Search results for: Pulmonary Embolism Severity Index (PESI) score

Authors: Siamak Shahidi, Nasrin Hashemi-Firouzi, Sara Soleimani-Asl, Alireza Komaki

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Introduction: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive memory and cognitive performance. Recently, an involvement of the serotonergic system and their receptors are suspected in the AD progression. In the present behavioral study, the effects of BIMU (selective 5-HT4 receptor agonist) on cognition and memory in the rat model of AD was investigated. Material and Methods: The animal model of the AD was induced by intracerebroventricular (Icv) injection of amyloid beta (Aβ) in adult male Wistar rats. Animals were divided into experimental groups included control, sham, Aβ, Aβ +BIMU groups. The treatment substances were icv injected (1 μg/μL) for thirty consecutive days. Then, novel object recognition (NOR) and passive avoidance learning (PAL) tests were applied to investigate memory and cognitive performance. Results: Aβ decrease the discrimination index of NOR test. Also, it increases the time spent in the dark compartment during PAL test, as compared with sham and control groups. In addition, compared to Aβ groups, BIMU significantly increased the discrimination index of NOR test and decreased the time spent in the dark compartment of PAL test. Conclusion: These findings suggest that 5-HT4 receptor activation prevents progression of memory and cognitive impairment in a rat model of AD.

Keywords: Alzheimer disease, cognition, memory, serotonin receptors

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Authors: Diana Coyl-Shepherd, Lisa Newland

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Research and theory suggest that parenting and parent-child attachment influence emotional development and well-being. Studies indicate that adolescents often describe differences in relationships with each parent and may form different types of attachment to mothers and fathers. During adolescence and young adulthood, romantic partners may also become attachment figures, influencing well being, and providing a relational context for emotion skill development. Mothers, however, tend to be remain the primary attachment figure; fathers and romantic partners are more likely to be secondary attachment figures. The following hypotheses were tested: 1) participants would rate mothers as more accepting and less rejecting than fathers, 2) participants would rate secure attachment to mothers higher and insecure attachment lower compared to father and romantic partner, 3) parental rejection and insecure attachment would be negatively related to life satisfaction and emotional intelligence, and 4) secure attachment and parental acceptance would be positively related life satisfaction and emotional intelligence. After IRB and informed consent, one hundred fifty adolescents and young adults (ages 11-28, M = 19.64; 71% female) completed an online survey. Measures included parental acceptance, rejection, attachment (i.e., secure, dismissing, and preoccupied), emotional intelligence (i.e., seeking and providing comfort, use, and understanding of self emotions, expressing warmth, understanding and responding to others’ emotional needs), and well-being (i.e., self-confidence and life satisfaction). As hypothesized, compared to fathers’, mothers’ acceptance was significantly higher t (190) = 3.98, p = .000 and rejection significantly lower t (190) = - 4.40, p = .000. Group differences in secure attachment were significant, f (2, 389) = 40.24, p = .000; post-hoc analyses revealed significant differences between mothers and fathers and between mothers and romantic partners; mothers had the highest mean score. Group differences in preoccupied attachment were significant, f (2, 388) = 13.37, p = .000; post-hoc analyses revealed significant differences between mothers and romantic partners, and between fathers and romantic partners; mothers have the lowest mean score. However, group differences in dismissing attachment were not significant, f (2, 389) = 1.21, p = .30; scores for mothers and romantic partners were similar; father means score was highest. For hypotheses 3 and 4 significant negative correlations were found between life satisfaction and dismissing parent, and romantic attachment, preoccupied father and romantic attachment, and mother and father rejection variables; secure attachment variables and parental acceptance were positively correlated with life satisfaction. Self-confidence was correlated only with mother acceptance. For emotional intelligence, seeking and providing comfort were negatively correlated with parent dismissing and mother rejection; secure mother and romantic attachment and mother acceptance were positively correlated with these variables. Use and understanding of self-emotions were negatively correlated with parent and partner dismissing attachment, and parent rejection; romantic secure attachment and parent acceptance were positively correlated. Expressing warmth was negatively correlated with dismissing attachment variables, romantic preoccupied attachment, and parent rejection; whereas attachment secure variables were positively associated. Understanding and responding to others’ emotional needs were correlated with parent dismissing and preoccupied attachment variables and mother rejection; only secure father attachment was positively correlated.

Keywords: adolescent emotional intelligence, life satisfaction, parent and romantic attachment, parental rejection and acceptance

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Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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Authors: Arti Bagada, Kantilal Vadalia, Mihir Raval

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Cilnidipine is practically insoluble in water which results in its insufficient oral bioavailability. The purpose of the present investigation was to formulate cilnidipine nanoparticles by nanoprecipitation method to increase the aqueous solubility and dissolution rate and hence bioavailability by utilizing various experimental statistical design modules. Experimental design were used to investigate specific effects of independent variables during preparation cilnidipine nanoparticles and corresponding responses in optimizing the formulation. Plackett Burman design for independent variables was successfully employed for optimization of nanoparticles of cilnidipine. The influence of independent variables studied were drug concentration, solvent to antisolvent ratio, polymer concentration, stabilizer concentration and stirring speed. The dependent variables namely average particle size, polydispersity index, zeta potential value and saturation solubility of the formulated nanoparticles of cilnidipine. The experiments were carried out according to 13 runs involving 5 independent variables (higher and lower levels) employing Plackett-Burman design. The cilnidipine nanoparticles were characterized by average particle size, polydispersity index value, zeta potential value and saturation solubility and it results were 149 nm, 0.314, 43.24 and 0.0379 mg/ml, respectively. The experimental results were good correlated with predicted data analysed by Plackett-Burman statistical method.

