Search results for: real time mode

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

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

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

Procedia PDF Downloads 155

Authors: L. Kiefer, C. Richter, G. Reinhart

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The uprising complexity in production systems due to an increasing amount of variants up to customer innovated products leads to requirements that hierarchical control systems are not able to fulfil. Therefore, factory planners can install autonomous manufacturing systems. The fundamental requirement for an autonomous control is the identification of objects within production systems. In this approach an attribute-based identification is focused for avoiding dose-dependent identification costs. Instead of using an identification mark (ID) like a radio frequency identification (RFID)-Tag, an object type is directly identified by its attributes. To facilitate that it’s recommended to include the identification and the corresponding sensors within handling processes, which connect all manufacturing processes and therefore ensure a high identification rate and reduce blind spots. The presented methodology reduces the individual effort to integrate identification processes in handling systems. First, suitable object attributes and sensor systems for object identification in a production environment are defined. By categorising these sensor systems as well as handling systems, it is possible to match them universal within a compatibility matrix. Based on that compatibility further requirements like identification time are analysed, which decide whether the combination of handling and sensor system is well suited for parallel handling and identification within an autonomous control. By analysing a list of more than thousand possible attributes, first investigations have shown, that five main characteristics (weight, form, colour, amount, and position of subattributes as drillings) are sufficient for an integrable identification. This knowledge limits the variety of identification systems and leads to a manageable complexity within the selection process. Besides the procedure, several tools, as an example a sensor pool are presented. These tools include the generated specific expert knowledge and simplify the selection. The primary tool is a pool of preconfigured identification processes depending on the chosen combination of sensor and handling device. By following the defined procedure and using the created tools, even laypeople out of other scientific fields can choose an appropriate combination of handling devices and sensors which enable parallel handling and identification.

Keywords: agent systems, autonomous control, handling systems, identification

Procedia PDF Downloads 177

Authors: Babatunde Dosumu, Obuks Ejohwomu, Akilu Yunusa-Kaltungo

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Cost estimation in construction is often difficult, particularly when dealing with risks and uncertainties, which are inevitable and peculiar to developing countries like Nigeria. Direct consequences of these are major deviations in cost, duration, and quality. The fundamental aim of this study is to develop a framework for assessing the impacts of risk on cost estimation, which in turn causes variabilities between contract sum and final account. This is very important, as initial estimates given to clients should reflect the certain magnitude of consistency and accuracy, which the client builds other planning-related activities upon, and also enhance the capabilities of construction industry professionals by enabling better prediction of the final account from the contract sum. In achieving this, a systematic literature review was conducted with cost variability and construction projects as search string within three databases: Scopus, Web of science, and Ebsco (Business source premium), which are further analyzed and gap(s) in knowledge or research discovered. From the extensive review, it was found that factors causing deviation between final accounts and contract sum ranged between 1 and 45. Besides, it was discovered that a cost estimation framework similar to Building Cost Information Services (BCIS) is unavailable in Nigeria, which is a major reason why initial estimates are very often inconsistent, leading to project delay, abandonment, or determination at the expense of the huge sum of money invested. It was concluded that the development of a cost estimation framework that is adjudged an important tool in risk shedding rather than risk-sharing in project risk management would be a panacea to cost estimation problems, leading to cost variability in the Nigerian construction industry by the time this ongoing Ph.D. research is completed. It was recommended that practitioners in the construction industry should always take into account risk in order to facilitate the rapid development of the construction industry in Nigeria, which should give stakeholders a more in-depth understanding of the estimation effectiveness and efficiency to be adopted by stakeholders in both the private and public sectors.

Keywords: cost variability, construction projects, future studies, Nigeria

Procedia PDF Downloads 209

Authors: Umar Saeed

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Peptidyl-prolyl cis/trans isomerases Par14 and Par17 in humans play crucial roles in diverse cellular processes, including protein folding, chromatin remodeling, DNA binding, ribosome biogenesis, and cell cycle progression. However, the effects of Par14 and Par17 on viral replication have been explored to a limited extent. We first time discovered their influential roles in promoting Hepatitis B Virus replication. In this study, we observed that in the presence of HBx, either Par14 or Par17 could upregulate HBV replication. However, in the absence of HBx, neither Par14 nor Par17 had any effect on replication. Their mechanism of action involves binding to specific motifs within HBc and HBx proteins. Notably, they target the conserved 133Arg-Pro134 (RP) motif of HBc and the 19RP20-28RP29 motifs of HBx. This interaction is fundamental for the stability of HBx, core particles, and HBc. Par14 and Par17 exhibit versatility by binding both outside and inside core particles, thereby facilitating core particle assembly through their participation in HBc dimer-dimer interactions. NAGE and immunoblotting analyses unveiled the binding of Par14/Par17 to core particles. Co-immunoprecipitation experiments further demonstrated the interaction of Par14/Par17 with core particle assembly-defective and dimer-positive HBc-Y132A. It's essential to emphasize that R133 is the key residue in the HBc RP motif that governs their interaction with Par14/Par17. Chromatin immunoprecipitation conducted on HBV-infected cells elucidated the participation of residues S19 and E46/D74 in Par14 and S44 and E71/D99 in Par17 in the recruitment of 133RP134 motif-containing HBc into cccDNA. Depleting PIN4 in liver cell lines results in a significant reduction in cccDNA levels, pgRNA, sgRNAs, HBc, core particle assembly, and HBV DNA synthesis. Notably, parvulin inhibitors like juglone and PiB have proven to be effective in substantially reducing HBV replication. These inhibitors weaken the interaction between HBV core particles and Par14/Par17, underscoring the dynamic nature of this interaction. It's also worth noting that specific Par14/Par17 inhibitors hold promise as potential therapeutic options for chronic hepatitis B.

