Search results for: risk factors for diabetic complications

Authors: Achim Washington, Reece Clothier, Jose Silva

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System Safety Regulations (SSR) are a central component to the airworthiness certification of Unmanned Aircraft Systems (UAS). There is significant debate on the setting of appropriate SSR for UAS. Putting this debate aside, the challenge lies in how to apply the system safety process to UAS, which lacks the data and operational heritage of conventionally piloted aircraft. The limited knowledge and lack of operational data result in uncertainty in the system safety assessment of UAS. This uncertainty can lead to incorrect compliance findings and the potential certification and operation of UAS that do not meet minimum safety performance requirements. The existing system safety assessment and compliance processes, as used for conventional piloted aviation, do not adequately account for the uncertainty, limiting the suitability of its application to UAS. This paper discusses the challenges of undertaking system safety assessments for UAS and presents current and envisaged research towards addressing these challenges. It aims to highlight the main advantages associated with adopting a risk based framework to the System Safety Performance Requirement (SSPR) compliance process that is capable of taking the uncertainty associated with each of the outputs of the system safety assessment process into consideration. Based on this study, it is made clear that developing a framework tailored to UAS, would allow for a more rational, transparent and systematic approach to decision making. This would reduce the need for conservative assumptions and take the risk posed by each UAS into consideration while determining its state of compliance to the SSR.

Keywords: Part 1309 regulations, risk models, uncertainty, unmanned aircraft systems

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Authors: Jisun Jun, Eun Ko, Sooim Shin, Kitae Kim, Moonsung Choi

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Diabetes is a metabolic disease characterized by hyperglycemia, insulin resistant, mitochondrial dysfunction. Diabetes is associated with the development of diabetic retinopathy resulting in worsening vision and eventual blindness. In this study, eyes were enucleated from glucose-immersed zebrafish which is a good animal model to generate diabetes, and then mitochondria were isolated to evaluate activities of mitochondrial electron transfer complexes. Surprisingly, the amount of isolated mitochondria was increased in eyes from glucose-immersed zebrafish compared to those from non-glucose-immerged zebrafish. Spectrophotometric analysis for measuring activities of mitochondrial complex I, II, III, and IV revealed that mitochondria functions was even enhanced in eyes from glucose-immersed zebrafish. These results indicated that 3 days or 7 days glucose-immersion on zebrafish to induce diabetes might contribute metabolic compensatory mechanism to restore their mitochondrial homeostasis on the early stage of diabetes in eyes.

Keywords: diabetes, glucose immersion, mitochondrial complexes, zebrafish

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Authors: Sara Grazhdani, Alma Cili, Arben Ivanaj

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Immune Thrombocytopenic Purpura is an autoimmune disease characterized by the destruction of platelets by immune mediators, their deficient production in the red bone marrow and increased splenic sequestration, leading to the appearance of thrombocytopenia and increased risk of hemorrhage. Treatment is indicated in patients with low platelet counts (<30 x 10 9 /L) who present clinically with hemorrhagic events or are at increased risk for hemorrhage. The goal of the treatment remains (I) prevention of hemorrhagic events and deaths resulting from them, (II) reaching an adequate level of the number of platelets, (III) treatment of patients with as few toxic effects as possible. Corticosteroid therapy remains the first choice in the treatment of patients with Primary Immune Thrombocytopenic Purpura. Rituximab (Mabthera) remains the first choice in the second line in the treatment of patients with Immune Thrombocytopenic Purpura, refractory to the use of cortisones.