Keywords: dissolution enhancement, nanoparticles, Plackett-Burman design, nanoprecipitation

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Authors: Chamtouri I., Kechida M.

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Background: Evaluation has a prominent role in medical education and graduation. This evaluation has usually done in face-to-face, by written or oral questions. Simulation is increasingly taking a part as a method of evaluation. Due to the Covid-19 pandemic, which disrupted face-to-face evaluation, simulation using serious games (SG) is emerging in the field of training and assessment of medical students. The aim of our study is to compare the results of the evaluation of medical students by virtual simulation by online serious games versus clinical case-multiple choice questions (MCQ) and to assess the degree of satisfaction from these two evaluation methods. Methods: Medical students from the same study level were voluntarily participated in this study. Groupe 1 had an evaluation by SG dealing with “diagnosis and management of ST-segment elevationmyocardialinfarction (STEMI)alreadyprepared on the website www.Mediactiv.com. Groupe 2 were evaluated by clinical case-MCQ having thes same topic as SG. Results of the two groups were compared. Satisfaction questionnaire was filled by the two groups. Satisfaction degree was compared between the two groups. Results. In this study, 64 medical students (G1:31 and G2: 33) were enrolled. Obtaining complete notes in the "questioning" and "clinical examination" parts is significantly more important in-group 1 compared to group 2. No significant difference detected between the two groups in terms of “ECG interpretation” and “diagnosis of STEMI” parts. A greater number of students of group 1 obtained the full note compared to group 2 in “the initial treatment part” (54.8% vs. 39.4%; p = 0.04). Thirty learners (96.8%) in-group 1 obtained a total score ≥ 50% versus 69.7% in-group 2 (p = 0.004). The full score of 100% was obtained in three learners in-group1, while no student scored 100% in-group2 (p = 0.027). Medical evaluation using SG was reported as more innovative, fun, and realistic compared to evaluation by clinical case-MCQ. No significant difference detected between the two methods in terms of stress. Conclusion: Simulation by SG can be considered as an innovative and effective method in evaluating medical students with a higher degree of satisfaction.

Keywords: evaluation, serious games, medical students, satisfaction

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Authors: Kalayanee Senasu

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This research investigates Thai people’s happiness based on socioeconomic factors, i.e. region, municipality, gender, age, and occupation. The research data were collected from survey data using interviewed questionnaires. The primary data were from stratified multi-stage sampling in each region, province, district, and enumeration area; and simple random sampling in each enumeration area. These data were collected in 13 provinces: Bangkok and three provinces in each of all four regions. The data were collected over two consecutive years. There were 3,217 usable responses from the 2017 sampling, and 3,280 usable responses from the 2018 sampling. The Senasu’s Thai Happiness Index (THaI) was used to calculate the happiness level of Thai people in 2017 and 2018. This Thai Happiness Index comprises five dimensions: subjective well-being, quality of life, philosophy of living, governance, and standard of living. The result reveals that the 2017 happiness value is 0.506, while Thai people are happier in 2018 (THaI = 0.556). For 2017 happiness, people in the Central region have the highest happiness (THaI = 0.532), which is followed closely by people in the Bangkok Metropolitan Area (THaI = 0.530). People in the North have the lowest happiness (THaI = 0.476) which is close to the level for people in the Northeast (THaI = 0.479). Comparing age groups, it is found that people in the age range 25-29 years old are the happiest (THaI = 0.529), followed by people in the age range 55-59 and 35-39 years old (THaI = 0.526 and 0.523, respectively). Additionally, people who live in municipal areas are happier than those who live in non-municipal areas (THaI = 0.533 vs. 0.475). Males are happier than females (THaI = 0.530 vs. 0.482), and retired people, entrepreneurs, and government employees are all in the high happiness groups (THaI =0.614, 0.608, and 0.593, respectively). For 2018 happiness, people in the Northern region have the highest happiness (THaI = 0.590), which is followed closely by people in the South and Bangkok Metropolitan Area (THaI = 0.578 and 0.577, respectively). People in the Central have the lowest happiness (THaI = 0.530), which is close to the level for people in the Northeast (THaI = 0.533). Comparing age groups, it is found that people in the age range 35-39 years old are the happiest (THaI = 0.572), followed by people in the age range 40-44 and 60-64 years old (THaI = 0.569 and 0.568, respectively). Similar to 2017 happiness, people who live in municipal areas are happier than those who live in non-municipal areas (THaI = 0.567 vs. 0. 552). However, males and females are happy at about the same levels (THaI = 0.561 vs. 0.560), and government employees, retired people, and state enterprise employees are all in the high happiness groups (THaI =0.667, 0.639, and 0.661, respectively).