Keywords: Par14Par17, HBx, HBc, cccDNA, HBV

Procedia PDF Downloads 67

Authors: Said Benaissa, David Plets, Emmeric Tanghe, Jens Trogh, Luc Martens, Leen Vandaele, Annelies Van Nuffel, Frank A. M. Tuyttens, Bart Sonck, Wout Joseph

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The herd monitoring and managing - in particular the detection of ‘attention animals’ that require care, treatment or assistance is crucial for effective reproduction status, health, and overall well-being of dairy cows. In large sized farms, traditional methods based on direct observation or analysis of video recordings become labour-intensive and time-consuming. Thus, automatic monitoring systems using sensors have become increasingly important to continuously and accurately track the health status of dairy cows. Wireless sensor networks (WSNs) and internet-of-things (IoT) can be effectively used in health tracking of dairy cows to facilitate herd management and enhance the cow welfare. Since on-cow measuring devices are energy-constrained, a proper characterization of the off-body wireless channel between the on-cow sensor nodes and the back-end base station is required for a power-optimized deployment of these networks in barns. The aim of this study was to characterize the off-body wireless channel in indoor (barns) environment at 868 MHz using LoRa nodes. LoRa is an emerging wireless technology mainly targeted at WSNs and IoT networks. Both large scale fading (i.e., path loss) and temporal fading were investigated. The obtained path loss values as a function of the transmitter-receiver separation were well fitted by a lognormal path loss model. The path loss showed an additional increase of 4 dB when the wireless node was actually worn by the cow. The temporal fading due to movement of other cows was well described by Rician distributions with a K-factor of 8.5 dB. Based on this characterization, network planning and energy consumption optimization of the on-body wireless nodes could be performed, which enables the deployment of reliable dairy cow monitoring systems.

Keywords: channel, channel modelling, cow monitoring, dairy cows, health monitoring, IoT, LoRa, off-body propagation, PLF, propagation

Procedia PDF Downloads 318

Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan

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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.

Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program

Procedia PDF Downloads 243

Authors: Saidulu Gadari, Manoj Kumar Yadav, V. K. Satheesh, Debasis Bhattacharyya, S. S. V. Ramakumar, Subhajit Sarkar

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Most Fluid Catalytic Cracking Units (FCCUs) are big profit makers and hence, always operated with several constraints. It is the primary source for production of gasoline, light olefins as petrochemical feedstocks, feedstock for alkylate & oxygenates, LPG, etc. in a refinery. Increasing unit capacity and improving product yields as well as qualities such as gasoline RON have dramatic impact on the refinery economics. FCCUs are often debottlenecked significantly beyond their original design capacities. Depending upon the unit configuration, operating conditions, and feedstock quality, the FCC unit can have a variety of bottlenecks. While some of these are aimed to increase the feed rate, improve the conversion, etc., the others are aimed to improve the reliability of the equipment or overall unit. Apart from investment cost, the other factors considered generally while evaluating the debottlenecking options are shutdown days, faster payback, risk on investment, etc. A low-cost solution such as replacement of feed injectors, air distributor, steam distributors, spent catalyst distributor, efficient cyclone system, etc. are the preferred way of upgrading FCCU. It also has lower lead time from idea inception to implementation. This paper discusses various bottlenecks generally encountered in FCCU and presents a case study on improvement of performance of one of the FCCUs in IndianOil through implementation of cost-effective technical solution including use of improved internals in Reactor-Regeneration (R-R) section. After implementation reduction in regenerator air, gas superficial velocity in regenerator and cyclone velocities by about 10% and improvement of CLO yield from 10 to 6 wt% have been achieved. By ensuring proper pressure balance and optimum immersion of cyclone dipleg in the standpipe, frequent formation of perforations in regenerator cyclones could be addressed which in turn improved the unit on-stream factor.

Keywords: FCC, low-cost, revamp, debottleneck, internals, distributors, cyclone, dipleg

Procedia PDF Downloads 215

Authors: Kailas L. Wasewar

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Biobutanol has been considered as a potential and alternative biofuel relative to the most popular biodiesel and bioethanol. End product toxicity is the major problems in commercialization of fermentation based process which can be reduce to some possible extent by removing biobutanol simultaneously. Several techniques have been investigated for removing butanol from fermentation broth such as stripping, adsorption, liquid–liquid extraction, pervaporation, and membrane solvent extraction. Liquid–liquid extraction can be performed with high selectivity and is possible to carry out inside the fermenter. Conventional solvents have few drawbacks including toxicity, loss of solvent, high cost etc. Hence alternative solvents must be explored for the same. Room temperature ionic liquids (RTILs) composed entirely of ions are liquid at room temperature having negligible vapor pressure, non-flammability, and tunable physiochemical properties for a particular application which term them as “designer solvents”. Ionic liquids (ILs) have recently gained much attention as alternatives for organic solvents in many processes. In particular, ILs have been used as alternative solvents for liquid–liquid extraction. Their negligible vapor pressure allows the extracted products to be separated from ILs by conventional low pressure distillation with the potential for saving energy. Morpholinium, imidazolium, ammonium, phosphonium etc. based ionic liquids have been employed for the separation biobutanol. In present chapter, basic concepts of ionic liquids and application in separation have been presented. Further, type of ionic liquids including, conventional, functionalized, polymeric, supported membrane, and other ionic liquids have been explored. Also the effect of various performance parameters on separation of biobutanol by ionic liquids have been discussed and compared for different cation and anion based ionic liquids. The typical methodology for investigation have been adopted such as contacting the equal amount of biobutanol and ionic liquids for a specific time say, 30 minutes to confirm the equilibrium. Further, biobutanol phase were analyzed using GC to know the concentration of biobutanol and material balance were used to find the concentration in ionic liquid.