Keywords: ITP, rituximab, prednisolone, relapse

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Authors: Novita Linda Akbar, Elmeida Effendy, Mustafa M. Amin

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Background: The most common of psychotic disorders is schizophrenia. Vitamin D is made from sunlight, and in the skin from UVB radiation from sunlight. If people with Vitamin D deficiency is common severe mental illness such as schizophrenia.Schizophrenia is a chronic mental illness characterised by positive symptoms and negatives symptoms, such as hallucinations and delusions, flat affect and lack of motivation we can found. In patients with Schizophrenia maybe have several environmental risk factors for schizophrenia, such as season of birth, latitude, and climate has been linked to vitamin D deficiency. There is also relationship between the risk of schizophrenia and latitude, and with an increased incidence rate of schizophrenia seen at a higher latitude. Methods: This study was an analytical study, conducted in BLUD RS Jiwa Propinsi Sumatera Utara and RSUD Deli Serdang, the period in May 2016 and ended in June 2016 with a sample of the study 60 sample (20 patients live in the Highland and Lowland, 20 healthy controls). Inclusion criteria were schizophrenic patients both men and women, aged between 18 to 60 years old, acute phase no agitation or abstinence antipsychotic drugs for two weeks, live in the Highland and Lowland, and willing to participate this study. Exclusion criteria were history of other psychotic disorders, comorbidities with other common medical condition, a history of substance abuse. Sample inspection for serum vitamin D using ELFA method. Statistical analysis using numeric comparative T-independent test. Results: The results showed that average levels of vitamin D for a group of subjects living in areas of high land was 227.6 ng / mL with a standard deviation of 86.78 ng / mL, the lowest levels of vitamin D is 138 ng / mL and the highest 482 ng / mL. In the group of subjects who settled in the low lands seem mean vitamin D levels higher than the mountainous area with an average 237.8 ng / mL with a standard deviation of 100.16 ng / mL. Vitamin D levels are lowest and the highest 138-585 ng / mL. Conclusion and Suggestion: The results of the analysis using the Mann Whitney test showed that there were no significant differences between the mean for the levels of vitamin D based on residence subject with a value of p = 0.652.

Keywords: latitude, schizophrenia, Vitamin D, Sumatera Utara

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Authors: Itsuo Yokoyama, Rikako Kikuti, Naoko Watabe, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Chronic kidney disease presents significant changes in mineral and bone metabolism, referred to as CKD-MBD. These changes lead to decreased bone mass, heightened bone fragility, fractures, and increased vascular and valvular calcification, ultimately impacting cardiovascular outcomes. Key contributors to these complications in dialysis patients include calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and the vitamin D hormonal system. Methods: In our outpatient dialysis clinic, we monitor the long-term effects of vascular calcifications by calculating the volume of calcified areas in the abdominal aorta based on CT scan data. The results revealed a progressive nature of vascular calcification. To extend our study, we measured the volume of calcification in bones (vertebrae and femur) corresponding to Hounsfield units of 200 and 300. The study aims to investigate changes in osteoporosis during a 5-year follow-up period and its relationship with extraosseous calcification. Results and Considerations: While extraosseous calcification demonstrated a generally progressive nature, often resistant to medical treatment, the degree of osteoporotic change varied among patients. The majority exhibited continuous osteoporotic changes, while some showed improvement or minimal changes in bone calcification. Variations in the distribution and magnitude of osteoporotic changes were observed between groups based on the timing of hemodialysis initiation during the study. The former group tended to display more osteoporotic changes, possibly attributed to differences in medication between the groups. Other contributing factors may include the patient's age, duration of dialysis, or causes of renal disease. In conclusion, we emphasize the importance of carefully monitoring calcium and phosphate levels and maintaining adequate dialysis therapy to prevent osteoporosis in dialysis patients.

Keywords: CKD-MBD, dialysis, calcification, kidney

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Authors: Amira Abdulrazzaq

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This paper is studying the opinion of faculty members and students about the future of education (e-learning) at the University of Bahrain. Through quantitative analysis a distribution of two surveys, one targeting students of IT College, and College of Arts and the other targeting Faculty members of both Colleges. Through the above survey, the paper measures the following factors: awareness and acceptance, satisfaction, usability, and usefulness. Results indicate positive reactions of all above factors.

