Search results for: environmental cases

Authors: Raul Guerrero, Sandro Machado, Miriam Carvalho

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Soil and aquifer pollution, caused by hydrocarbon liquid spilling, is induced by misguided operational practices and inefficient safety guidelines. According to the Environmental Brazilian Institute (IBAMA), during 2013 alone, over 472.13 m3 of diesel oil leaked into the environment nationwide for those reported cases only. Regarding the aforementioned information, there’s an indisputable need to adopt appropriate environmental safeguards specially in those areas intended for the production, treatment, transportation and storage of hydrocarbon fluids. According to Brazilian norm, ABNT-NBR 7505-1:2000, compacted soil or mineral barriers used in structural contingency levees, such as storage tanks, are required to present a maximum water permeability coefficient, k, of 1x10-6 cm/s. However, as discussed by several authors, water can not be adopted as the reference fluid to determine the site’s containment performance against organic fluids. Mainly, due to the great discrepancy observed in polarity values (dielectric constant) between water and most organic fluids. Previous studies, within this same research group, proposed an optimal range of values for the soil’s index properties for mineral barrier composition focused on organic fluid containment. Unfortunately, in some circumstances, it is not possible to encounter a type of soil with the required geotechnical characteristics near the containment site, increasing prevention and construction costs, as well as environmental risks. For these specific cases, the use of an organic product or material as an additive to enhance mineral-barrier containment performance may be an attractive geotechnical solution. This paper evaluates the effect of activated carbon (AC) content additions into a clayey soil towards hydrocarbon fluid permeability. Variables such as compaction energy, carbon texture and addition content (0%, 10% and 20%) were analyzed through laboratory falling-head permeability tests using distilled water and commercial diesel as percolating fluids. The obtained results showed that the AC with smaller particle-size reduced k values significantly against diesel, indicating a direct relationship between particle-size reduction (surface area increase) of the organic product and organic fluid containment.

Keywords: activated carbon, clayey soils, permeability, surface area

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Authors: Yu Li, Jingwu He, Yuexi Xiong

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The spar layout will affect the wing’s stiffness characteristics, and irrational spar arrangement will reduce the overall bending and twisting resistance capacity of the wing. In this paper, the active structural stiffness design theory is used to match the stiffness-center axis position and load-cases under the corresponding multiple flight conditions, in order to achieve better stiffness properties of the wing. The combination of active stiffness method and principle of stiffness distribution is proved to be reasonable supplying an initial reference for wing designing. The optimized layout of spars is eventually obtained, and the high-aspect-ratio wing will have better stiffness characteristics.

Keywords: active structural stiffness design theory, high-aspect-ratio wing, flight load cases, layout of spars

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Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

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Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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Authors: Ajitesh Pal, Arpan Datta Roy, H. K. Pratihari

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The different illegal firearms crudely made by skilled gunsmith from scrap materials are popularly known as country made firearms. Such firearms along with improvised ammunition are clandestinely marketed at the cheaper price without any license to the extremist group, criminal, poachers and firearm lovers. As per National Crime Records Bureau (NCRB), MHA, Govt of India about 80% firearm cases are committed by country made/improvised firearms. The ballistic division of the laboratory has examined a good number of cases. The analysis of firearm cases received for forensic examination revealed that 7.65mm calibre pistols mostly improvised firearm are commonly used in firearm related crime cases. In the present communication, physical parameters and other characteristics features of some 7.65mm calibre pistols have been discussed in detail. The detailed study on country made (CM) firearm will help to prepare a database related to type of material used, origin of the raw material and tools used for inscription. The study also includes to establish the chemistry of propellants & head stamp pattern. The database will be helpful to the firearm examiners, researchers, students pursuing study on forensic science as reference material.

Keywords: improvised pistol, stringent gun law, working mechanism, parameters, database

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Authors: Auttasuriyanan Pakpoom, Setthasakko Watchaneeporn

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The main purpose of this study is to gain a clearer understanding of key determinants that drive environmental management and barriers that hinder its development. The study employs semi-structured interviews with key informants accompanied by site observations. Key informants include production, environmental and plant managers of six beverage companies, including three Thai and three multinational companies in Thailand. It is found that corporate image, government subsidies, top management leadership and education institutes are four primary factors influencing the implementation of environmental management in the beverage processors. No demand from Asian buyers, employee resistance to change and lack of environmental knowledge are identified as barriers.