Keywords: happiness, quality of life, Thai happiness index, socio-economic factors

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Authors: Shanujah Mathuranayagam, William Fuentes, Samanthika Liyanapathirana

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This paper introduces an enhanced version of the coupled hydro-mechanical hypoplastic model. The model is able to simulate volumetric collapse upon wetting and incorporates suction effects on stiffness and strength. Its mechanical constitutive equation links Bishop’s effective stress with strain and suction, featuring a normal consolidation line (NCL) with a compression index (λ) presenting a non-linear dependency with the degree of saturation. The Bulk modulus has been modified to ensure that under rapid volumetric collapse, the stress state remains at the NCL. The coupled model comprises eighteen parameters, with nine for the hydraulic component and nine for the mechanical component. Hydraulic parameters are calibrated with the use of water retention curves (IWRC) across varied soil densities, while mechanical parameters undergo calibration using isotropic and triaxial tests on both unsaturated and saturated samples. The model's performance is analyzed through the back-calculation of two experimental studies: (i) wetting under different vertical stresses for Lower Cromer Till and (ii) isotropic loading and triaxial loading for undisturbed loess. The results confirm that the proposed model is able to predict the hydro-mechanical behavior of unsaturated soils.

Keywords: hypoplastic model, volumetric collapse, normal consolidation line, compression index (λ), degree of saturation, soil suction

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Authors: Xiaohong Xu, Tianchu Zhang, Yangfan Chen, Rongtai Tan

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In Canada, Air Quality Health Index (AQHI) is a scale designed to help residences understand the impact of air quality on human health. In Ontario, Canada, AQHI was implemented in June 2015. This study investigated temporal variability of daily AQHI and impact of regional transport on AQHI in Windsor, Ontario, Canada from 2016 to 2019. During 2016–2019, 1428 daily AQHIs were recorded in Windsor Downtown Station. Among those, the AQHIs were at the low health risk level (AQHI = 1, 2 or 3) in 82% of days, only a few days at high risk level (AQHI = 7), the rest were at moderate health risk level (AQHI = 4, 5, 6), indicating air quality in Windsor was fairly good with relatively low health risk. The annual mean AQHI value decreased from 2.95 in 2016 to 2.81 in 2019, demonstrating the improvement of air quality. Half of the days, AQHI were 3 regardless of season. AQHI was higher in the warm season (3.1) than in the cold season (2.6) due to more frequent moderate risk days (27%, AQHI = 4) in warm season and more frequent low risk days (42%, AQHI = 2) in the cold season. Among the three pollutants considered in AQHI calculation, O3 was the most frequently reported dominant contributor to daily AQHI (88% of days), followed by NO2 (12%), especially in the cold season, with small contribution from PM2.5 (<1%). In the past two decades, NO2 concentrations had decreased significantly and O3 concentrations had increased, resulting in daily AQHI being less reliance on NO2 (from 51% of days being the primary contributor during 2003–2010 to 12% during 2016–2019) and more on O3 concentrations (49% to 88%). Trajectory analysis found that AQHI ≤ 3 days were closely associated with air masses from the north and northwest, whereas AQHI > 3 days were closely associated with air masses from the west and southwest. This is because northerly flows brought in clear air mass owing to less industrial facilities, while polluted air masses were transported from the south of Windsor, where several industrial states of the US were located. Overall, O3 concentrations dictate the daily AQHI values, the seasonal variability of AQHI, and the impact of regional transport on AQHI in Windsor. This makes further reductions of AQHI challenging because O3 concentrations are likely to continue increasing due to weakened consumption of O3 by NO owing to decreasing NO emissions and more hot days because of climate change. The predominant and increasing contribution of O3 to AQHI calls for more effective control measures to mitigate O3 pollution and its impact on human health and the environment.

Keywords: air quality, Air Quality Health Index (AQHI), hysplit, regional transport, windsor

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Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Gaurav Vaidya, N. R. Mandal

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UN Summit, 2000 had resolved to provide access to sanitation to whole humanity as part of ‘Millennium Development Goals -2015’. However, more than one third of world’s population still did not have the access to basic sanitation facilities by 2015. Therefore, it will be a gigantic challenge to achieve goal-6 of ‘UN Sustainable Development Goal’ to ensure availability and sustainable management of sanitation for all by the year 2030. Countries attempt to find out own ways of meeting this challenge of providing access to safe sanitation and as part of monitoring the actions have prepared varied types of ‘performance assessment frameworks (PAF)’. India introduced Service Level Benchmarking (SLB) in 2010 to set targets and achieve the goals of NUSP. Further, a method of reviewing performance was introduced as ‘Swachh Sarvekshan’ (Cleanliness Surveys) in 2016 and in 2017 guidelines for the same was revised. This study, as a first step, reviews the documents in use in India with a conclusion that the frameworks adopted are based on target setting, financial allocation and performance in achieving the targets set. However, it does not focus upon sanitation needs holistically i.e., areas and aspects not targeted through projects are not covered in the performance assessment. In this context, as a second step, this study reviews literature available on performance assessment frameworks for urban sanitation in selected other countries and compares the same with that in India. The outcome of the comparative review resulted in identification of unaddressed aspects as well as inadequacy of parameters in Indian context. Thirdly, in an attempt to restructure the performance assessment process and develop an index in urban sanitation, researches done in other urban services such as health and education were studied focusing on methods of measuring under-performance. As a fourth step, a tentative modified framework is suggested with the help of understanding drawn from above for urban sanitation using stages of Urban Sanitation Service Chain Management (SSCM) and modified set of parameters drawn from the literature review in the first and second steps. This paper reviews existing literature on SSCM procedures, Performance Index in sanitation and other urban services and identifies a tentative list of parameters and a framework for measuring under-performance in sanitation services. This may aid in preparation of a Service Delivery Under-performance Index (SDUI) in future.