Keywords: biobutanol, separation, ionic liquids, sustainability, biorefinery, waste biomass

Procedia PDF Downloads 91

Authors: Chiara Colarusso, Michela Terlizzi, Aldo Pinto, Rosalinda Sorrentino

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Cigarette smoking is the main cause and the most common risk factor for both COPD and lung cancer. In our previous studies, we proved that caspase-11 in mice and its human analogue, caspase-4, are involved in lung carcinogenesis and that AIM2 inflammasome might play a pro-cancerous role in lung cancer. Therefore, the aim of this study was to investigate potential crosstalk between COPD and lung cancer, focusing on AIM2 and caspase-11-dependent inflammasome signaling pathway. To mimic COPD, we took advantage of an experimental first-hand smoking mouse model and, to confirm what was observed in mice, we used human samples of lung adenocarcinoma patients stratified according to the smoking and COPD status. We demonstrated that smoke exposure led to emphysema-like features, bronchial tone impairment, and release of IL-1-like cytokines (IL-1α, IL-1β, IL-33, IL-18) in a caspase-1 independent manner in C57Bl/6N. Rather, a dysfunctional caspase-11 in smoke-exposed 129Sv mice was associated to lower bronchial inflammation, collagen deposition, and IL-1-like inflammation. In addition, for the first time, we found that AIM2 inflammasome is involved in lung inflammation in smoking and COPD, in that its expression was higher in smoke-exposed C57Bl/6N compared to 129Sv smoking mice, who instead did not show any alteration of AIM2 in both macrophages and dendritic cells. Moreover, we found that AIM2 expression in the cancerous tissue, albeit higher than non-cancerous tissue, was not statistically different according to the COPD and smoking status. Instead, the higher expression of AIM2 in non-cancerous tissue of smoker COPD patients than smokers who did not have COPD was correlated to a higher hazard ratio of poor survival rate than patients who presented lower levels of AIM2. In conclusion, our data highlight that caspase-11 in mice is associated to smoke-induced lung latent inflammation which could drive the establishment of lung cancer, and that AIM2 inflammasome plays a role at the crosstalk between smoking/COPD and lung adenocarcinoma in that its higher presence is correlated to lower survival rate of smoker COPD adenocarcinoma.

Keywords: COPD, inflammasome, lung cancer, lung inflammation, smoke

Procedia PDF Downloads 156

Authors: Marah Joy A. Nanglegan

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A survey was conducted to describe knowledge, attitude, practices, information needs, and information seeking behavior of small-scale farmers on Organic Agriculture Production (OAP) in a rural community in Ifugao, Philippines. Respondents’ age ranged from 23-67 years old. Most of them are male, married, and have reached high school level. The major source of income is farming with an average monthly income of less than Php 5,000 for a household size of seven. More than fifty percent of the respondents are members of a farmer’s organization. Farm size is less than one hectare. Majority of them own their farms and have been farming for more than twenty years. Very few attended training on Organic Agriculture Production (OAP). Most of them are not aware of any OAP program in their community. Hence, their farming practices are mostly conventional. The overall level of knowledge on OAP among all respondents was below the average. On attitude, most of the respondents agreed that organic farming would decrease production costs by reducing input purchases. They believe it benefits both the consumer and the producer. In fact, they are aware of the many benefits of organic farming, especially on health. Likewise, many of them agreed on the benefits of organic farming to soil fertility, to the environment, and to increase the income of farmers. Many of them, however, see organic farming as troublesome and difficult in terms of time and effort, obtaining organic inputs, limited production, and marketing aspects. They also have heavy reliance on pesticides and herbicides to control pests and diseases. On practices, majority of the respondents stated that they practiced crop rotation, manual weeding, and the use of animal manure. Most of them desired to do organic farming but needed information such as production techniques, costs, and marketing opportunities. Their most preferred communication channel is through extension agents and contact farmers. Their most preferred communication method is through trainings and seminars as well as through farm demonstrations. Results of this study will serve as a basis for developing appropriate communication strategies to improve knowledge, attitude, and practices of respondents on organic agriculture as well as enhance the promotion of organic agriculture production in the community.

Keywords: Ifugao, knowledge attitude practices, organic agriculture, Philippines

Procedia PDF Downloads 164

Authors: A. Kachmazova, A. Shadiev, Y. Teterin, P. Yartcev

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Introduction: Biliary calculi disease (LCS) still occupies the leading position among urgent diseases of the abdominal cavity, manifesting itself from asymptomatic course to life-threatening states. Nowadays arsenal of diagnostic methods for choledocholithiasis is quite wide: ultrasound, hepatobiliscintigraphy (HBSG), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERCP). Among them, transabdominal ultrasound (TA ultrasound) is the most accessible and routine diagnostic method. Nowadays ERCG is the "gold" standard in diagnosis and one-stage treatment of biliary tract obstruction. However, transpapillary techniques are accompanied by serious postoperative complications (postmanipulative pancreatitis (3-5%), endoscopic papillosphincterotomy bleeding (2%), cholangitis (1%)), the lethality being 0.4%. GBSG and MRI are also quite informative methods in the diagnosis of choledocholithiasis. Small size of concrements, their localization in intrapancreatic and retroduodenal part of common bile duct significantly reduces informativity of all diagnostic methods described above, that demands additional studying of this problem. Materials and Methods: 890 patients with the diagnosis of cholelithiasis (calculous cholecystitis) were admitted to the Sklifosovsky Scientific Research Institute of Hospital Medicine in the period from August, 2020 to June, 2021. Of them 115 people with mechanical jaundice caused by concrements in bile ducts. Results: Final EUS diagnosis was made in all patients (100,0%). In all patients in whom choledocholithiasis diagnosis was revealed or confirmed after EUS, ERCP was performed urgently (within two days from the moment of its detection) as the X-ray operation room was provided; it confirmed the presence of concrements. All stones were removed by lithoextraction using Dormia basket. The postoperative period in these patients had no complications. Conclusions: EUS is the most informative and safe diagnostic method, which allows to detect choledocholithiasis in patients with discrepancies between clinical-laboratory and instrumental methods of diagnosis in shortest time, that in its turn will help to decide promptly on the further tactics of patient treatment. We consider it reasonable to include EUS in the diagnostic algorithm for choledocholithiasis. Disclosure: Nothing to disclose.