Keywords: environmental management, beverage, government subsidies, education institutes, employee resistance, environmental knowledge, Thailand

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Authors: Somayeh Bahrami, Seyed Jalal Dehghani Firoozabadi

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Environmental governance is an interdisciplinary concept in political ecology and environmental policy focusing on the necessity of embedding the environmental issues in all levels of decision-making and act of states. Similar to sustainable development the concept of environmental governance believes that economic and political life of societies and countries need to be considered as a subset of the environment. This concept has been accepted by North Countries, those that have done the most irreparable environmental damage since the Industrial Revolution. Although North Countries are more responsible for damage to the environment, considering the global fluidity logic of environmental challenges, such an impression doesn’t cause developing countries to disavow responsibility for regional and international cooperation to protect the environment. Establishing an environmental governance at all levels of local, national, regional and global is one of the most significant ways to improve sustainable development. Given to the various political and economic difficulties developing countries including the Middle East face, building environmental governance in these countries is difficult but feasible, as these difficulties have not impeded their mutual partnership for confronting joint environmental issues. However, the environmental issues wouldn’t be solved only by mutual partnership but by establishing environmental governance, establishing regional environmental institutions (an introduction to building Regional Environmental Governance) and delegation of some environmental authorities to the mentioned institutions. The research is aimed at examining necessities, opportunities, and barriers to establishing Regional Environmental Governance in the Middle East. Therefore, this research seeks to answer the question of whether establishing Regional Environmental Governance is possible in the Middle East and if so then why. This study used descriptive-analytical methods and the inferential methodology has been used to reach the goals. Data has been collected by using library and internet sources as well as news sources on the basis of objective-historical data.

Keywords: environmental democracy (ED), environmental governance (EG), middle east (ME), regional environmental governance (REG)

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Authors: Oluwasegun A. Oke, Mayowa A. Abolaji, Oluwaseun A. Adefila

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Environmental problems have become a priority on the world political agenda for the last two decades and this is inevitably linked with the general degradation of our environment which calls for ultimate attention. Therefore, this study searched for better and more involving methods of imparting environmental knowledge to average learner with the view of creating awareness, increasing knowledge as well as changing their attitude positively towards conservation of the environment. The study also investigated the effectiveness of conservation club in creating awareness (among students) about environmental conservation. About 240 Students were randomly selected for data collection using validated instruments (questionnaires). T-test statistics, chi-square and simple percentage were the major statistical tools employed in data analysis. This study revealed that environmental conservation club plays a vital role in creating awareness as well as promoting students understanding of environmental issues to promote positive attitude towards natural environment.

Keywords: environmental conservation, biodiversity, awareness program, environmental disasters

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Authors: Benoit Jauniaux, Azzam Ismail

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Objectives: The aims were to identify all incident adult cases of idiopathic inflammatory myopathies (IIMs) in the City of Leeds, UK, and to estimate the risk of cancer in IIMs as compared with the general population. Methods: Cases of IIMs were ascertained by review of all muscle biopsy reports from the Neuropathology Laboratory. A review of medical records was undertaken for each case to review the clinical diagnosis and collect epidemiological data such as age, ethnicity, sex, and comorbidities, including cancer. Leeds denominator population numbers were publicly obtainable. Results: Two hundred and six biopsy reports were identified, and after review, 50 incident cases were included in the study between June 2010 and January 2021. Out of the 50 cases, 27 were male, and 23 were female. The mean incidence rate of IIMs in Leeds throughout the study period was 7.42/1 000 000 person years. The proportion of IIMs cases with a confirmed malignancy was 22%. Compared to the general population, the relative risk of cancer was significantly greater in the IIMs population(31.56, P < 0.01). Conclusions: The incidence rate of IIMs in Leeds was consistent with data from previous literature, however, disagreement exists between different methods of IIMs case inclusion due to varying clinical criteria and definitions. IIMs are associated with increased risk of cancer however, the pathogenesis of this relationship still requires investigating. This study supports the practice of malignancy screening and long-term surveillance in patients with IIMs.