Keywords: assessment, performance, sanitation, services

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Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

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Authors: Francisco Toledo-Castillo, María Josefa Sospedra-Baeza, Sergio Hidalgo-Fuentes

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Motorcycles constitute about 9% of all motorized vehicles in Spain and are generally overrepresented in traffic accidents, accounting for 21% of total accidents. Six years of motorcycle accident data were obtained through the national accident database of Spain (Dirección General de Tráfico). Some of the studied factors are age, gender, helmet wearing, alcohol consumption, speeding, subject’s driving license and for how long it has been held, the trip purpose, and the presence of a passenger on the vehicle. Key findings show helmet use, unsafe speed, the trip purpose, weather, distraction, collision type and other variables play significant roles in crash-injury outcomes. Finally, we examine evolution of mortality and severity from 2006 to 2011.

Keywords: motorcycle accidents, risk factors, statistics, Spain

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Authors: Bruna F. Oliveira, Teresa I. Gonçalves, Marcelo M. Sousa, Sandra M. Pimenta, Octávio F. Ramalho, José B. Cruz, Flávia V. Barbosa

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The EU Circular Economy action plan, launched in 2020, is one of the major initiatives to promote the transition into a more sustainable industry. The circular economy is a popular concept used by many companies nowadays. Some industries are better forwarded to this reality than others, and the tannery industry is a sector that needs more attention due to its strong environmental impact caused by its dimension, intensive resources consumption, lack of recyclability, and second use of its products, as well as the industrial effluents generated by the manufacturing processes. For these reasons, the zero-waste goal and the European objectives are further being achieved. In this context, a need arises to provide an effective methodology that allows to determine the level of circularity of tannery companies. Regarding the complexity of the circular economy concept, few factories have a specialist in sustainability to assess the company’s circularity or have the ability to implement circular strategies that could benefit the manufacturing processes. Although there are several methodologies to assess circularity in specific industrial sectors, there is not an easy go-to methodology applied in factories aiming for cleaner production. Therefore, a straightforward methodology to assess the level of circularity, in this case of a tannery industry, is presented and discussed in this work, allowing any company to measure the impact of its activities. The methodology developed consists in calculating the Overall Circular Index (OCI) by evaluating the circularity of four key areas -energy, material, economy and social- in a specific factory. The index is a value between 0 and 1, where 0 means a linear economy, and 1 is a complete circular economy. Each key area has a sub-index, obtained through key performance indicators (KPIs) regarding each theme, and the OCI reflects the average of the four sub-indexes. Some fieldwork in the appointed company was required in order to obtain all the necessary data. By having separate sub-indexes, one can observe which areas are more linear than others. Thus, it is possible to work on the most critical areas by implementing strategies to increase the OCI. After these strategies are implemented, the OCI is recalculated to check the improvements made and any other changes in the remaining sub-indexes. As such, the methodology in discussion works through continuous improvement, constantly reevaluating and improving the circularity of the factory. The methodology is also flexible enough to be implemented in any industrial sector by adapting the KPIs. This methodology was implemented in a selected Portuguese small and medium-sized enterprises (SME) tannery industry and proved to be a relevant tool to measure the circularity level of the factory. It was witnessed that it is easier for non-specialists to evaluate circularity and identify possible solutions to increase its value, as well as learn how one action can impact their environment. In the end, energetic and environmental inefficiencies were identified and corrected, increasing the sustainability and circularity of the company. Through this work, important contributions were provided, helping the Portuguese SMEs to achieve the European and UN 2030 sustainable goals.

Keywords: circular economy, circularity index, sustainability, tannery industry, zero-waste

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Authors: Misbah Nizamani, Saira Malik

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Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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Authors: Zahid O. Alibrahim, Craig D. Williams, Clive L. Roberts

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The study area (Ecton mining area) is located in the southern part of the Peak District in Derbyshire, England. It is bounded by the River Manifold from the west. This area has been mined for a long period. As a result, huge amounts of potentially toxic metals were released into the surrounding area and are most likely to be a significant source of heavy metal contamination to the local soil, water and vegetation. In order to appraise the potential heavy metal pollution in this area, 37 topsoil samples (5-20 cm depth) were collected and analysed for their total content of Cu, Pb, Zn, Mn, Cr, Ni and V using ICP (Inductively Coupled Plasma) optical emission spectroscopy. Multivariate Geospatial analyses using the GIS technique were utilised to draw geochemical maps of the metals of interest over the study area. A few hotspot points, areas of elevated concentrations of metals, were specified, which are presumed to be the results of anthropogenic activities. In addition, the soil’s environmental quality was evaluated by calculating the Mullers’ Geoaccumulation index (I geo), which suggests that the degree of contamination of the investigated heavy metals has the following trend: Pb > Zn > Cu > Mn > Ni = Cr = V. Furthermore, the potential ecological risk, using the enrichment factor (EF), was also specified. On the basis of the calculated amount or the EF, the levels of pollution for the studied metals in the study area have the following order: Pb>Zn>Cu>Cr>V>Ni>Mn.