Keywords: endoscopic ultrasonography, choledocholithiasis, common bile duct, concrement, ERCP

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Authors: M. P. Tripathi, Priti Tiwari

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Soil and Water Assessment Tool (SWAT) is a distributed parameter continuous time model and was tested on daily and fortnightly basis for a small agricultural watershed (Dhangaon) of Chhattisgarh state in India. The SWAT model recently interfaced with ArcGIS and called as ArcSWAT. The watershed and sub-watershed boundaries, drainage networks, slope and texture maps were generated in the environment of ArcGIS of ArcSWAT. Supervised classification method was used for land use/cover classification from satellite imageries of the years 2009 and 2012. Manning's roughness coefficient 'n' for overland flow and channel flow and Fraction of Field Capacity (FFC) were calibrated for monsoon season of the years 2009 and 2010. The model was validated on a daily basis for the years 2011 and 2012 by using the observed daily rainfall and temperature data. Calibration and validation results revealed that the model was predicting the daily surface runoff and sediment yield satisfactorily. Sensitivity analysis showed that the annual sediment yield was inversely proportional to the overland and channel 'n' values whereas; annual runoff and sediment yields were directly proportional to the FFC. The model was also tested (calibrated and validated) for the fortnightly runoff and sediment yield for the year 2009-10 and 2011-12, respectively. Simulated values of fortnightly runoff and sediment yield for the calibration and validation years compared well with their observed counterparts. The calibration and validation results revealed that the ArcSWAT model could be used for identification of critical sub-watershed and for developing management scenarios for the Dhangaon watershed. Further, the model should be tested for simulating the surface runoff and sediment yield using generated rainfall and temperature before applying it for developing the management scenario for the critical or priority sub-watersheds.

Keywords: watershed, hydrologic and water quality, ArcSWAT model, remote sensing, GIS, runoff and sediment yield

Procedia PDF Downloads 379

Authors: Jevonte Abioye, Dylan Savary

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The aim of this research is to present a disaggregated geostatistical analysis of the subnational provincial trends of child mortality variation in Zimbabwe from a child health policy perspective. Soon after gaining independence in 1980, the government embarked on efforts towards promoting equitable health care, namely through the provision of primary health care. Government intervention programmes brought hope and promise, but achieving equity in primary health care coverage was hindered by previous existing disparities in maternal health care disproportionately concentrated in urban settings to the detriment of rural communities. The article highlights policies and programs adopted by the government during the millennium development goals period between 1990-2015 as a response to the inequities that characterised the country’s maternal health care. A longitudinal comparative method for a spatial variation on child mortality rates across provinces is developed based on geostatistical analysis. Cross-sectional and time-series data was extracted from the World Health Organisation (WHO) global health observatory data repository, demographic health survey reports, and previous academic and technical publications. Results suggest that although health care policy was uniform across provinces, not all provinces received the same antenatal and perinatal services. Accordingly, provincial rates of child mortality growth between 1994 and 2015 varied significantly. Evidence on the trends of child mortality rates and maternal health policies in Zimbabwe can be valuable for public child health policy planning and public service delivery design both in Zimbabwe and across developing countries pursuing the sustainable development agenda.

Keywords: antenatal care, perinatal care, infant mortality rate, neonatal mortality rate, under-five mortality rate, millennium development goals, sustainable development agenda

Procedia PDF Downloads 203

Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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Authors: Monika Simkute-Bukante

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Teachers significantly influence student achievements, personal development, and academic success. Consequently, they are subject to heightened expectations and scrutiny from governments, school administrations, parents, and even students. Increasing responsibilities and pressures impact teachers’ professional well-being, contributing to a global trend of increased teacher turnover and shortages due to stress and heavy workloads. Given the critical role of teachers in educating young people, it is essential to implement strategies to retain them. School administrations are pivotal in creating an environment conducive to optimal performance. However, there remains a gap in understanding how school administration leadership impacts teachers' professional well-being and its potential for improvement. This research aims to define teacher professional well-being, identify its attributes, and explore the factors influencing it, with a particular focus on the role of school administration. Employing the concept analysis method, this study reviews scholarly publications from 2019 to 2024 to articulate the components of teacher professional well-being. The findings highlight key attributes of teacher well-being, including self-efficacy, work engagement, job satisfaction, relationships with colleagues and students, support from administration, work autonomy, school climate, time pressure, workload, resilience, stress, burnout, and turnover intentions. The analysis demonstrates that school administration leadership directly affects these aspects by providing support in challenging situations, empowering teachers, offering recognition, facilitating open communication, and ensuring autonomy at work. In conclusion, the research shows that teachers' professional well-being is heavily dependent on relationships with school administration, colleagues, and students, as well as the overall school climate. It suggests that by enhancing these elements, school leaders can significantly improve teacher professional well-being. Recommendations are made for developing strategies to support these relationships, thereby fostering an environment that enhances teacher retention and effectiveness.

Keywords: concept analysis, teacher professional well-being, school administration leadership, well-being factors

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Authors: Eva Ujaczki, Rama Krishna Chinnam, Ronan Courtney, Syed A. M. Tofail, Lisa O'Donoghue

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Concrete is the second most widely used material in the world and is made of cement, sand, and aggregates. Cement is a hydraulic binder which reacts with water to form a solid material. In the cement manufacturing process, the right mix of minerals from mined natural rocks, e.g., limestone is melted in a kiln at 1450 °C to form a new compound, clinker. In the final stage, the clinker is milled into a fine cement powder. The principal cement types manufactured in Ireland are: 1) CEM I – Portland cement; 2) CEM II/A – Portland-fly ash cement; 3) CEM II/A – Portland-limestone cement and 4) CEM III/A – Portland-round granulated blast furnace slag (GGBS). The production of eco-efficient, blended cement (CEM II, CEM III) reduces CO₂ emission and improves energy efficiency compared to traditional cements. Blended cements are produced locally in Ireland and more than 80% of produced cement is blended. These eco-efficient, blended cements are a relatively new class of construction materials and a kind of geopolymer binders. From a terminological point of view, geopolymer cement is a binding system that is able to harden at room temperature. Geopolymers do not require calcium-silicate-hydrate gel but utilize the polycondensation of SiO₂ and Al₂O₃ precursors to achieve a superior strength level. Geopolymer materials are usually synthesized using an aluminosilicate raw material and an activating solution which is mainly composed of NaOH or KOH and Na₂SiO₃. Cement is the essential ingredient in concrete which is vital for economic growth of countries. The challenge for the global cement industry is to reach to increasing demand at the same time recognize the need for sustainable usage of resources. Therefore, in this research, we investigated the potential for Irish wastes to be used in geopolymer cement type applications through a national stakeholder workshop with the Irish construction sector and relevant stakeholders. This paper aims at summarizing Irish stakeholder’s perspective for introducing new secondary raw materials, e.g., bauxite residue or increasing the fly ash addition into cement for eco-efficient cement production.