Keywords: e-learning, education, moodle, WebCT

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Authors: Calogero Lo Destro

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Numerous nations around the world are facing exceptional challenges in employing measures to stop the spread of COVID-19. Following the recommendations of the World Health Organization, a series of preventive measures have been adopted. However, individuals must comply with these rules and recommendations in order to make these measures effective. While COVID-19 was climaxing, it seemed of crucial importance to analyze which psychosocial factors contribute to the acceptance of such preventive behavior, thus favoring the management of COVID-19 worldwide health crisis. In particular, the identification of aspects related to obstacles and facilitation of adherence to social distancing has been considered crucial in the containment of the virus spread. Since the virus was firstly detected in China, Asian people could be considered a relevant outgroup targeted for exclusion. We also hypothesized social distance could be influenced by characteristics of the target, such as smiling or coughing. 260 participants participated in this research on a voluntary basis. They filled a survey designed to explore a series of COVID-19 measures (such as exposure to virus and fear of infection). We also assessed participants state and trait anxiety. The dependent variable was social distance, based on a measure of seating distance designed ad hoc for the present work. Our hypothesis that participants could report greater distance in response to Asian people was not confirmed. On the other hand, significantly lower distance in response to smiling compared to coughing targets was reported. Adopting a regression analysis model, we found that participants' social distance, in response to both coughing and smiling targets, was predicted by fear of infection and by the perception COVID-19 could become a pandemic. Social distance in response to the coughing target was also significantly and positively predicted by age and state anxiety. In summary, the present work has sought to identify a set of psychological variables, which may still be predictive of social distancing.

Keywords: COVID-19, social distancing, health, preventive behaviors, risk of infection

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Authors: Kingkan Pongsiri

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The study of marketing mix influencing on hotel booking decision making: Japanese senior traveler case aims to study the individual factors that are involved in the decision-making reservation for Japanese elderly travelers. Then, it aims to study other factors that influence the decision of tourists booking elderly Japanese people. This is a quantitative research methods, total of 420 completed questionnaires were collect via a Non-Probability sampling techniques. The study found that the majority of samples were female, 53.3 percent of 224 people aged between 66-70 years were 197, representing a 46.9 percent majority, the marital status of marriage is 212 per cent.50.5. Majority of samples have a bachelor degree of education with number of 326 persons (77.6 percentages) 50 percentages of samples (210 people) have monthly income in between 1,501-2,000 USD. The Samples mostly have a length of stay in a short period between 1-14 days counted as 299 people which representing 71.2 percentages of samples. The senior Japanese tourists apparently sensitive to the factors of products/services the most. Then they seem to be sensitive to the price, the marketing promotion and people, respectively. There are two factors identified as moderately influence to the Japanese senior tourists are places or distribution channels and physical evidences.

Keywords: Japanese senior traveler, marketing mix, senior tourist, hotel booking

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Authors: Abd-Alrahman Embaby, Ayman Abu Halawa, Medhat Ramadan

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The infiltrated water into the subsurface activates expansive soil in localized manner, leading to the differential heaving and destructive of the construction. The Watershed Modeling System (WMS) and Hydrologic Engineering Center (HEC-1) are used to delineate and identify the drainage system and basin morphometry in Tabuk area, where flash floods and accumulation of water may take place. Eight drainage basins effect on Tabuk city. Three of them are expected to be high. The flash floods and surface runoff behavior in these basins are important for any protection projects. It was found that the risky areas that contain Tabuk shale could be expanded when exposed to flash floods and/or surface runoff. The resident neighborhoods in the middle of Tabuk city and affected by surface runoff of the tributaries of the basin of Wadi Abu Nishayfah, Na'am and Atanah outlet, represent high-risk zones. These high-risk neighborhoods are Al Qadsiyah, Al Maseif, Arrwdah, Al Nakhil and Al Rajhi. It can be avoided new constructions on these districts. The low or very low-risk zones include the western and the eastern districts. The western side of the city is lying in the upstream of the small basin. It is suitable for a future urban extension. The direction of surface runoff flow or storm water drain discharge should be away from Tabuk city. The quicker the water can flow out, the better it is.

