inequity are plotted separately as the conventional approach. In the second, the Value-Equity curve is derived. The comparative results show that the solutions are in a similar range of inequity with lower total costs. This is due to the freedom of environmental violation attained in value index. As a result, the conventional approach can well be replaced by the value index particularly for problems optimizing these objectives. This reduces the process to achieve the best solutions and may find better classification for scenario definition. It is also concluded that decision makers are better to focus on value index and weighting its contents to find the most sustainable alternatives based on their requirements.

Keywords: waste load allocation (WLA), value index, multi objective particle swarm optimization (MOPSO), Haraz River, equity

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Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

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The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

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Authors: Paulin Mbecke

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Research Issue: Under economic constraints, socio-economic conditions of households worsen discounting child’s wellbeing to the bottom of many governments and households’ priority lists. In such situation, many governments fail to rebalance priorities in providing services such as education, housing and social security which are the prerequisites for the wellbeing of children. Consequently, many households struggle to respond to basic needs especially those of children. Although economic conditions play a crucial role in creating prosperity or poverty in households and therefore the wellbeing or misery for children; they are not the sole cause. Research Insights: The review of the South African Index of Multiple Deprivation and the South African Child Gauge establish the extent to which economic conditions impact on the wellbeing or misery of children. The analysis of social, cultural, environmental and structural theories demonstrates that non-economic factors contribute equally to the wellbeing or misery of children, yet, they are disregarded. In addition, the assessment of a child abuse database proves a weak correlation between economic factors (prosperity or poverty) and child’s wellbeing or misery. Theoretical Implications: Through critical social research theory and modelling, the paper proposes a Theory-Based Model that combines different factors to facilitate the understanding of child’s wellbeing or misery. Policy Implications: The proposed model assists in broad policy and decision making and reviews processes in promoting child’s wellbeing and in preventing, intervening and managing child’s misery with regard to education, housing, and social security.

Keywords: children, child’s misery, child’s wellbeing, household’s despair, household’s prosperity

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Authors: Rebecca A. Deek

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There is evidence that erratic and extreme weather is becoming a common occurrence, and even predictions that this will become even more frequent and more severe. It also appears that the severity of earthquakes is intensifying. Some observers believe that human conduct has given reasons for such change; others attribute this to environmental and geological cycles. However, as some physicists, environmental scientists, politicians, and others continue to debate the connection between weather events, seismic activities, and climate change, other scientists, engineers, and urban planners are exploring how can our habitat become more responsive and resilient to such phenomena. There are a number of recent instances of nature’s destructive events that provide basis for the development of defensive measures.

Keywords: biomimicry, natural disasters, protection of human lives, resilient infrastructures

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Authors: Enido Fabiano de Ramos, Ieda Kanashiro Makiya, Francisco I. Giocondo Cesar

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This study investigates the application of Digital Twins (DT) in Smart Hospital Environments (SHE), through a bibliometric study and literature review, including comparison with the principles of Industry 4.0. It aims to analyze the current state of the implementation of digital twins in clinical and non-clinical operations in healthcare settings, identifying trends and challenges, comparing these practices with Industry 4.0 concepts and technologies, in order to present a basic framework including stages and maturity levels. The bibliometric methodology will allow mapping the existing scientific production on the theme, while the literature review will synthesize and critically analyze the relevant studies, highlighting pertinent methodologies and results, additionally the comparison with Industry 4.0 will provide insights on how the principles of automation, interconnectivity and digitalization can be applied in healthcare environments/operations, aiming at improvements in operational efficiency and quality of care. The results of this study will contribute to a deeper understanding of the potential of Digital Twins in Smart Hospitals, in addition to the future potential from the effective integration of Industry 4.0 concepts in this specific environment, presented through the practical framework, after all, the urgent need for changes addressed in this article is undeniable, as well as all their value contribution to human sustainability, designed in SDG3 – Health and well-being: ensuring that all citizens have a healthy life and well-being, at all ages and in all situations. We know that the validity of these relationships will be constantly discussed, and technology can always change the rules of the game.

Keywords: digital twin, smart hospital, healthcare operations, industry 4.0, SDG3, technology

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Authors: Piotr Synaszko, Michał Sałaciński, Andrzej Leski

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This paper describes the analysis of construction Mi-2 helicopter rotor blades in order to determine the causes of appearance disbonds. Authors describe construction of rotor blade with impact on bonded joins and areas of water migration. They also made analysis which determines possibility of disbond between critical parts of rotor blades based on more than one hundred non-destructive inspections results. They showed which parts of the blades most likely to damage. The main source of damage is water presence.