Keywords: idiopathic inflammatory myopathies, myositis, polymyositis, dermatomyositis, malignancy, epidemiology, incidence rate, relative risk

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Authors: Hadi Rouhi Belvirdi

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With the increasing demand for sustainable development, recycled materials are receiving more attention in construction projects. To promote sustainable development, this review article evaluates the feasibility of using recycled concrete in construction projects from an economic and environmental perspective. The results show that making concrete using recycled concrete is a suitable strategy for sustainable development. A complete examination of the physical and chemical properties of these recycled materials also provides important information about their suitability for use in the construction industry. Most of the studies do not show surprising results of the compressive or bending strength of these materials, and only the aspect of sustainable development of these materials is of interest. Their application can be investigated more in masonry and joinery works, but among them, some studies sometimes obtained more compressive and bending strength than the control sample, which can be used in concrete structures. Most of the cases introduced and discussed in this study can be implemented and help the country and the people of Iran preserve the environment and discuss sustainable development.

Keywords: environmental recycling, sustainable development, recycled materials, construction management

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Authors: Y. A. Kumar

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Environmental awareness issues in Kazakhstan are one of the most undermined topics both among the public community and in terms of state rhetoric. In the context of official state documents, so far only two official environmental codes and national programs called Zhasyl Kazakhstan were introduced in the country in 2021. While on the one hand the Environmental Code was introduced with the purpose to modernize, frame and enlist main legislative aspects on various sectors of environmental law in Kazakhstan, on the other hand, the Zhasyl Kazakhstan Program has been implemented as a state program to address with numerous environmental projects various environmental issues ranging from air pollution to waste management as well as aspects related to ecological education and low environmental awareness matters. In this regard, the main goal of this paper is to analyze critically the main content of both of these documents with a particular focus on sections related to environmental awareness-raising aspects. For that, this paper applied a subjective-based content analysis in order to identify interesting insights on regulatory legal aspects, future research streams, and uncovering of improved legislative frameworks in the context of an environmental awareness issue. Apart from that, five open-ended questions were sent out to the Ministry of Ecology, Geology and Natural Resources to obtain primary data on the state’s view in regards to current previous, recent and future aspects of environmental awareness issues in the country.

Keywords: Kazakhstan, environmental awareness, environmental code, Zhasyl Kazakhstan, content analysis

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Authors: Martin Gascón Hove, Ralph Vermeltfoort, Alessandro Fiorini, Erwan Dulaurent, Henning von Perbandt

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Introduction: The outbreak of the COVID-19 pandemic has completely changed the global health situation, with more than 400 million cases published and over 5 million deaths. European Air Transport Command (EATC) is integrated by seven nations, and among its capabilities is that of aeromedical evacuation (AM). Material and methods: Impact of novel coronavirus was analysed based on the number and characteristics of patients and executed missions within EATC and, particularly by Spain, during the biennium 2020-2021. Results: One thousand sixty patients were transported in 186 missions. Neither death nor disease contagion was reported during AM performances. Military cases transferred were 986, mostly routine priority (91,4%), and 74 were civilians, who were transported in 17 missions, and 81,1% of which were categorized as urgent. Niger led the list of original countries, with 191 evacuated patients. 76,1% of requests came from Italy and Germany. Airbus A310 was the most used aircraft (32,2%). Germany transported 222 patients of another nationality, while Spain executed eight missions and repatriated 68 cases, 58 of which were from Mali. Conclusions: COVID-19 has led to a surged number of evacuated patients inside EATC, which has proven to be a safe and effective means of transportation, even in critical cases. Spain has gained prominence since its annexation in 2015.

Keywords: COVID-19, SARS-CoV-2, pandemic, aviation, Spain

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Authors: Amaliny Yoganathan-Hasselbeck

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Based on the assumption, that strategic licensing is more valuable and sustainable for the economy than a legal dispute and action for an injunction, the strategy of licensing in patent infringement cases was studied. A theoretical framework was developed based on the transaction costs approach, describing the major variables within the process of licensing to an alleged patent infringer. An exploratory case study analysis was conducted on the basis of expert interviews with patent licensing agencies, patent attorneys, licensing departments of companies and research institutions. Key findings define the major criteria in each step of the licensing process and include the factors determining the intensity of patent tracking e.g. patent policies, the decision criteria when dealing with patent infringement cases, e.g. market position and reputation, and the transaction itself starting with the initiation of the contact with the alleged patent infringer, negotiating the licensing contract and monitoring the license agreement.