Keywords: digital elevation model (DEM), flash floods, Saudi Arabia, Tabuk City, watershed modeling system (WMS)

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Authors: A. Aguezzoul

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The Logistics Services Providers (LSPs) selection and performance is a strategic decision that affects the overall performance of any company as well as its supply chain. It is a complex process, which takes into account various conflicting quantitative and qualitative factors, as well as outsourced logistics activities. This article focuses on the evolution of the weights associated to these factors over the last years in order to better understand the change in the importance that logistics professionals place on them criteria when choosing their LSPs. For that, an analysis of 17 main studies published during 2014-2017 period was carried out and the results are compared to those of a previous literature review on this subject. Our analysis allowed us to deduce the following observations: 1) the LSPs selection is a multi-criteria process; 2) the empirical character of the majority of studies, conducted particularly in Asian countries; 3) the criteria importance has undergone significant changes following the emergence of information technologies that have favored the work in close collaboration and in partnership between the LSPs and their customers, even on a worldwide scale; 4) the cost criterion is relatively less important than in the past; and finally 5) with the development of sustainable supply chains, the factors associated with the logistic activities of return and waste processing (reverse logistics) are becoming increasingly important in this multi-criteria process of selection and evaluation of LSPs performance.

Keywords: logistics outsourcing, logistics providers, multi-criteria decision making, performance

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Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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Authors: Ana Fouto

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Background: Continuing Personal Development (CPD) enables professionals to keep up to date with the professional requirements, broadening their knowledge and expertise. However, much of the research explores the registered professionals’ experiences and the factors that influence their choice of engaging, despite the unregistered staff providing the majority of the direct patient care. Aim: To explore the Nursing/Midwifery Assistants’ (NAs) perception of the concept of CPD, as well as explore the factors that influence the NAs to engage (or not) with CPD experiences. Methodology: This pilot study used a qualitative approach through a case study, where a semi-structured interview was applied to three NAs to explore the factors that influence the decision-making of process of CPD engagement. Thematic analysis was used to analyse their answers and interpret patterns and associations. Findings: All the participants agreed that CPD is important and relevant to their practice and personal lives. Five main categories were identified: NAs’ scope of practice, the impact of CPD; decision-making process; challenges; changes required. Although similar findings to the registered nurses were identified, the lack of CPD regulation for NAs and the rapid evolution of their role make the CPD engagement more problematic. Conclusion: Engagement with CPD is influenced by a wide range of professional (organisational and national) and personal factors. NAs perceive lack of management support at different stages of the CPD activities as a main influence. Organisations should be more flexible in the recruitment, offer of CPD choices, content, delivery, and contractual arrangements of NAs, which may increase engagement.

Keywords: nursing assistants, engagement, factors, pilot, continuing professional development (CPD)

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Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

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Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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Authors: Feijoo E. Colomine Duran, Carlos E. Peñaloza Corredor

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There modeling component selection financial investment (Portfolio) a variety of problems that can be addressed with optimization techniques under evolutionary schemes. For his feature, the problem of selection of investment components of a dichotomous relationship between two elements that are opposed: The Portfolio Performance and Risk presented by choosing it. This relationship was modeled by Markowitz through a media problem (Performance) - variance (risk), ie must Maximize Performance and Minimize Risk. This research included the study and implementation of multi-objective evolutionary techniques to solve these problems, taking as experimental framework financial market equities Colombia Stock Exchange between 2009-2015. Comparisons three multiobjective evolutionary algorithms, namely the Nondominated Sorting Genetic Algorithm II (NSGA-II), the Strength Pareto Evolutionary Algorithm 2 (SPEA2) and Indicator-Based Selection in Multiobjective Search (IBEA) were performed using two measures well known performance: The Hypervolume indicator and R_2 indicator, also it became a nonparametric statistical analysis and the Wilcoxon rank-sum test. The comparative analysis also includes an evaluation of the financial efficiency of the investment portfolio chosen by the implementation of various algorithms through the Sharpe ratio. It is shown that the portfolio provided by the implementation of the algorithms mentioned above is very well located between the different stock indices provided by the Colombia Stock Exchange.