Keywords: disbonds, environmental effect, helicopter rotor blades, service life extension

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Authors: Samir Malhotra, Rajan K. Khandotra, Rakesh K. Dhiman, Neelam Chadha

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There is paucity of data about safety and efficacy of probiotic treatment on patient outcomes in cirrhosis. Specifically, it is important to know whether probiotics can improve mortality, hepatic encephalopathy (HE), number of hospitalizations, ammonia levels, quality of life, and adverse events. Probiotics may improve outcomes in patients with acute or chronic HE. However, it is also important to know whether probiotics can prevent development of HE, even in situations where patients do not have acute HE at the time of administration. It is also important to know if probiotics are useful as primary prophylaxis of HE. We aimed to conduct an updated systematic review and meta-analysis to evaluate the safety and efficacy of probiotics in patients with cirrhosis. We searched PubMed, Cochrane library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify randomised clinical trials comparing probiotics with other treatments in cirrhotics. Data was analyzed using MedCalc. Probiotics had no effect on mortality but significantly reduced HE (14 trials, 1073 patients, OR 0.371; 95% CI 0.282 to 0.489). There was not enough data to conduct a meta-analysis on outcomes like hospitalizations and quality of life. The effect on plasma ammonia levels was not significant (SMD -0.429; 95%CI -1.034 – 0.177). There was no difference in adverse events. To conclude, although the included studies had a high risk of bias, the available evidence does suggest a beneficial effect on HE. Larger studies with longer periods of follow-up are needed to determine if probiotics can reduce all-cause mortality.

Keywords: cirrhosis, hepatic encephalopathy, meta-analysis, probiotic

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Authors: Angkawinijwong Sasiwan, Setthasakko Watchaneeporn

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This paper aims to gain an understanding of supporting factors and barriers to implementing eco-efficiency of automotive industry in Thailand. It employs in-depth interviews with key involved informants, including environmental managers, plant managers and environmental officers of six leading companies. It is found that board of directors, legislation and customers’ need are three main supporting factors in implementing eco-efficiency. Data collection and lack of awareness and knowledge about eco-efficiency are identified as barriers.

Keywords: eco-efficiency, supporting factors, barriers, automotive industry, Thailand

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Authors: Stephanie Remedios, Linda Veronica Rios

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Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

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Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

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Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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Authors: Francis Zerd, Brian E. Moore, Atuganile E. Malango, Patrick W. Hosokawa, Kevin O. Lillehei, Laurence Lemery Mchome, D. Ryan Ormond

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Introduction: Since neuropathologic diagnosis in the developing world is hampered by limitations in technical infrastructure, trained laboratory personnel, and subspecialty-trained pathologists, the use of telepathology for diagnostic support, second-opinion consultations, and ongoing training holds promise as a means of addressing these challenges. This research aims to assess the utility of static teleneuropathology in improving neuropathologic diagnoses in low- and middle-income countries. Methods: Consecutive neurosurgical biopsy and resection specimens obtained at Muhimbili National Hospital in Tanzania between July 1, 2018, and June 30, 2019, were selected for retrospective, blinded static-image neuropathologic review followed by on-site review by an expert neuropathologist. Results: A total of 75 neuropathologic cases were reviewed. The agreement of static images and on-site glass diagnosis was 71% with strict criteria and 88% with less stringent criteria. This represents an overall improvement in diagnostic accuracy from 36% by general pathologists to 71% by a neuropathologist using static telepathology (or 76% to 88% with less stringent criteria). Conclusions: Telepathology offers a suitable means of providing diagnostic support, second-opinion consultations, and ongoing training to pathologists practicing in resource-limited countries. Moreover, static digital teleneuropathology is an uncomplicated, cost-effective, and reliable way to achieve these goals.