Keywords: innovation, licensing, patent, patent infringement, strategy, technology

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Authors: Massimo Tadi, M. Hadi Mohammad Zadeh, Ozge Ogut

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Although how cities’ forms are structured is studied, more efforts are needed on systemic comprehensions and evaluations of the urban morphology through quantitative metrics that are able to describe the performance of a city in relation to its formal properties. More research is required in this direction in order to better describe the urban form characteristics and their impact on the environmental performance of cities and to increase their sustainability stewardship. With the aim of developing a better understanding of the built environment’s systemic structure, the intention of this paper is to present a holistic methodology for studying the behavior of the built environment and investigate the methods for measuring the effect of urban structure to the environmental performance. This goal will be pursued through an inquiry into the morphological components of the urban systems and the complex relationships between them. Particularly, this paper focuses on proximity, referring to the proximity of different land-uses, is a concept with which Integrated Modification Methodology (IMM) explains how land-use allocation might affect the choice of mobility in neighborhoods, and especially, encourage or discourage non-motived mobility. This paper uses proximity to demonstrate that the structure attributes can quantifiably relate to the performing behavior in the city. The target is to devise a mathematical pattern from the structural elements and correlate it directly with urban performance indicators concerned with environmental sustainability. The paper presents some results of this rigorous investigation of urban proximity and its correlation with performance indicators in four different areas in the city of Milan, each of them characterized by different morphological features.

Keywords: built environment, ecology, sustainable indicators, sustainability, urban morphology

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Authors: Hanan Mohamed Abd Elmoneim, Rawan Saleh AlJawi, Razan Saleh AlJawi, Aseel Abdullah AlMasoudi , Zyad Adnan Turkistani, Anas Abdulkarim Alkhoutani , Ohood Musaed AlJuhani , Hanan Attiyah AlZahrani

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Background Esophageal cancer is the eighth most common cancer worldwide. More than 90% of esophageal cancers are either squamous cell carcinoma or adenocarcinoma. Squamous dysplasia is a precancerous lesion for squamous cell carcinoma and Barrett's esophagus is the precancerous lesion for adenocarcinoma. Gastro-esophageal reflux disease (GERD) is the initiation factor for Barrett's esophagus. Cyclooxygenase-2 (COX-2) is a key enzyme in arachidonic metabolism. It appears to play an important role in gastrointestinal carcinogenesis. COX-2 activity may be a potential target for the prevention of cancer progression by selective COX-2 inhibitors, which decrease proliferation and increase apoptosis. Objectives To assess COX-2 expression in premalignant and malignant esophageal epitheliums changes and detect its roles in progression of these lesions. Materials and Methods We analyzed the expression of COX-2 immunohistochemically in 40 esophageal biopsies utilizing the streptavidin-biotin-peroxidase complex method on archival formalin fixed-paraffin embedded blocks. Histopathologically, 17 (42.5%) of cases were non-malignant cases which included GERD, Barrett's esophagus and squamous dysplasia. The malignant cases were 23 (57.5%) squamous cell carcinoma, adenocarcinoma and undifferentiated carcinoma. Results In non-malignant cases 7 (41.2%) out of 17 cases had high COX-2 expression. In squamous cell carcinoma 10 (83.3%) out of 12 cases had high COX-2 expression. The expression of COX-2 was high in all 9 (100%) cases of adenocarcinoma. COX-2 expression is significantly increased (P=0.005 and P=0.0001) in squamous cell carcinoma and adenocarcinoma respectively. There was a significant difference in COX-2 immunoreactivity between malignant and non-malignant lesions (P=0.0003). Conclusion COX-2 is responsible for the progression of esophageal diseases from benign to malignant. We recommend that COX-2 immunohistochemistry should be done routinely for premalignant and malignant esophageal lesions as selective COX-2 inhibitors will be helpful in the treatment. Further studies on molecular and genetic basis of COX-2 expression are needed to unmask its role and relation to progression of esophageal lesions.

Keywords: Cox-2, Esophageal adinocarcinoma, Esophageal squamous cell carcinoma, Immunohistochemistry.

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Grienggrai Rajchakit

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As we all know that coronavirus is announced as a pandemic in the world by WHO. It is speeded all over the world with few days of time. To control this spreading, every citizen maintains social distance and self-preventive measures are the best strategies. As of now, many researchers and scientists are continuing their research in finding out the exact vaccine. The machine learning model finds that the coronavirus disease behaves in an exponential manner. To abolish the consequence of this pandemic, an efficient step should be taken to analyze this disease. In this paper, a recurrent neural network model is chosen to predict the number of active cases in a particular state. To make this prediction of active cases, we need a database. The database of COVID-19 is downloaded from the KAGGLE website and is analyzed by applying a recurrent LSTM neural network with univariant features to predict the number of active cases of patients suffering from the corona virus. The downloaded database is divided into training and testing the chosen neural network model. The model is trained with the training data set and tested with a testing dataset to predict the number of active cases in a particular state; here, we have concentrated on Andhra Pradesh state.