Keywords: finance, optimization, portfolio, Markowitz, evolutionary algorithms

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Authors: Daphine Namara, Jeremy I. Schwartz, Andrew K. Tusubira, Willi McFarland, Caroline Birungi, Fred C. Semitala, Martin Muddu

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Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is a need for rigorous studies to validate this association in the face of increasing DTG use and the burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case-control study to assess the risk of hyperglycemia associated with the use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia, while controls had no hyperglycemia, as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. The analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96-25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18-35, aOR 12.38, 95% CI 3.79-40.50) and hypertension (aOR 5.78, 95% CI 2.53-13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is a need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.

Keywords: HIV, hyperglycemia, doluteravir, diabetes

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Authors: Kimberly Samaha

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In order to attract new types of investors into the emerging Bio-Economy, new methodologies to analyze investment risk are needed. The Bio-Hub Ecosystem model was developed to address a critical area of concern within the global energy market regarding the use of biomass as a feedstock for power plants. This study looked at repurposing existing biomass-energy plants into Circular Zero-Waste Bio-Hub Ecosystems. A Bio-Hub model that first targets a ‘whole-tree’ approach and then looks at the circular economics of co-hosting diverse industries (wood processing, aquaculture, agriculture) in the vicinity of the Biomass Power Plants facilities. This study modeled the economics and risk strategies of cradle-to-cradle linkages to incorporate the value-chain effects on capital/operational expenditures and investment risk reductions using a proprietary techno-economic model that incorporates investment risk scenarios utilizing the Monte Carlo methodology. The study calculated the sequential increases in profitability for each additional co-host on an operating forestry-based biomass energy plant in West Enfield, Maine. Phase I starts with the base-line of forestry biomass to electricity only and was built up in stages to include co-hosts of a greenhouse and a land-based shrimp farm. Phase I incorporates CO2 and heat waste streams from the operating power plant in an analysis of lowering and stabilizing the operating costs of the agriculture and aquaculture co-hosts. Phase II analysis incorporated a jet-fuel biorefinery and its secondary slip-stream of biochar which would be developed into two additional bio-products: 1) A soil amendment compost for agriculture and 2) A biochar effluent filter for the aquaculture. The second part of the study applied the Monte Carlo risk methodology to illustrate how co-location derisks investment in an integrated Bio-Hub versus individual investments in stand-alone projects of energy, agriculture or aquaculture. The analyzed scenarios compared reductions in both Capital and Operating Expenditures, which stabilizes profits and reduces the investment risk associated with projects in energy, agriculture, and aquaculture. The major findings of this techno-economic modeling using the Monte Carlo technique resulted in the masterplan for the first Bio-Hub to be built in West Enfield, Maine. In 2018, the site was designated as an economic opportunity zone as part of a Federal Program, which allows for Capital Gains tax benefits for investments on the site. Bioenergy facilities are currently at a critical juncture where they have an opportunity to be repurposed into efficient, profitable and socially responsible investments, or be idled and scrapped. The Bio-hub Ecosystems techno-economic analysis model is a critical model to expedite new standards for investments in circular zero-waste projects. Profitable projects will expedite adoption and advance the critical transition from the current ‘take-make-dispose’ paradigm inherent in the energy, forestry and food industries to a more sustainable Bio-Economy paradigm that supports local and rural communities.

Keywords: bio-economy, investment risk, circular design, economic modelling

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Authors: Emad Al-Abdallat, Faris G. Bakri, Azmi Mahafza, Rayyan Al Ali, Nidaa Ababneh, Ahmed Idhair