Keywords: eco-efficient, cement, geopolymer, blending

Procedia PDF Downloads 166

Authors: Lima Antony

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In G. M. Hopkins’s poetics and aesthetics there is scope for a comparative study with Indian discourses on aesthetics, an area not adequately explored so far. This exploration will enrich the field of comparative study of diverse cultural expressions and their areas of similarity. A comparative study of aesthetic and religious experiences in diverse cultures will open up avenues for the discovery of similarities in self-experiences and their transcendence. Such explorations will reveal similar patterns in aesthetic and religious experiences. The present paper intends to prove this in the theories of Hopkins and Indian aesthetics. From the time of the Vedas Indian sages have believed that aesthetic enjoyment could develop into a spiritual realm. From the Natyasastra of Bharata, Indian aesthetics develops and reaches its culmination in later centuries into a consciousness of union with the mystery of the Ultimate Being, especially in Dhvanaāloka of Anandavardhana and Locana of Abhinavagupta. Dhvanyaloka elaborates the original ideas of rasa (mood or flavor) and dhvani (power of suggestion) in Indian literary theory and aesthetics. Hopkins was successful, like the ancient Indian alankarikas, in creating aesthetically superb patterns at various levels of sound and sense for which he coined the term ‘inscape’. So Hopkins’s aesthetic theory becomes suitable for transcultural comparative study with Indian aesthetics especially the dhvani theories of Anandavardhana and Abhinavagupta. Hopkins’s innovative approach to poetics and his selection of themes are quite suitable for analysis in the light of Indian literary theories. Indian philosophy views the ultimate reality called Brahman, as the 'soul,' or inner essence, of all reality. We see in Hopkins also a search for the essence of things and the chiming of their individuality with the Ultimate Being in multidimensional patterns of sound, sense and ecstatic experience. This search culminates in the realization of a synthesis of the individual self with the Ultimate Being. This is achieved through an act of surrender of the individuality of the self before the Supreme Being. Attempts to reconcile the immanent and transcendent aspects of the Ultimate Being can be traced in the Indian as well as Hopkins’s aesthetics which can contribute to greater understanding and harmony between cultures.

Keywords: Dhvani, Indian aesthetics, transcultural studies, Rasa

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Authors: Ese Urhie, Bosede Olopade, Muyiwa Oladosun, Henry Okodua

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In the past three and half decades, aside from the fact that the contribution of the industrial sector to gross domestic product in Nigeria has nose-dived, its performance has also been highly unstable. Investment funds needed to develop the industrial sector usually come from both internal and external sources. The internal sources include surplus generated within the industrial sector and surplus diverted from other sectors of the economy. It has been observed that due to the small size of the industrial sector in developing countries, very limited funds could be raised for further investment. External sources of funds which many currently industrialized and some ‘newly industrializing countries’ have benefited from including direct and indirect investment by foreign capitalists; foreign aid and loans; and investments by nationals living abroad. Foreign direct investment inflow in Nigeria has been declining since 2009 in both absolute and relative terms. High level of human capital has been identified as one of the crucial factors that explain the miraculous growth of the ‘Asian Tigers’. Its low level has also been identified as the major cause for the low level of FDI flow to Nigeria in particular and Africa in general. There has been positive, but slow improvement in human capital indicators in Nigeria in the past three decades. In spite of this, foreign direct investment inflow has not only been low; it has declined drastically in recent years. i) Why has the improvement in human capital in Nigeria failed to attract more FDI inflow? ii) To what extent does the level of human capital influence FDI inflow in Nigeria? iii) Is there a threshold of human capital stock that guarantees sustained inflow of FDI? iv) Does the quality of human capital matter? v) Does the influence of other (negative) factors outweigh the benefits of human capital? Using time series secondary data, a system of equations is employed to evaluate the effect of human capital on FDI inflow in Nigeria on one hand and the effect of FDI on the level of industrialization on the other. A weak relationship between human capital and FDI is expected, while a strong relationship between FDI and industrial growth is expected from the result.

Keywords: human capital, foreign direct investment, industrialization, gross domestic product

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Authors: Martins A. Adefisoye, Mpaka Lindelwa, Fadare Folake, Anthony I. Okoh