Keywords: COVID-19, coronavirus, KAGGLE, LSTM neural network, machine learning

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Authors: Saimir Heta, Rialda Xhizdari, Kers Kapaj, Ilma Robo

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Background: The interests of both individuals involved, both the dentist with his professionalism, and the patient who claims and expects the proper professional dental service, are determined in cases of dental malpractice. The latter is a phenomenon that is also wearing the "cloak" of bilateral manipulations, which in themselves require strong legal control to regulate the relations between the involved parties. The two individuals are involved both individually and even professionally and emotionally, with support in the "ultimate" interests of the two people, which in the case of conflicts or grievances, which as a result are transported to the family or society of the affected individual. Main text: The reason for malpractice is the most difficult part to find and then to interpret. It can be professional in the view of "so much I know how to do, so much done", or in the view of the impossibility of individual health conditions to achieve high professional expectations. But, the reason can also be individual with the intention of doing bad without reason or with the source of an unhealthy mind and the source of malicious thinking. The professional himself is a human being and as such may be under the effect of individual treatments or vices, therefore causing misuse, a case that must be distinguished from intentional misuse and which must be judged for the results or damages caused by the professional based on criminal law. Conclusions: Malpractice in some cases may be unavoidable, beyond the good intention of the dental intervention, which should be well understood by both parties involved in this relationship. Malpractice is not necessarily related only to difficult clinical cases, but sometimes also appears as a random deviation of a dental treatment with a welldefined professional protocol. The legal support in the interpretation of malpractice cases should be much more specific according to previous cases, this practice specifically, perhaps also according to different religious states.

Keywords: dental ethics, malpractice, professional dental service, legal support

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Authors: Lok Raj Joshi, Naveen Prakash Shah, Sharad Kumar Sharma, I. Ratna Bhattarai, Rajendra Basnet, Deepak Dahal, Bahagwan Maharjan, Seraphine Kaminsa

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Context: Tuberculosis (TB) is a significant health issue in Nepal, a country with a high burden of the disease. Despite efforts to control TB, there is still a gap in the notification of TB cases, which hinders effective control and treatment. This paper aims to address this notification gap and proposes strategies to improve TB control in Nepal. Research Aim: The aim of this research is to understand and address the tuberculosis notification gap in Nepal. The focus is on enhancing the healthcare system, involving the private sector and communities, raising awareness, and addressing social determinants to achieve sustainable TB control. Methodology: The research methodology involved a review of existing epidemiological data and research studies related to TB in Nepal. Additionally, consultation with an expert group from the TB control program in Nepal provided insights into the current state of TB control and challenges in addressing the notification gap. Findings: The findings reveal that only 55% of TB cases were reported in 2022, indicating a significant notification gap. Of the reported cases, only 32% and 19% were referred by the private sector and community, respectively. Furthermore, 20% of diagnosed cases were not treated in the initial phase. The estimated number of cases of multidrug-resistant TB (MDR TB) was 2,800, suggesting a low diagnosis rate. Among the diagnosed MDR TB cases, only 60% were receiving treatment. Additionally, it was observed that 20% of diagnosed MDR TB cases were from India and not enrolling in TB treatment in Nepal, indicating a high rate of defaulters. Theoretical Importance: The study highlights the importance of adopting a holistic strategy to address the notification gap in TB cases in Nepal. It emphasizes the need to enhance healthcare infrastructure, raise awareness, involve the private sector and local communities, establish effective methods to trace initial defaulters, implement TB interventions in border regions, and mitigate the social stigma associated with the disease. Data Collection and Analysis Procedures: Data for this study was collected through a review of existing epidemiological data and research studies. The data were then analyzed to identify patterns, trends, and gaps in TB case notification in Nepal.