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Background: Morgues are high-risk areas for the spread of infection from the cadavers to the staff during the postmortem examination. Infection can spread from corpses to workers by the airborne route, by direct contact, or from needle and sharp object injuries. Objective: Knowledge about the prevalence of these infections among autopsies is prudent to appreciate any risk of transmission and to further enforce safety measures. Method: A total of 242 autopsies were tested. Age ranged from 3 days to 94 years (median 75.5 years, mean 45.3 (21.9 ± SD)). There were 172 (71%) males. Results: The cause of death was considered natural in 137 (56.6%) cases, accidental in 89 (36.8%), homicidal in 9 (3.7%), suicidal in 4 (1.7%), and unknown in 3 (1.2%). Hepatitis B surface antigen was positive in 5 (2.1%) cases. Hepatitis C virus antibody was detected in 5 (2.1%) cases and the hepatitis C virus polymerase chain reaction was positive in 2 of them (0.8%). HIV antibody was not detected in any of the cases. Conclusions: Autopsies can be associated with exposure to blood borne viruses. Autopsies performed during the study period were tested for hepatitis B surface antigen, hepatitis C virus antibody, and human immunodeficiency virus antibody. Positive tests were subsequently confirmed by polymerase chain reaction. There is low prevalence of infections with these viruses in our autopsy cases. However, the risk of transmission remains a threat. Healthcare workers in the forensic departments should adhere to standard precautions.

Keywords: autopsy, hepatitis B virus, hepatitis C virus, human immunodeficiency virus, Jordan

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Authors: Maria Kralova, Michal Palecek

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We have detected factors leading to recidivism (the Czech Republic data). The employment during imprisonment turned out to be the most significant predictor with a positive effect on reduction of a rate of recidivism. Accordingly, we mainly focus on this predictor and its economic consequences. Smart public policy can cut government costs dramatically as more than a half of prisoners in the Czech Republic are recidivists. The operating cost cut of the Czech prison service could be CZK 127,680,000 (USD 5,889,623) in 2013 if a public policy had been set smarter.

Keywords: cost-cut, effective, optimal, public policy, reducing recidivism

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Authors: David Alejandro Torres-Lopez , Lilia Albores-Gallo, Ronald Soto-Calderon, Roberto Lagunes-Cordoba

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Autism Screening Questionnaire for Daycare Attendees (ASQ-DAT) is a screening instrument that assesses the risk of autism in children between 12 and 47 months, being the first free observational instrument created according to the criteria of the DSM-5 that can be applied by teachers in nurseries. The people in charge of answering the questionnaires are the daycare assistants. Its application presents a series of previous activities with which daycare assistants are familiar (dance, games, oral narration and breakfast), which are executed with the children and then answer a questionnaire with dichotomous questions "Yes/No" in approximately 3 minutes per child. The instrument was developed with the participation of nurseries according to the protocols of the creation of psychometric instruments of the Classical Test Theory having as a gold standard ADOS-2 Modules T and 1. The results of the investigation show that the use of ASQ-DAT combined with the application of M-CHAT / RF provides more information about the risk of ASD in young children, which allows improvements in the screening.

Keywords: diagnosis, screening, autism, daycare

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Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

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Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

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Authors: Laref Nabil

Abstract:

Ecology is at the center of many debates and international regulations. It therefore becomes a necessity and a privileged axis in many countries policy. The rise of environmental problems, the particularism of the hospital as an actor Public Health must lead by example in hygiene, prevention of risks to man and his environment. In this, it seemed interesting to make a poster on hospital liquid effluents in order to know not only the regulatory aspects but also their degree of pollution and their management in health institutions. Materials and methods: Samples taken at several looks, analysis performed at STEP Reghaia Algiers. Discussion and / or findings: In general, central gaze analysis results of water we can conclude that the contents of the various physico-chemical parameters greatly exceed the standards. Although the hypothesis of assimilating hospital liquid effluents domestic waters is confirmed, the liquid effluent from the University Hospital of Beni Messous and dumped in the natural environment still represent ecotoxicological risk.

Keywords: health, hospital, liquid effluents, water

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Authors: Abhishek Saha, Serene Tay, Gerard Pijcke

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The availability of high-resolution topography and rainfall information in urban areas has made it necessary to revise modeling approaches used for simulating flood risk assessments. Lidar derived elevation models that have 1m or lower resolutions are becoming widely accessible. The classical approaches of 1D-2D flow models where channel flow is simulated and coupled with a coarse resolution 2D overland flow models may not fully utilize the information provided by high-resolution data. In this context, a study was undertaken to compare three different modeling approaches to simulate flooding in an urban area. The first model used is the base model used is Sobek, which uses 1D model formulation together with hydrologic boundary conditions and couples with an overland flow model in 2D. The second model uses a full 2D model for the entire area with shallow water equations at the resolution of the digital elevation model (DEM). These models are compared against another shallow water equation solver in 2D, which uses a subgrid method for grid refinement. These models are simulated for different horizontal resolutions of DEM varying between 1m to 5m. The results show a significant difference in inundation extents and water levels for different DEMs. They are also sensitive to the different numerical models with the same physical parameters, such as friction. The study shows the importance of having reliable field observations of inundation extents and levels before a choice of model and data can be made for spatial flood risk assessments.