Keywords: enrichment factor, geoaccumulation index, GIS, heavy metals, multivariate analysis

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Authors: Hassan M. Al-Ahmadi

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The fatality index (deaths/100 K population) due to road traffic accidents in the Kingdom of Saudi Arabia (KSA) is over 25, according to the World Health Organization Statistics (WHO) statistics, which is much higher than in the neighboring Arab regions. The KSA has implemented measures to mitigate traffic accidents by enforcing road safety regulations. As a result, there has been a slight decline in the frequency of road traffic accidents within the Kingdom. This study was based on the variations in the accidents for three provinces of KSA, i.e., Riyadh, Eastern Province (EP), & Qaseem, for 2016 and 2017 using ANOVA method. Data appropriateness for the ANOVA method was confirmed by the normality and the randomness of residuals. Additionally, the half-normal plot was used to identify the significant terms for the ANOVA analysis. The analysis revealed that the accidents in the EP were significantly higher than in the other two provinces during the analysis period. The monthly variation showed a spike in the accidents from month 7th to 9th month in the EP region and a slight drop in the accidents in the Qaseem and the Riyadh region during the same period, which was attributed to the increased leisure travels from the other regions to the EP. Furthermore, most of the accidents were found to occur in the age group of 18+ and 30+, and also the major reduction of accidents in 2017 as compared to 2016 was found to have occurred in the same group. These findings can be beneficial for developing strategies to further reduce the number of accidents.

Keywords: fatality index, emergency, road traffic accident, safety, leisure travels

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Authors: Ogunwole Cecilia Oluwakemi, Timothy Ayomitunde Aderemi

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Provision of sufficient food and elimination of abject poverty have usually been the conventional benefits of agriculture in any society. Meanwhile, despite the fact that Nigeria is an agrarian society, food insecurity and poverty have become the issues of concern among both scholars and policymakers in the recent times. Against this backdrop, this study examined the nexus among agriculture, food security, and poverty reduction in Nigeria from 1990 to 2019 within the framework of the Cointegration and Granger Causality approach. Data was collected from the Central Bank of Nigeria Statistical Bulletin and the World Development Indicators, respectively. The following are the major results that emanated from the study. A long run equilibrium relationship exists among agricultural value added, food production index, and GDP per capita in Nigeria. Similarly, there is a unidirectional causality which flows from food production index to poverty reduction in Nigeria. In the same vein, one way causality flows from poverty reduction to agricultural value added in Nigeria. Consequently, this study makes the following recommendation for the policymakers in Nigeria, and other African countries by extension, that agricultural value added and food production are the important variables that cannot be undermined when poverty reduction occupies the central focus of the policymakers. Therefore, any time these policymakers want to reduce poverty, policies that drive agricultural value added and food production should be embarked upon. Therefore, this study will contribute to the literature by establishing the type of linkage that exists between agriculture, food security, and poverty reduction in Nigeria.

Keywords: agriculture, value added, food production, GDP per capita, Nigeria

Procedia PDF Downloads 185

Authors: Kshanaprava Dhalsamant, Punyadarshini P. Tripathy, Shanker L. Shrivastava

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With present high global population, the need for rising food usage by minimizing food wastage and investment is highly necessary to achieve food security. The purpose of this study is to enlighten the effect of pre-drying treatment on rehydration, color, texture, nanohardness, microstructure and surface morphology of solar dried potato samples dried in the mixed-mode solar dryer. Locally bought potatoes were cleaned and cut into cylindrical pieces and pretreated with sodium metabisulfite (0.5%) for 10 min before placing them in natural convection solar dryer designed and developed in Indian Institute of Technology Kharagpur, India. Advanced quality characteristics were studied using Atomic Force Microscope (AFM), Scanning Electron Microscopy (SEM) and nanoindentation method, along with color, texture and water activity. The rehydration indices of solar dried potatoes were significantly biased by pretreatment followed by rehydration temperature. A lower redness index (a*) with a higher value of yellowness index (b*), chroma (C*) and hue angle (h*) were obtained for pretreated samples. Also, the average nanohardness (H) of untreated samples exhibited substantial lower value (18.46%) compared to pretreated samples. Additionally, a creep displacement of 43.27 nm during 20 s dwell time under constant load of 200

Keywords: pretreatment, nanohardness, microstructure, surface morphology

Procedia PDF Downloads 163

Authors: Shivalal Sharma, Sanjib K. Sharma, Madhab Lamsal

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Background: The aim of this study was to evaluate the clinical and laboratory changes three months after full-mouth scaling and root planing (SRP) in periodontitis patients with type 2 diabetes mellitus (DM). Methods: Forty-seven type 2 DM subjects with moderate to severe periodontitis were randomly divided into two groups. Treatment group (TG), 25 subjects, received full-mouth scaling and root planning; control group (CG), 22 subjects, received no treatment. At baseline and at the end of three months, glycated hemoglobin (HbA1c) values, fasting glucose, and clinical parameters like plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded in all the patients. Following SRP, the patients were enrolled in a monthly interval maintenance program for 3 months. Results: A statistically significant effect could be demonstrated for PI, GI, PPD, and CAL for the treatment group. HbA1c levels in the treatment group decreased significantly whereas the control group showed a slight but insignificant increase for these parameters. Conclusions: The results of this study showed that non-surgical periodontal treatment (SRP) is associated with improved glycemic control in type 2 DM patients and could be undertaken along with the standard measures for the diabetic patient care.