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Evolution and rapid dissemination of antibiotic resistance from one ecosystem to another has been responsible for wide-scale epidemic and endemic spreads of multi-drug resistance pathogens. This study assessed the prevalence of Enterobacteriaceae in different environmental samples, including river water, hospital effluents, abattoir wastewater, animal rectal swabs and faecal droppings, soil, and vegetables, using standard microbiological procedure. The identity of the isolates were confirmed using matrix-assisted laser desorption ionization-time of flight mass spectrophotometry (MALDI-TOF) while the isolates were profiled for resistance against a panel of 16 antibiotics using disc diffusion (DD) test, and the occurrence of resistance genes (ARG) was determined by polymerase chain reactions (PCR). Enterobacteriaceae counts in the samples range as follows: river water 4.0 × 101 – 2.0 × 104 cfu/100 ml, hospital effluents 1.5 × 103 – 3.0 × 107 cfu/100 ml, municipal wastewater 2.3 × 103 – 9.2 × 104 cfu/100 ml, faecal droppings 3.0 × 105 – 9.5 × 106 cfu/g, animal rectal swabs 3.0 × 102 – 2.9 × 107 cfu/ml, soil 0 – 1.2 × 105 cfu/g and vegetables 0 – 2.2 × 107 cfu/g. Of the 700 randomly selected presumptive isolates subjected to MALDI-TOF analysis, 129 (18.4%), 68 (9.7%), 67 (9.5%), 41 (5.9%) were E. coli, Klebsiella spp., Enterobacter spp., and Citrobacter spp. respectively while the remaining isolates belong to other genera not targeted in the study. The DD test shows resistance ranging between 91.6% (175/191) for cefuroxime and (15.2%, 29/191) for imipenem The predominant multiple antibiotic resistance phenotypes (MARP), (GM-AUG-AP-CTX-CXM-CIP-NOR-NI-C-NA-TS-T-DXT) occurred in 9 Klebsiella isolates. The multiple antibiotic resistance indices (MARI) the isolates (range 0.17–1.0) generally showed >95% had MARI above the 0.2 thresholds, suggesting that most of the isolates originate from high-risk environments with high antibiotic use and high selective pressure for the emergence of resistance. The associated ARG in the isolates include: bla TEM 61.9 (65), bla SHV 1.9 (2), bla OXA 8.6 (9), CTX-M-2 8.6 (9), CTX-M-9 6.7 (7), sul 2 26.7 (28), tet A 16.2 (17), tet M 17.1 (18), aadA 59.1 (62), strA 34.3 (36), aac(3)A 19.1 (20), (aa2)A 7.6 (8), and aph(3)-1A 10.5 (11). The results underscore the need for preventative measures to curb the proliferation of antibiotic-resistant bacteria including Enterobacteriaceae to protect public health.

Keywords: enterobacteriaceae, antibiotic-resistance, MALDI-TOF, resistance genes, MARP, MARI, public health

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Authors: Slah Eddine Ben Fadhel

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Despite the development of new pedagogic methods, current teaching practices put more emphasis on the learning products than on the processes learners deploy. In school syllabi, for instance, very little time is devoted to both the explanation and analysis of strategies aimed at resolving problems by means of targeting students’ metacognitive procedures. Within a cognitive framework, teaching/learning contexts are conceived of in terms of cognitive, metacognitive and affective activities intended for the treatment of information. During these activities, learners come to develop an array of knowledge and strategies which can be subsumed within an active and constructive process. Through the investigation of strategies and metacognition concepts, the purpose is to reflect upon the modalities at the heart of the learning process and to demonstrate, similarly, the inherent significance of a cognitive approach to learning. The scope of this paper is predicated on a study where the population is a group of 76 primary school pupils who experienced difficulty with learning French. The population was divided into two groups: the first group was submitted during three months to a strategy-based training to learn French. All through this phase, the teachers centred class activities round making learners aware of the strategies the latter deployed and geared them towards appraising the steps these learners had themselves taken by means of a variety of tools, most prominent among which is the logbook. The second group was submitted to the usual learning context with no recourse whatsoever to any strategy-oriented tasks. The results of both groups point out the improvement of linguistic competences in the French language in the case of those pupils who were trained by means of strategic procedures. Furthermore, this improvement was noted in relation with the native language (Arabic), a fact that tends to highlight the importance of the interdisciplinary investigation of (meta-)cognitive strategies. These results show that strategic learning promotes in pupils the development of a better awareness of their own processes, which contributes to improving their general linguistic competences.

Keywords: constructive approach, cognitive strategies, metacognition, learning

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Authors: Varsha Chorsiya, Pooja Aneja, Dhananjay Kaushik, Abhinav Yadav

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Intoduction: Women’s Health Initiatives (WHI) focuses on defining the risks and benefits of strategies that could potentially reduce the incidence of obesity, heart disease, breast cancer and colorectal cancer, and fractures in menopause women. The utility of the present research work determines to find the role of Hormone Replacement Therapy (HRT) in changing the different component of body composition during perimenopause period. Methods: A comparative cross-sectional study included 30 subjects, aged between 40 and 50 years which were assigned into 2 groups i.e. 15 subjects in HRT (Group A) and 15 subjects in non-HRT (Group B). The subjects were taken from the hospitals and clinics of Faridabad undergoing HRT in supervision of the consultant gynecologist. The informed consents were signed before including the participants in the study. The body composition and lipid profile were evaluated for all the subjects. Result and Discussion: The BMI, body density, percent body fats and fat mass in both groups showed statistically significant differences i.e. p < 0.05. Our study did not reveal any statistically significant difference between non-HRT and HRT for lipid profile composition of HDL, LDL, VLDL, ratio, triglycerides and total cholesterol although these indicators (LDL, VLDL, ratio, triglycerides and total cholesterol) showed difference clinically with a higher mean values for non-HRT as compared to HRT group. The mean value for HDL was higher for HRT group in contrast to non-HRT group. The result clearly showed that HRT group has a good lipid profile composition. Conclusion: In conclusion, our data show that HRT has statistically significant role in determining BMI, fat percent mass and fat mass. The lipid profile including LDL, HDL, VLDL, ratio, triglycerides and total cholesterol found to be clinically better in HRT group as compared to the non-HRT group. The rationale for non-significant lipid profile probably lie in the fact that hormonal changes need a particular time period and might become significant in post-menopausal period.