Keywords: neuropathology, resource-limited settings, static image, Tanzania, teleneuropathology

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Authors: Hamid Hanifi, Adel Azar, Alireza Booshehri

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In order to know about the capability level of R & D units in automotive industry, it is essential that organizations always compare themselves with standard level and higher than themselves so that to be improved continuously. In this research, with respect to the importance of this issue, we have tried to present an assessment model for R & D capabilities having reviewed on new products development in automotive industry of Iran. Iran Khodro Company was selected for the case study. To this purpose, first, having a review on the literature, about 200 indicators effective in R & D capabilities and new products development were extracted. Then, of these numbers, 29 indicators which were more important were selected by industry and academia experts and the questionnaire was distributed among statistical population. Statistical population was consisted of 410 individuals in Iran Khodro Company. We used the 410 questionnaires for exploratory factor analysis and then used the data of 308 questionnaires from the same population randomly for confirmatory factor analysis. The results of exploratory factor analysis led to categorization of dimensions in 9 secondary dimensions. Naming the dimensions was done according to a literature review and the professors’ opinion. Using structural equation modeling and AMOS software, confirmatory factor analysis was conducted and ultimate model with 9 secondary dimensions was confirmed. Meanwhile, 9 secondary dimensions of this research are as follows: 1) Research and design capability, 2) Customer and market capability, 3) Technology capability, 4) Financial resources capability, 5) Organizational chart, 6) Intellectual capital capability, 7) NPD process capability, 8) Managerial capability and 9) Strategy capability.

Keywords: research and development, new products development, structural equations, exploratory factor analysis, confirmatory factor analysis

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Authors: Zahra Bakhtiari

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Middle East countries confront a multitude of main environmental challenges which are inevitable. The unstable economic and political structure which dominates numerous middle East countries makes it difficult to react effectively to unfavorable climate change impacts. This study applies a qualitative methodology and relies on secondary literature aimed to investigate how countries in the Middle East are balancing economic security and climatic security in terms of budgeting, infrastructure investment, political engagement (domestically through discourses or internationally in terms of participation in international organizations or bargaining, etc.) There has been provided an outline of innovative measures in both economic and environmental fields that are in progress in the Middle East countries and what capacity they have for economic development and environmental adaptation, as well as what has already been performed. The primary outcome is that countries that rely more on infrastructure investment such as negative emissions technologies (NET) through green social capital enterprises and political engagement, especially nationally determined contributions (NDCs) commitments and United Nations Framework Convention on Climate Change (UNFCCC), experience more economic and climatological security balance in the Middle East. Since implementing these measures is not the same in all countries in the region, we see different levels of balance between climate security and economic security. The overall suggestion is that the collaboration of both the bottom-up and top-down approaches helps create strategic environmental strategies which are in line with the economic circumstances of each country and creates the desired balance.

Keywords: climate change, economic growth, sustainability, the Middle East, green economy, renewable energy

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Authors: Dennis Kreutzer, Sarah Müller-Abdelrazeq, Ingrid Isenhardt

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Resource scarcity, energy transition and the planned climate neutrality pose enormous challenges for manufacturing companies. In order to achieve these goals and a holistic sustainable development, the European Union has listed the circular economy as part of the Circular Economy Action Plan. In addition to a reduction in resource consumption, reduced emissions of greenhouse gases and a reduced volume of waste, the principles of the circular economy also offer enormous economic potential for companies, such as the generation of new circular business models. However, many manufacturing companies, especially small and medium-sized enterprises, do not have the necessary capacity to plan their transformation. They need support and strategies on the path to circular transformation, because this change affects not only production but also the entire company. Maturity models offer an approach, as they enable companies to determine the current status of their transformation processes. In addition, companies can use the models to identify transformation strategies and thus promote the transformation process. While maturity models are established in other areas, e.g. IT or project management, only a few circular economy maturity models can be found in the scientific literature. The aim of this paper is to analyse the identified maturity models of the circular economy through a systematic literature review (SLR) and, besides other aspects, to check their completeness as well as their quality. Since the terms "maturity model" and "readiness model" are often used to assess the transformation process, this paper considers both types of models to provide a more comprehensive result. For this purpose, circular economy maturity models at the company (micro) level were identified from the literature, compared, and analysed with regard to their theoretical and methodological structure. A specific focus was placed, on the one hand, on the analysis of the business units considered in the respective models and, on the other hand, on the underlying metrics and indicators in order to determine the individual maturity level of the entire company. The results of the literature review show, for instance, a significant difference in the holism of their assessment framework. Only a few models include the entire company with supporting areas outside the value-creating core process, e.g. strategy and vision. Additionally, there are large differences in the number and type of indicators as well as their metrics. For example, most models often use subjective indicators and very few objective indicators in their surveys. It was also found that there are rarely well-founded thresholds between the levels. Based on the generated results, concrete ideas and proposals for a research agenda in the field of circular economy maturity models are made.