Keywords: TB, tuberculosis, private sector, community, migrants, nepal

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Authors: Mudafara Bengleil

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Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: poisoning, children, hospital, medical

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Authors: Moon Jung Kim, Guil Rhim

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The clinical sensitivity of the “VEUPLEXTM TBI assay”, a clinical trial medical device, in mild traumatic brain injury was 28.6% (95% CI, 19.7%-37.5%), and the clinical specificity was 94.0% (95% CI, 89.3%). -98.7%). In addition, when the results analyzed by marker were put together, the sensitivity was higher when interpreting the two tests together than the two tests, UCHL1 and GFAP alone. Additionally, when sensitivity and specificity were analyzed based on CT results for the mild traumatic brain injury patient group, the clinical sensitivity for 2 CT-positive cases was 50.0% (95% CI: 1.3%-98.7%), and 19 CT-negative cases. The clinical specificity for cases was 68.4% (95% CI: 43.5% - 87.4%). Since the low clinical sensitivity for the two CT-positive cases was not statistically significant due to the small number of samples analyzed, it was judged necessary to secure and analyze more samples in the future. Regarding the clinical specificity analysis results for 19 CT-negative cases, there were a large number of patients who were actually clinically diagnosed with mild traumatic brain injury but actually received a CT-negative result, and about 31.6% of them showed abnormal results on VEUPLEXTM TBI assay. Although traumatic brain injury could not be detected in 31.6% of the CT scans, the possibility of actually suffering a mild brain injury could not be ruled out, so it was judged that this could be confirmed through follow-up observation of the patient. In addition, among patients with mild traumatic brain injury, CT examinations were not performed in many cases because the symptoms were very mild, but among these patients, about 25% or more showed abnormal results in the VEUPLEXTM TBI assay. In fact, no damage is observed with the naked eye immediately after traumatic brain injury, and traumatic brain injury is not observed even on CT. But in some cases, brain hemorrhage may occur (delayed cerebral hemorrhage) after a certain period of time, so the patients who did show abnormal results on VEUPLEXTM TBI assay should be followed up for the delayed cerebral hemorrhage. In conclusion, it was judged that it was difficult to judge mild traumatic brain injury with the VEUPLEXTM TBI assay only through clinical findings without CT results, that is, based on the GCS value. Even in the case of CT, it does not detect all mild traumatic brain injury, so it is difficult to necessarily judge that there is no traumatic brain injury, even if there is no evidence of traumatic brain injury in CT. And in the long term, more patients should be included to evaluate the usefulness of the VEUPLEXTM TBI assay in the detection of microscopic traumatic brain injuries without using CT.

Keywords: brain injury, traumatic brain injury, GFAP, UCHL1

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Authors: Sara Mouffouk, Fatma Belaid, Asma Hechani, Chaima Mouffouk

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Cancer of the cervix caused by HPV (human papillomavirus ) is for many years a real public health problem, it is ranked 2nd deadly female cancer kills more than 270 000 women each year worldwide. In Algeria, the mortality of cervical cancer decreases with the impact, but the prognosis of these cancers remains bleak: The 5-year relative survival is 60 %. The mode of transmission is usually sexuel. Our study was undertaken to show the link between HPV and cervical cancer and the importance of Pap smear screening in this type of pathology. On the total sample, 76.11 % showed abnormal cervical smears of which 13% have mild cases and hormonal reaction Change, and 44% represent inflammatory smears and normal cases 35%, while long seven years from 2005 to 2012. Thus, 43% of abnormal smear results between ASCUS, AGUS, low and high grade carcinoma and adenocarcinoma and 57 % of other cases of unknown origin. The average age of women at risk of developing adenocarcinoma is 45-50 with a 67% to 33% of the same risk in women of age group 41-45 years although the percentage of cases of HPV infected patients was 2% in the past seven years. We found that with increasing age, the risk is argued. Due to several factors such as multiparty can reduced the resistance of the uterine epithelium and even as the multi that promotes contamination HPV causes repeated infections with HPV.

Keywords: cervical cancer, human papillomavirus (HPV) screening, prevention, vaccines

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Authors: Abolaji Mayowa Akinyele

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The purpose of this study was to investigate student’s awareness, Knowledge and understanding of environmental issues for sustainable development. Findings revealed that; despite the positive attitude shown by students towards environmental education, a relatively low level of understanding of environmental concept was recorded in school settings regardless of efforts by government and other environmental agencies at creating awareness about environmental related issues. This brought about the investigation of students environmental education knowledge in high school settings. About 205 Students were randomly selected for data collection using validated instruments titled student’s knowledge and attitude questionnaire as well as student’s response to questions (interview) concerning global warming. T-test statistics, chi-square and simple percentage were the major statistical tools employed in data analysis. This study revealed that environment based-education (school curriculum) as well as efforts by government/environmental agencies (mass media) plays a major role in promoting students understanding, of environmental concepts, awareness of major environmental issues and positive attitude towards natural environment.