Keywords: periodontitis, type 2 diabetes mellitus, non-surgical periodontal therapy, SRP

Procedia PDF Downloads 295

Authors: Esengül Elibol, Arzu Kader Harmancı Seren

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Individuals' reasons to choose a profession, profession image perceptions and future plans related to that profession affect their success in their future work lives. For nursing profession, this situation at the same time is important in terms of the health and safety of patients. The purpose of this study is to determine why medical vocational high school students in İstanbul choose nursing profession, their nursing image perceptions and future plans related to the profession. Descriptive and cross-sectional design are used. The study was carried out in four medical vocational high school in İstanbul. All third and fourth grade students who are attending to nursing programs and voluntary for participation were included in the study. In collecting data, two questionnaires that aim to learn about socio-demographic characteristics, profession choice reasons and future plans of nursing students and ‘Nursing Image Scale’ were used. Scale consisted of 28 items including individuals' opinions on nursing profession image and three sub-categories ‘General View,’ ‘Communication,’ and ‘Vocational-Educational Qualities.’ Analyzing profession choice reasons and future plans of participants, it is determined that majority chose nursing for easily finding a job (46.9%) and that majority had a dream profession other than nursing (65.8%). Analyzing nursing image perception of participants, it is determined that average of general view sub-category total scores was 9.75±2.27, average of communication sub-category total scores was8.68±2.86, and average of vocational-educational qualities sub-category total score was 21.18±3.96. In the perception score averages, meaningful differences were found according to independent variables. In conclusion, it was determined that majority of the participant students chose nursing for easily finding a job, perceived profession image negatively, and had a dream profession other than nursing.

Keywords: nursing image, medical vocational health school, perception, profession, student nurse

Procedia PDF Downloads 268

Authors: Ansong Richard Omari, Yosei Oikawa, Yoshiharu Fujii, Dorothea Sonoko Bellingrath-Kimura

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Renewed interest in soil management aimed at improving the productive capacity of Sub Saharan Africa (SSA) soils has called for the need to analyse the long term effect of different fertilization systems on soil. This study was conducted in two agroecological zones (i.e., Guinea Savannah (GS) and Deciduous forest (DF)) of Ghana to evaluate the impacts of long term (> 5 years) fertilization schemes on soil chemical and microbial properties. Soil samples under four different fertilization schemes (inorganic, inorganic and organic, organic, and no fertilization) were collected from 20 farmers` field in both agroecological zones. Soil analyses were conducted using standard procedures. All average soil quality parameters except extractable C, potential mineralizable nitrogen and CEC were significantly higher in DF sites compared to GS. Inorganic fertilization proved superior in soil chemical and microbial biomass especially in GS zone. In GS, soil deterioration index (DI) revealed that soil quality deteriorated significantly (−26%) under only organic fertilization system whereas soil improvement was observed under inorganic and no fertilization sites. In DF, either inorganic or organic and inorganic fertilization showed significant positive effects on soil quality. The high soil chemical composition and enhanced microbial biomass in DF were associated with the high rate of inorganic fertilization.

Keywords: deterioration index, fertilization scheme, microbial biomass, tropical agroecological zone

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Authors: Sadie Khorramnia, Asha Bonney, Kate Galloway, Andrew Kyoong

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Sleep plays a pivotal role in the registration and consolidation of memory. Multiple observational studies have demonstrated that self-reported sleep duration and sleep quality are associated with cognitive performance. Montreal Cognitive Assessment questionnaire is a screening tool to assess mild cognitive (MCI) impairment with a 90% diagnostic sensitivity. In our current study, we used MOCA to identify MCI in patients who underwent sleep study in our sleep department. We then looked at the clinical risk factors and sleep-related parameters in subjects found to have mild cognitive impairment but without a diagnosis of sleep-disordered breathing. Clinical risk factors, including physician, diagnosed hypertension, diabetes, and depression and sleep-related parameters, measured during sleep study, including percentage time of each sleep stage, total sleep time, awakenings, sleep efficiency, apnoea hypopnoea index, and oxygen saturation, were evaluated. A total of 90 subjects who underwent sleep study between March 2019 and October 2019 were included. Currently, there is no pharmacotherapy available for MCI; therefore, identifying the risk factors and attempting to reverse or mitigate their effect is pivotal in slowing down the rate of cognitive deterioration. Further characterization of sleep parameters in this group of patients could open up opportunities for potentially beneficial interventions.