Keywords: maturity model, circular economy, transformation, metric, assessment

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

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Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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Authors: Yan Zhang

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Predictive maintenance is a technique to predict when an in-service machine will fail so that maintenance can be planned in advance. Analytics-driven predictive maintenance is gaining increasing attention in many industries such as manufacturing, utilities, aerospace, etc., along with the emerging demand of Internet of Things (IoT) applications and the maturity of technologies that support Big Data storage and processing. This study aims to build an end-to-end analytics solution that includes both real-time machine condition monitoring and machine learning based predictive analytics capabilities. The goal is to showcase a general predictive maintenance solution architecture, which suggests how the data generated from field machines can be collected, transmitted, stored, and analyzed. We use a publicly available aircraft engine run-to-failure dataset to illustrate the streaming analytics component and the batch failure prediction component. We outline the contributions of this study from four aspects. First, we compare the predictive maintenance problems from the view of the traditional reliability centered maintenance field, and from the view of the IoT applications. When evolving to the IoT era, predictive maintenance has shifted its focus from ensuring reliable machine operations to improve production/maintenance efficiency via any maintenance related tasks. It covers a variety of topics, including but not limited to: failure prediction, fault forecasting, failure detection and diagnosis, and recommendation of maintenance actions after failure. Second, we review the state-of-art technologies that enable a machine/device to transmit data all the way through the Cloud for storage and advanced analytics. These technologies vary drastically mainly based on the power source and functionality of the devices. For example, a consumer machine such as an elevator uses completely different data transmission protocols comparing to the sensor units in an environmental sensor network. The former may transfer data into the Cloud via WiFi directly. The latter usually uses radio communication inherent the network, and the data is stored in a staging data node before it can be transmitted into the Cloud when necessary. Third, we illustrate show to formulate a machine learning problem to predict machine fault/failures. By showing a step-by-step process of data labeling, feature engineering, model construction and evaluation, we share following experiences: (1) what are the specific data quality issues that have crucial impact on predictive maintenance use cases; (2) how to train and evaluate a model when training data contains inter-dependent records. Four, we review the tools available to build such a data pipeline that digests the data and produce insights. We show the tools we use including data injection, streaming data processing, machine learning model training, and the tool that coordinates/schedules different jobs. In addition, we show the visualization tool that creates rich data visualizations for both real-time insights and prediction results. To conclude, there are two key takeaways from this study. (1) It summarizes the landscape and challenges of predictive maintenance applications. (2) It takes an example in aerospace with publicly available data to illustrate each component in the proposed data pipeline and showcases how the solution can be deployed as a live demo.

Keywords: Internet of Things, machine learning, predictive maintenance, streaming data

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Authors: Micheale Yifter Weldemichael, Hailay Mehari Gebremedhn, Teklehaimanot Hailesslasie

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The advancement of target-specific genome editing tools, including clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein9 (Cas9), mega-nucleases, base editing (BE), prime editing (PE), transcription activator-like endonucleases (TALENs), and zinc-finger nucleases (ZFNs), have paved the way for a modern era of gene editing. CRISPR/Cas9, as a versatile, simple, cost-effective and robust system for genome editing, has dominated the genome manipulation field over the last few years. The application of CRISPR/Cas9 in sorghum improvement is particularly vital in the context of ecological, environmental and agricultural challenges, as well as global climate change. In this context, gene editing using CRISPR/Cas9 can improve nutritional value, yield, resistance to pests and disease and tolerance to different abiotic stress. Moreover, CRISPR/Cas9 can potentially perform complex editing to reshape already available elite varieties and new genetic variations. However, existing research is targeted at improving even further the effectiveness of the CRISPR/Cas9 genome editing techniques to fruitfully edit endogenous sorghum genes. These findings suggest that genome editing is a feasible and successful venture in sorghum. Newer improvements and developments of CRISPR/Cas9 techniques have further qualified researchers to modify extra genes in sorghum with improved efficiency. The fruitful application and development of CRISPR techniques for genome editing in sorghum will not only help in gene discovery, creating new, improved traits in sorghum regulating gene expression sorghum functional genomics, but also in making site-specific integration events.