Keywords: environmental issues, sustainable development, students attitude, students knowledge

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Authors: Nandita Chaube, S. S. Nathawat

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Sleep paralysis is a state of sleep disturbance in which people experience hypnogogic or hypnopompic hallucinations marked by an inability to move their bodies or speak out while reporting the consciousness about their surroundings. Philosophical explanation of sleep paralysis has been quoted in the ancient texts in terms of incubus and succubus. However, pathologically, it has been linked to several disorders including narcolepsy, migraines, anxiety disorders, and obstructive sleep apnea but it can also occur in isolation. Some other significant factors may include perceived stress, spiritual and paranormal beliefs, etc. Hence, a qualitative analysis of five such cases reporting symptoms of sleep disturbances with the criterion of sleep paralysis has been reported here. The study considered various psychological factors like stressful life events, feelings of inadequacy, spirituality, and paranormal beliefs. Results disclosed that four of the five cases were inclined towards the paranormal beliefs and the entire sample indicated a noticeably augmented level of spirituality and feelings of inadequacy. Furthermore, three cases reported experiencing greater stress following life events. Among other factors, all the cases were characterized with sleeping in the supine position, sleeping alone, an experience of fear, a sense of pressure on their chest, a presence of someone in the room and increased level of feelings of inadequacy.

Keywords: genesis, inadequacy, paranormal, sleep-paralysis, spiritual, stress

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Authors: F. Gallop, C. Ward, M. Zaky, M. Vaghela, R. Sabaratnam

Abstract:

Nitrous oxide (N₂O) has been used in anaesthesia for over 150 years owing to advantageous physical and pharmacological properties. However, with a global warming potential of 310, we have an urgent responsibility to reduce its usage and emission. Anecdotal evidence in our hospital trust suggests minimal N₂O usage, yet our theatres receive a staggering supply. This warranted further investigation. We used a data collection tool to prospectively capture quantitative and qualitative data regarding N₂O cases during one week: this recorded demographics, N₂O indications, clinical management, and total N₂O consumption in litres. In addition, N₂O usage in dental sedation suites and paediatric theatres was separately quantified. Pipeline supply data was acquired from British Oxygen Company accounts. We captured 490 cases. 4% (n=19) used N₂O, 63% (n=12) of these in dental theatres. Common N₂0 indications were induction speed (37%) and rapidly increasing anaesthesia depth (32%). In adult cases, N₂O was always used intraoperatively rather than solely at induction. 74% (n=14) of anaesthetists reported environmental concern over using N₂O. The week’s total N₂O usage was 8109 litres, amounting to 421,668 litres annually. However, the annual N₂O pipeline supply is 2,997,000 litres; an enormous 1.8 million Kg of CO₂. Our results supportively demonstrate that the N₂O pipeline supply greatly exceeds its clinical use. Acknowledging clinical areas not audited, the discrepancy between supply and usage suggests approximately 2.5 million litres of yearly wastage. We consequently recommend terminating the N₂O pipeline supply in minimally used areas, eliminating 1.5 million Kg of CO₂ emissions. High usage clinical areas could consider portable N₂O cylinders as an alternative. In Sweden, N₂O destruction technology is routinely used to minimise CO₂ emissions. Our results support National Health System investment in similar infrastructure.

Keywords: anaesthesia, environment, medical gases, nitrous oxide, sustainability

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Authors: Amin Ebrahimi Ghadi, Morteza Moalagh

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This research is carried out to find how a perfect combination of IoT architecture (Internet of Things) and ERP system can strengthen environmental accounting to incorporate both economic and environmental information. IoT (e.g., sensors, software, and other technologies) can be used in the company’s value chain from raw material extraction through materials processing, manufacturing products, distribution, use, repair, maintenance, and disposal or recycling products (Cradle to Grave model). The desired ERP software then will have the capability to track both midpoint and endpoint environmental impacts on a green supply chain system for the whole life cycle of a product. All these enable environmental accounting to calculate, and real-time analyze the operation environmental impacts, control costs, prepare for environmental legislation and enhance the decision-making process. In this study, we have developed a model on how to use IoT devices in life cycle assessment (LCA) to gather emissions, energy consumption, hazards, and wastes information to be processed in different modules of ERP systems in an integrated way for using in environmental accounting to achieve sustainability.