Keywords: apnoea hypopnea index, mild cognitive impairment, sleep architecture, sleep study

Procedia PDF Downloads 140

Authors: Bhojan Dhakal, Naba Raj Devkota, Chet Raj Upreti, Maheshwar Sapkota

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A study was conducted to find out the production potential, nutrient composition, and the variability of the most commonly available fodder trees along with the varying altitude to help optimize the dry matter requirement during winter lean period. The study was carried out from March to June, 2012 in Lho and Prok Village Development Committee of Manaslu Conservation Area (MCA), located in Gorkha district of Nepal. The other objective of the research was to learn the impact of climate change on livestock production linking it with feed availability. The study was conducted in two parts: social and biological. Accordingly, a households (HHs) survey was conducted to collect primary data from 70 HHs, focusing on the perception of respondents on impacts of climatic variability on the feeding management. The next part consisted of understanding yield potential and nutrient composition of the four most commonly available fodder trees (M. azedirach, M. alba, F. roxburghii, F. nemoralis), within two altitudes range: (1500-2000 masl and 2000-2500 masl) by using a RCB design in 2*4 factorial combination of treatments, each replicated four times. Results revealed that majority of the farmers perceived the change in climatic phenomenon more severely within the past five years. Farmers were using different adaptation technologies such as collection of forage from jungle, reducing unproductive animals, fodder trees utilization, and crop by product feeding at feed scarcity period. Ranking of the different fodder trees on the basis of indigenous knowledge and experiences revealed that F. roxburghii was the best-preferred fodder tree species (index value 0.72) in terms overall preferability whereas M. azedirach had highest growth and productivity (index value 0.77), F. roxburghii had highest adoptability (index value 0.69) and palatability (index value 0.69) as well. Similarly, fresh yield and dry matter yield of the each fodder trees was significant (P < 0.01) between the altitude and within species. Fodder trees yield analysis revealed that the highest dry matter (DM) yield (28 kg/tree) was obtained for F. roxburghii but that remained statistically similar (P > 0.05) to the other treatment. On the other hand, most of the parameters: ether extract (EE), acid detergent lignin (ADL), acid detergent fibre (ADF), cell wall digestibility (CWD), relative digestibility (RD), digestible nutrient (TDN), and Calcium (Ca) among the treatments were highly significant (P < 0.01). This indicates the scope of introducing productive and nutritive fodder trees species even at the high altitude to help reduce fodder scarcity problem during winter. The finding also revealed the scope of promoting all available local fodder trees species as crude protein content of these species were similar.

Keywords: fodder trees, yield potential, climate change, nutrient composition

Procedia PDF Downloads 307

Authors: Paiwan Buachan, Maneekarn Namsa-Aid, Suchada Jongrungruangchok, Foengchat Jarintanan, Wanlaya Uthaisang-Tanechpongtamb

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Lung cancer or pulmonary carcinoma is the uncontrolled growth of abnormal cells in one or both of the lungs. These abnormal cells can spread to other organs of the body through lymphatic system or bloodstream which is called metastatic stage that leading cause of cancer death. Terrein (C₈H₁₀O₃; MW= 154.06 kDa) is a secondary bioactive fungal metabolite, which was isolated from the Aspergillus terreus. In this study, we investigated the effects of terrein on the inhibition of human lung cancer cell proliferation and metastasis. The A549 human non-small cell lung cancer cell line was used as a model. Terrein significantly inhibited lung cancer cell proliferation measuring by a colorimetric MTT assay (IC₅₀ 0.32 mM) and significantly inhibited metastatic processes including migration, invasion, and adhesion that determined by wound healing assay, transwell assay, and adhesion assay, respectively. These findings indicate that terrein could be a potential therapeutic agent for lung cancer.

Keywords: terrein, lung cancer, anticancer, antimetastatic

Procedia PDF Downloads 165

Authors: Elżbieta Antczak

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Cities offer important opportunities for economic development and for expanding access to basic services, including health care and education, for large numbers of people. Moreover, green areas (as an integral part of sustainable urban development) present a major opportunity for improving urban environments, quality of lives and livelihoods. This paper examines, using spatial concentration and spatial taxonomic measures, regional diversification of greenery in the cities of Poland. The analysis includes location quotients, Lorenz curve, Locational Gini Index, and the synthetic index of greenery and spatial statistics tools: (1) To verify the occurrence of strong concentration or dispersion of the phenomenon in time and space depending on the variable category, and, (2) To study if the level of greenery depends on the spatial autocorrelation. The data includes the greatest Polish cities, categories of the urban greenery (parks, lawns, street greenery, and green areas on housing estates, cemeteries, and forests) and the time span 2004-2015. According to the obtained estimations, most of cites in Poland are already taking measures to become greener. However, in the country there are still many barriers to well-balanced urban greenery development (e.g. uncontrolled urban sprawl, poor management as well as lack of spatial urban planning systems).

Keywords: greenery, urban areas, regional spatial diversification and concentration, spatial taxonomic measure

Procedia PDF Downloads 284

Authors: Amrane Meriem, Oukid Salyha

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The presence of defects or bugs in software can lead to costly setbacks, operational inefficiencies, and compromised user experiences. The integration of Machine Learning(ML) techniques has emerged to predict and preemptively address software defects. ML represents a proactive strategy aimed at identifying potential anomalies, errors, or vulnerabilities within code before they manifest as operational issues. By analyzing historical data, such as code changes, feature im- plementations, and defect occurrences. This en- ables development teams to anticipate and mitigate these issues, thus enhancing software quality, reducing maintenance costs, and ensuring smoother user interactions. In this work, we used a recommendation system to improve the performance of ML models in terms of predicting the code severity and effort estimation.