Keywords: CRISPR/Cas9, genome editing, quality, sorghum, stress, yield

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Authors: M. Petunia Tsweleng

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Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

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Authors: Mya Achike

Abstract:

Background and Significance: Perinatal mental illness covers a wide range of conditions and has a huge influence on maternal-child health. Issues and challenges with perinatal mental health have been associated with poor pregnancy, birth, and postpartum outcomes. It is estimated that one out of five new and expectant mothers experience some degree of perinatal mental illness, which makes this a hugely significant health outcome. Certain factors increase the maternal risk for mental illness. Challenges related to poverty, migration, extreme stress, exposure to violence, emergency and conflict situations, natural disasters, and pandemics can exacerbate mental health disorders. It is widely expected that perinatal mental health is being negatively affected during the present COVID-19 pandemic. Methods: A review of studies that reported a measurement tool to assess perinatal mental health outcomes during the COVID-19 pandemic was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, CINAHL, and Google Scholar were used to search for peer-reviewed studies published after late 2019, in accordance with the emergence of the virus. The search resulted in the inclusion of ten studies. Approach to measure health outcome: The main approach to measure perinatal mental illness is the use of self-administered, validated questionnaires, usually in the clinical setting. Summary: Widespread use of these tools has afforded the clinical and research communities the ability to identify and support women who may be suffering from mental illness disorders during a pandemic. More research is needed to validate tools in other vulnerable, perinatal populations.

Keywords: mental health during covid, perinatal mental health, perinatal mental health measurement tools, perinatal mental health tools

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Authors: Azeez O. Ganiyu

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Climate change is expected to lead to substantial changes in rainfall patterns in southwest Nigeria, and this may have substantial consequence for forest management and for conservation outcomes throughout the region. We examine three different forest types across an environmental spectrum from semi-arid to humid subtropical and consider their response to water shortages and other environmental stresses; we also explore the potential consequence for conservation and timber production by considering impacts on forest structure and limiting stand density. Analysis of a series of scenarios provides the basis for a critique of existing management practices and suggests practical alternatives to develop resilient forests with minimal diminution of production and environmental services. We specifically discuss practical silviculture interventions that are feasible at the landscape-scale, that are economically viable, and that have the potential to enhance resilience of forest stands. We also discuss incentives to encourage adoption of these approaches by private forest owners. We draw on these case studies in southwestern Nigeria to offer generic principle to assist forest researchers and managers faced with similar challenges elsewhere.

Keywords: climate change, forest, future, silviculture, Nigeria

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Authors: Alireza Ansariyar, Safieh Laaly

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Over the last decades, the vehicle industry has shown increased interest in integrating autonomous, connected, and electrical technologies in vehicle design with the primary hope of improving mobility and road safety while reducing transportation’s environmental impact. Using the State of Maryland (M.D.) in the United States as a pilot study, this research investigates CAVs’ fuel consumption and air pollutants (C.O., PM, and NOx) and utilizes meaningful linear regression models to predict CAV’s environmental effects. Maryland transportation network was simulated in VISUM software, and data on a set of variables were collected through a comprehensive survey. The number of pollutants and fuel consumption were obtained for the time interval 2010 to 2021 from the macro simulation. Eventually, four linear regression models were proposed to predict the amount of C.O., NOx, PM pollutants, and fuel consumption in the future. The results highlighted that CAVs’ pollutants and fuel consumption have a significant correlation with the income, age, and race of the CAV customers. Furthermore, the reliability of four statistical models was compared with the reliability of macro simulation model outputs in the year 2030. The error of three pollutants and fuel consumption was obtained at less than 9% by statistical models in SPSS. This study is expected to assist researchers and policymakers with planning decisions to reduce CAV environmental impacts in M.D.