Keywords: ERP, environmental accounting, green supply chain, IOT, life cycle assessment, sustainability

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Authors: Veruska C. Dutra, Mary L. G. S. Senna

Abstract:

The principle of sustainability has been studied by different sciences with the purpose of formulating clear and concrete models. Much has been discussed about sustainability, and several points of view have been used to try to explain it; environmental science emerges from various environmental discourses that are willing to establish a new concept for understanding this complexity. This way, we focus on the activity of ecotourism as a way to integrate sustainable practices proposed by environmental science, and thus, make it possible to create a new perspective for eco-tourists and the managers of tourist destinations towards nature. The aim of this study was to suggest a direction for environmental awareness, based on environmental science, to change the eco-tourist's view of nature in ecotourism tours. The methodology used was based on a case study concerning the Jalapão State Park - JSP, located in the State of Tocantins, Northern Brazil. The study was based on discussions, theoretical studies, bibliographical research and on-site research. We have identified that to incite the tourists’ awareness, they need to visit nature to understand the environmental problems and promote actions for its preservation. We highlight in this study actions to drive their human perception through environmental science, so that the ecotourism itinerary tours to the JSP, promote a balance between the natural environment and the tourist, making them, in this way, environmental tourists.

Keywords: science, environmental, ecoturism, Jalapão

Procedia PDF Downloads 339

Authors: K. Y. Chen, Y. N. Jia, H. Chua, C. W. Kan

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In United States (US), the environmental policy went through two stages that are government control period and market mechanism period. In the government control period in the 1970s, environmental problems in U.S. are treated by mandatory direct control method, including promulgation of laws, formulation of emission standards and mandatory installation of pollution treatment equipment. After the 1980s, the environmental policy in U.S. went into the second stage, in which the government strengthened the incentives and coordination effects of market. Since then, environmental governance had been partially replaced by means of economic regulation of the market. Green Tax Policy and Marketable Pollution Permits are good examples of government's economic interventions. U.S. Federal Government regards environmental industry as high-tech industry which is promoted in this period. Therefore, in the paper, we aim to analyse the effect of environmental investment on the sustainable development in the US. Acknowledgment: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: United States, public environmental investment, analysis, sustainable development

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Authors: T. Suleiman, C. Mchugh, H. Ranu

Abstract:

Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: K. Y. Chen, H. Chua, C. W. Kan

Abstract:

Japan is a well-developed country but the environmental issues are still a hot issue. In this study, we will analyse how the environmental investment affects the sustainable development in Japan. This paper will first describe the environmental policy of Japan and the effort input by the Japan government. Then, we will collect the yearly environmental data and also information about the environmental investment. Based on the data collected, we try to figure out the relationship between environmental investment and sustainable development in Japan. In addition, we will analyse the SWOT of environmental investment in Japan. Based on the economic information collected, Japan established a sound material-cycle society through changes in business and life styles. A comprehensive legal system for this kind of society was established in Japan. In addition, other supporting measures, such as financial measures, utilization of economic instruments, implementation of research and promotion of education and science and technology, help Japan to cope with the recent environmental challenges. Japan’s excellent environmental technologies changed its socioeconomic system. They are at the highest global standards. This can be reflected by the number of patents registered in Japan which has been on the steady growth. Country by country comparison in the application for patents on environmental technologies also indicates that Japan ranks high in such areas as atmospheric pollution and water quality management, solid waste management and renewable energy. This is a result of the large expenditure invested on research and development.

Keywords: Japan, environmental investment, sustainable development, analysis

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Authors: Duygu Çelgin

Abstract:

Until the new Occupational Health and Safety Law of Turkey, most of the workers were excluded from the mandatory occupational health and safety services. This new law, made the OHS services mandatory for all workers from all sectors including both public and private. However, in the application some problems and disadvantageous cases are occurred and the government also considered these cases. In this study, the new OHS law of Turkey and the regulations prepared according to the law are studied with the literature search.

Keywords: occupational health and safety in Turkey, OHS servicing in Turkey, safety experts, OHS support

Procedia PDF Downloads 471