Keywords: body composition, hormone replacement therapy, perimenopause, women health

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Authors: Saleh Kasiri Bidhendi, Shiva Tashakori

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With the increasing application of six-wheel robots in various industries, including agriculture and environmental monitoring, there is a growing demand for efficient and reliable control systems that can improve manoeuvrability and at the same time reduce energy consumption. Moving on uneven terrains, various factors such as obstacles or soil heterogeneity can cause the robot to slip. There is limited research addressing this issue. Although the robot is supposed to track a predetermined path, sudden lateral deviation necessitates path planning. To further address this issue, explicit steering is added by activating actuators on steerable wheels, while the SMC controller still commands differential traction forces on all wheels. This integration improves energy efficiency and obstacle traversability while maintaining the merits of skid-steering, such as tight turning manoeuvrability. However, achieving the desired steer angles presents certain challenges. Inverse kinematics was initially employed to achieve the needed steering angles from the desired position, but this approach led to excessive steering without yawing the body. Switching to desired velocity values instead of position limited over-steering but caused zero lateral velocity on horizontal paths, which was problematic for unforeseen skidding. To overcome this, a proportional controller has been employed, using lateral error as its input and providing a proportional yaw angle as output, the P-controller contributes to modifying the steering angles. The controller's robustness has been verified through sensitivity analyses under critical speeds and turning radius conditions. Our findings offer valuable insights into designing more efficient steering controls for rocker-bogie mechanisms in challenging situations, emphasizing the importance of reducing energy¬ consumption.

Keywords: six-wheel robots, inverse kinematics, integrated steering, path following, manoeuvrability, energy efficiency, uneven terrains

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Authors: Samar Swaid

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Today, corporates are moving toward the adoption of Design-Thinking techniques to develop products and services, putting their consumer as the heart of the development process. One of the leading companies in Design-Thinking, IDEO (Innovation, Design, Engineering Organization), defines Design-Thinking as an approach to problem-solving that relies on a set of multi-layered skills, processes, and mindsets that help people generate novel solutions to problems. Design thinking may result in new ideas, narratives, objects or systems. It is about redesigning systems, organizations, infrastructures, processes, and solutions in an innovative fashion based on the users' feedback. Tim Brown, president and CEO of IDEO, sees design thinking as a human-centered approach that draws from the designer's toolkit to integrate people's needs, innovative technologies, and business requirements. The application of design thinking has been witnessed to be the road to developing innovative applications, interactive systems, scientific software, healthcare application, and even to utilizing Design-Thinking to re-think business operations, as in the case of Airbnb. Recently, there has been a movement to apply design thinking to machine learning and artificial intelligence to ensure creating the "wow" effect on consumers. The Association of Computing Machinery task force on Data Science program states that" Data scientists should be able to implement and understand algorithms for data collection and analysis. They should understand the time and space considerations of algorithms. They should follow good design principles developing software, understanding the importance of those principles for testability and maintainability" However, this definition hides the user behind the machine who works on data preparation, algorithm selection and model interpretation. Thus, the Data Science program includes design thinking to ensure meeting the user demands, generating more usable machine learning tools, and developing ways of framing computational thinking. Here, describe the fundamentals of Design-Thinking and teaching modules for data science programs.

Keywords: data science, design thinking, AI, currculum, transformation

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Authors: Ritwik Saha, Anindita Chaudhuri

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The psychological dimension of work-based mobility of the contemporary time in the context of the ever-changing socio-economic process mounting the interest to address the consequential issues of quality of life and well-being of the migrant section of society. The negotiation with the fluidity of the job market and the changing psychosocial dimensions within and between psychosocial relations may disentangle the resilience as well as the mechanism of diligence toward migrant (marginal) life. The work-based mobility and its associated phenomena have highly impacted the migrant’s quality of life especially the marginalized (socioeconomically weak) ones along with their family members staying away from them. The subjective experiences of the journey of their migrant life and reconstruction of the psychosocial being in terms of existence and well-being at the host place are the minimal addressed issues in migrant literature. Hence this gap instigates to bring forth the issue with the present study exploring the phenomenal aspects of lived experiences, resilience, and sense-making of the well-being of migrant living by the marginalized migrant people engaging in unorganized space. In doing so qualitative research method was followed, and semi-structured interviews were used for data collection from the four selected migrant groups (Fuchkawala, Bhunjawala, Bhari - drinking water supplier, Construction worker) as they migrated to Kolkata and its metropolis area from different states of India, Five participants from each group (20 participants in total) age range between 20 to 45 were interviewed physically and participants’ observatory notes were taken to capture their lived experiences, audio recordings were transcribed and analyzed systematically following Charmaz’s three-layer coding of grounded theory. Being truthful to daily industry, the strong desire to build children’s future, the mastering mechanism to dual existence, use of traditional social network these four themes emerges after analysis of the data. However, incorporating fate as their usual way of life and making sense of well-being through their assertion is another evolving aspect of migrant life.

Keywords: lived experiences, marginal living, resilience, sense-making process, well-being

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Authors: Shahrzad Zolfagharnassab, Abdul Rashid Mohamed Shariff, Reza Ehsani, Hawa Ze Jaffar, Ishak Aris

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Ripeness estimation of oil palm fresh fruit is important processes that affect the profitableness and salability of oil palm fruits. The adulthood or ripeness of the oil palm fruits influences the quality of oil palm. Conventional procedure includes physical grading of Fresh Fruit Bunches (FFB) maturity by calculating the number of loose fruits per bunch. This physical classification of oil palm FFB is costly, time consuming and the results may have human error. Hence, many researchers try to develop the methods for ascertaining the maturity of oil palm fruits and thereby, deviously the oil content of distinct palm fruits without the need for exhausting oil extraction and analysis. This research investigates the potential of infrared images (Thermal Images) as a predictor to classify the oil palm FFB ripeness. A total of 270 oil palm fresh fruit bunches from most common cultivar of oil palm bunches Nigresens according to three maturity categories: under ripe, ripe and over ripe were collected. Each sample was scanned by the thermal imaging cameras FLIR E60 and FLIR T440. The average temperature of each bunches were calculated by using image processing in FLIR Tools and FLIR ThermaCAM researcher pro 2.10 environment software. The results show that temperature content decreased from immature to over mature oil palm FFBs. An overall analysis-of-variance (ANOVA) test was proved that this predictor gave significant difference between underripe, ripe and overripe maturity categories. This shows that the temperature as predictors can be good indicators to classify oil palm FFB. Classification analysis was performed by using the temperature of the FFB as predictors through Linear Discriminant Analysis (LDA), Mahalanobis Discriminant Analysis (MDA), Artificial Neural Network (ANN) and K- Nearest Neighbor (KNN) methods. The highest overall classification accuracy was 88.2% by using Artificial Neural Network. This research proves that thermal imaging and neural network method can be used as predictors of oil palm maturity classification.