Keywords: connected and autonomous vehicles, statistical model, environmental effects, pollutants and fuel consumption, VISUM, linear regression models

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Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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Authors: Rachael Andrews, Viktoria McMillan, Shuaib Nasser, Christopher M. Roberts

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Background and objective: The National Review of Asthma Deaths (NRAD) found that asthma management and care was inadequate in 26% of cases reviewed. Major shortfalls identified were adherence to national guidelines and standards and, particularly, the organisation of care, including supervision and monitoring in primary care, with 70% of cases reviewed having at least one avoidable factor in this area. 5.4 million people in the UK are diagnosed with and actively treated for asthma, and approximately 60,000 are admitted to hospital with acute exacerbations each year. The majority of people with asthma receive management and treatment solely in primary care. This has therefore created concern that many people within the UK are receiving sub-optimal asthma care resulting in unnecessary morbidity and risk of adverse outcome. NRAD concluded that a national asthma audit programme should be established to measure and improve processes, organisation, and outcomes of asthma care. Objective: To develop a primary care dataset enabling extraction of information from GP practices in Wales and providing robust data by which results and lessons could be drawn and drive service development and improvement. Methods: A multidisciplinary group of experts, including general practitioners, primary care organisation representatives, and asthma patients was formed and used as a source of governance and guidance. A review of asthma literature, guidance, and standards took place and was used to identify areas of asthma care which, if improved, would lead to better patient outcomes. Modified Delphi methodology was used to gain consensus from the expert group on which of the areas identified were to be prioritised, and an asthma patient and carer focus group held to seek views and feedback on areas of asthma care that were important to them. Areas of asthma care identified by both groups were mapped to asthma guidelines and standards to inform and develop primary and secondary care datasets covering both adult and pediatric care. Dataset development consisted of expert review and a targeted consultation process in order to seek broad stakeholder views and feedback. Results: Areas of asthma care identified as requiring prioritisation by the National Asthma Audit were: (i) Prescribing, (ii) Asthma diagnosis (iii) Asthma Reviews (iv) Personalised Asthma Action Plans (PAAPs) (v) Primary care follow-up after discharge from hospital (vi) Methodologies and primary care queries were developed to cover each of the areas of poor and variable asthma care identified and the queries designed to extract information directly from electronic patients’ records. Conclusion: This paper describes the methodological approach followed to develop primary care datasets for a National Asthma Audit. It sets out the principles behind the establishment of a National Asthma Audit programme in response to a national asthma mortality review and describes the development activities undertaken. Key process elements included: (i) mapping identified areas of poor and variable asthma care to national guidelines and standards, (ii) early engagement of experts, including clinicians and patients in the process, and (iii) targeted consultation of the queries to provide further insight into measures that were collectable, reproducible and relevant.

Keywords: asthma, primary care, general practice, dataset development

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Authors: Katia C. Bortoletto, Maria Isabel C. de Freitas, Rodrigo B. N. de Oliveira

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The environmental vulnerability studies are essential for priority actions to the reduction of disasters risk. The aim of this study is to analyze the socio-environmental vulnerability obtained through a Census survey, followed by both a statistical analysis (PCA/SPSS/IBM) and a spatial analysis by GIS (ArcGis/ESRI), taking as a case study the Municipality of Caraguatatuba-SP, Brazil. In the municipal development plan analysis the emphasis was given to the Special Zone of Social Interest (ZEIS), the Urban Expansion Zone (ZEU) and the Environmental Protection Zone (ZPA). For the mapping of the social and environmental vulnerabilities of the study area the exposure of people (criticality) and of the place (support capacity) facing disaster risk were obtained from the 2010 Census from the Brazilian Institute of Geography and Statistics (IBGE). Considering the criticality, the variables of greater influence were related to literate persons responsible for the household and literate persons with 5 or more years of age; persons with 60 years or more of age and income of the person responsible for the household. In the Support Capacity analysis, the predominant influence was on the good household infrastructure in districts with low population density and also the presence of neighborhoods with little urban infrastructure and inadequate housing. The results of the comparative analysis show that the areas with high and very high vulnerability classes cover the classes of the ZEIS and the ZPA, whose zoning includes: Areas occupied by low-income population, presence of children and young people, irregular occupations and land suitable to urbanization but underutilized. The presence of zones of urban sprawl (ZEU) in areas of high to very high socio-environmental vulnerability reflects the inadequate use of the urban land in relation to the spatial distribution of the population and the territorial infrastructure, which favors the increase of disaster risk. It can be concluded that the study allowed observing the convergence between the vulnerability analysis and the classified areas in urban zoning. The occupation of areas unsuitable for housing due to its characteristics of risk was confirmed, thus concluding that the methodologies applied are agile instruments to subsidize actions to the reduction disasters risk.

Keywords: socio-environmental vulnerability, urban zoning, reduction disasters risk, methodologies

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