Keywords: software engineering, machine learning, bugs detection, effort estimation

Procedia PDF Downloads 80

Authors: Nabil Mezhoud

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The economic operation of electric energy generating systems is one of the predominant problems in energy systems. Due to the need for better reliability, high energy quality, lower losses, lower cost and a clean environment, the application of renewable and sustainable energy sources, such as wind energy, solar energy, etc., in recent years has become more widespread. In this work, one of a bio-inspired meta-heuristic algorithm inspired by the flashing behavior of fireflies at night called the Firefly Algorithm (FFA) is applied to solve the Optimal Energy Management (OEM) and the environmental index (EI) problems of a micro-grid (MG) operating by Renewable and Sustainable Generation Systems (RSGS). Our main goal is to minimize the nonlinear objective function of an electrical microgrid, taking into account equality and inequality constraints. The FFA approach was examined and tested on a standard MG system composed of different types of RSGS, such as wind turbines (WT), photovoltaic systems (PV), and non-renewable energy, such as fuel cells (FC), micro turbine (MT), diesel generator (DEG) and loads with energy storage systems (ESS). The results are promising and show the effectiveness and robustness of the proposed approach to solve the OEM and the EI problems. The results of the proposed method have been compared and validated with those known references published recently.

Keywords: renewable energy sources, energy management, distributed generator, micro-grids, firefly algorithm

Procedia PDF Downloads 68

Authors: Nuraddeen Usman, Khiruddin Abdullah, Mohd Nawawi, Amin Khalil Ismail

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A magnetic survey is carried out in order to locate the remains of construction items, specifically concrete pillars. The conventional Euler deconvolution technique can perform the task but it requires the use of fixed structural index (SI) and the construction items are made of materials with different shapes which require different SI (unknown). A Euler deconvolution technique that estimate background, horizontal coordinate (xo and yo), depth and structural index (SI) simultaneously is prepared and used for this task. The synthetic model study carried indicated the new methodology can give a good estimate of location and does not depend on magnetic latitude. For field data, both the total magnetic field and gradiometer reading had been collected simultaneously. The computed vertical derivatives and gradiometer readings are compared and they have shown good correlation signifying the effectiveness of the method. The filtering is carried out using automated procedure, analytic signal and other traditional techniques. The clustered depth solutions coincided with the high amplitude/values of analytic signal and these are the possible target positions of the concrete pillars being sought. The targets under investigation are interpreted to be located at the depth between 2.8 to 9.4 meters. More follow up survey is recommended as this mark the preliminary stage of the work.

Keywords: concrete pillar, magnetic survey, geotechnical investigation, Euler Deconvolution

Procedia PDF Downloads 255

Authors: Bliss Singhal

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Epilepsy is a prevalent neurological disorder affecting approximately 50 million individuals worldwide and 1.2 million Americans. There exist millions of pediatric patients with intractable epilepsy, a condition in which seizures fail to come under control. The occurrence of seizures can result in physical injury, disorientation, unconsciousness, and additional symptoms that could impede children's ability to participate in everyday tasks. Predicting seizures can help parents and healthcare providers take precautions, prevent risky situations, and mentally prepare children to minimize anxiety and nervousness associated with the uncertainty of a seizure. This research proposes a comprehensive framework to predict seizures in pediatric patients by evaluating machine learning algorithms on unimodal neuroimaging data consisting of electroencephalogram signals. The bandpass filtering and independent component analysis proved to be effective in reducing the noise and artifacts from the dataset. Various machine learning algorithms’ performance is evaluated on important metrics such as accuracy, precision, specificity, sensitivity, F1 score and MCC. The results show that the deep learning algorithms are more successful in predicting seizures than logistic Regression, and k nearest neighbors. The recurrent neural network (RNN) gave the highest precision and F1 Score, long short-term memory (LSTM) outperformed RNN in accuracy and convolutional neural network (CNN) resulted in the highest Specificity. This research has significant implications for healthcare providers in proactively managing seizure occurrence in pediatric patients, potentially transforming clinical practices, and improving pediatric care.

Keywords: intractable epilepsy, seizure, deep learning, prediction, electroencephalogram channels

Procedia PDF Downloads 78

Authors: S. Girish, N. Ajay

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Permeation properties have been widely used to quantify durability characteristics of concrete for assessing long term performance and sustainability. The processes of deterioration in concrete are mediated largely by water. There is a strong interest in finding a better way of assessing the material properties of concrete in terms of durability. Water sorptivity is a useful single material property which can be one of the measures of durability useful in service life planning and prediction, especially in severe environmental conditions. This paper presents the results of the comparative study of sorptivity of Self-Compacting Concrete (SCC) with conventionally vibrated concrete. SCC is a new, special type of concrete mixture, characterized by high resistance to segregation that can flow through intricate geometrical configuration in the presence of reinforcement, under its own mass, without vibration and compaction. SCC mixes were developed for the paste contents of 0.38, 0.41 and 0.43 with fly ash as the filler for different cement contents ranging from 300 to 450 kg/m3. The study shows better performance by SCC in terms of capillary absorption. The sorptivity value decreased as the volume of paste increased. The use of higher paste content in SCC can make the concrete robust with better densification of the micro-structure, improving the durability and making the concrete more sustainable with improved long term performance. The sorptivity based on secondary absorption can be effectively used as a durability index to predict the time duration required for the ingress of water to penetrate the concrete, which has practical significance.

Keywords: self-compacting concrete, service life prediction, sorptivity, volume of paste

Procedia PDF Downloads 316