Keywords: artificial neural network, maturity classification, oil palm FFB, thermal imaging

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Authors: Pankaj Singh Rawat, Rajeew Kumar, Pradeep Ram, Priyanka Pandey

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Wheat is an important cereal crop for food security. Boosting the wheat production and productivity is the major challenge across the nation. Good quality of seed is required for maintaining optimum plant stand which ultimately increases grain yield. Ensuring a good germination is one of the key steps to ensure proper plant stand and moisture assurance during seed germination may help to speed up the germination. The tiny size of nanoparticles may help in entry of water into seed without disturbing their internal structure. Considering above, a laboratory experiment was conducted during 2012-13 at G.B. Pant University of Agriculture and Technology, Pantnagar, India. The completely randomized design was used for statistical analysis. The experiment was conducted in two phases. In the first phase, the appropriate concentration of nanoparticles for seed treatment was screened. In second phase seed soaking hours of nanoparticles for better seed germination were standardized. Wheat variety UP2526 was taken as test crop. Four nanoparticles (TiO₂, ZnO, nickel and chitosan) were taken for study. The crop germination studies were done in petri dishes and standard package and practices were used to raise the seedlings. The germination studies were done by following standard procedure. In first phase of the experiment, seeds were treated with 50 and 300 ppm of nanoparticles and control was also maintained for comparison. In the second phase of experiment, seeds were soaked for 4 hours, 6 hours and 8 hours with 50 ppm nanoparticles of TiO₂, ZnO, nickel and chitosan along with control treatment to identify the soaking time for better seed germination. Experiment revealed that the application of nanoparticles help to enhance seed germination. The study revealed that seed treatment with  nanoparticles at 50 ppm concentration increases root length, shoot length, seedling length, shoot dry weight, seedling dry weight, seedling vigour index I and seedling vigour index II as compared to seed soaking at 300 ppm concentration. This experiment showed that seed soaking up to 4 hr was better as compared to 6 and 8 hrs. Seed soaking with nanoparticles specially TiO₂, ZnO, and chitosan proved to enhance germination and seedling growth indices of wheat crop.

Keywords: nanoparticles, seed germination, seed soaking, wheat

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Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: M.Younus, M. Athar Khan, Asif Adrees

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The present research endeavour was made to investigate the Public Health impact of Salmonellosis through consuming the meat and eggs of the carrier’s birds and to see the prevalence of Salmonella enteritidis and Salmonella typhimurium from poultry feed, poultry meat, and poultry eggs and their role in the chain of transmission of salmonellae to human beings and causing food poisoning. The ultimate objective was to generate data to improve the quality of poultry products and human health awareness. Salmonellosis is one of the most wide spread food borne zoonoses in all the continents of the world. The etiological agents Salmonella enteritidis and Salmonella typhimurium not only produce the disease but during the convalescent phase (after the recovery of disease) remain carriers for indefinite period of time. The carrier state was not only the source of spread of disease with in the poultry but also caused typhoid fever in humans. The chain of transmission started from poultry feed to poultry meat and ultimately to humans as dead end hosts. In this experiment a total number of 200 samples of human stool and blood were collected randomly (100 samples of human stool and 100 samples of human blood) of 100 patients suspected from food poisoning patients from different hospitals of Lahore area for the identification of Salmonella enteritidis and Salmonella typhimurium through PCR method in order to see the public health impact of Salmonellosis through consuming the meat and eggs of the carrier birds. On the average 14 and 10 stool samples were found positive against Salmonella enteritidis and Salmonella typhimurium from each of the 25 patients from each hospital respectively in case of suspected food poisoning patients. Similarly on an average 5% and 6% blood samples were found positive from 25 patients of each hospital respectively. There was a significant difference (P< 0.05) in the sero positivity of stool and blood samples of suspected food poisoning patients as far as Salmonella enteritidis and Salmonella typhimurium was concerned. However there was no significant difference (P<0.05) between the hospitals.

Keywords: salmonella, zoonosis, food, transmission, eggs

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Authors: Mahnaz Jafari, Parisa Izadpanahi, Francesco Mancini, Muhammad Qureshi

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The advancement in Information Technology (IT) has been an intrinsic element in the developments of the 21st century bringing benefits such as increased economic productivity. However, its widespread application has also been associated with inadvertent negative impacts on society and the environment necessitating selective interventions to mitigate these impacts. This study responded to this need by developing a Green IT Rating Tool (GIRT) for higher education institutions (HEI) in Australia to evaluate the sustainability of IT-related practices from an environmental, social, and economic perspective. Each dimension must be considered equally to achieve sustainability. The development of the GIRT was informed by the views of interviewed IT professionals whose opinions formed the basis of a framework listing Green IT initiatives in order of their importance as perceived by the interviewed professionals. This framework formed the base of the GIRT, which identified Green IT initiatives (such as videoconferencing as a substitute for long-distance travel) and the associated weighting of each practice. The proposed sustainable Green IT model could be integrated into existing IT systems, leading to significant reductions in carbon emissions and e-waste and improvements in energy efficiency. The development of the GIRT and the findings of this study have the potential to inspire other organizations to adopt sustainable IT practices, positively impact the environment, and be used as a reference by IT professionals and decision-makers to evaluate IT-related sustainability practices. The GIRT could also serve as a benchmark for HEIs to compare their performance with other institutions and to track their progress over time. Additionally, the study's results suggest that virtual and cloud-based technologies could reduce e-waste and energy consumption in the higher education sector. Overall, this study highlights the importance of incorporating Green IT practices into the IT systems of HEI to contribute to a more sustainable future.

Keywords: green information technology, international higher-educational institution, sustainable solutions, environmentally friendly IT systems

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