Keywords: flooding, DEM, shallow water equations, subgrid

Procedia PDF Downloads 132

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

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

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

Procedia PDF Downloads 144

Authors: Hung-Jen Lin, Chien-Hao Wang, Chien-Peng Huang, Yu-Sheng Tseng, En-Cheng Yang, Joe-Air Jiang

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Bees’ incoming and outgoing behavior is a decisive index which can indicate the health condition of a colony. Traditional methods for monitoring the behavior of honey bees (Apis mellifera) take too much time and are highly labor-intensive, and the lack of automation and synchronization disables researchers and beekeepers from obtaining real-time information of beehives. To solve these problems, this study proposes to use an Internet of Things (IoT)-based system for counting honey bees’ incoming and outgoing activities using an infrared interruption technique, while environmental factors are recorded simultaneously. The accuracy of the established system is verified by comparing the counting results with the outcomes of manual counting. Moreover, this highly -accurate device is appropriate for providing quantitative information regarding honey bees’ incoming and outgoing behavior. Different statistical analysis methods, including one-way ANOVA and two-way ANOVA, are used to investigate the influence of environmental factors, such as temperature, humidity, illumination and ambient pressure, on bees’ incoming and outgoing behavior. With the real-time data, a standard model is established using the outcomes from analyzing the relationship between environmental factors and bees’ incoming and outgoing behavior. In the future, smart control systems, such as a temperature control system, can also be combined with the proposed system to create an appropriate colony environment. It is expected that the proposed system will make a considerable contribution to the apiculture and researchers.

Keywords: ANOVA, environmental factors, honey bee, incoming and outgoing behavior

Procedia PDF Downloads 358

Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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Authors: Bishoy Abouelsoud Saad Amin

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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.

Keywords: computer game, metaphor, middle school students, virtual environments computer auditing, risk, measures to prevent, information management computer-related health hazard, musculoskeletal disorders, computer usage, work ability index

Procedia PDF Downloads 47

Authors: Toan Vu Duc, Son Ha Viet

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This research presents the first comprehensive survey of congener profiles (7 indicator congeners) of polybrominated diphenyl ethers (PBDEs) in sediment samples covering ten sites in CauBay River, Vietnam. Chemical analyses were carried out in gas chromatography–mass spectrometry (GC–MS) for tri- to hepta- brominated congeners. Results pointed out a non-homogenous contamination of the sediment with ∑7 PBDE values ranging from 8.93 to 25.64ng g−1, reflecting moderate to low contamination closely in conformity to other Asian aquatic environments. The general order of decreasing congener contribution to the total load was: BDE 47 > 99 > 100 > 154, similar to the distribution pattern worldwide. PBDEs had rare risks in the sediment of studied area. However, due to the propensity of PBDEs to accumulate in various compartments of wildlife and human food webs, evaluation of biological tissues should be undertaken as a high priority.

Keywords: residue, risk assessment, PBDEs, sediment

Procedia PDF Downloads 289

Authors: Nima Safaei, Arezoo Masoud, Babak Safaei

Abstract:

In recent years, there has been a growing emphasis on the role of urban planning in walking capability and the effects of individual and socioeconomic factors on the physical activity levels of city dwellers. Although considerable number of studies are conducted about walkability and for identifying the effective factors in walking mode choice in developed countries, to our best knowledge, literature lacks in the study of factors affecting choice of walking mode in developing countries. Due to the high importance of health aspects of human societies and in order to make insights and incentives for reducing traffic during rush hours, many researchers and policy makers in the field of transportation planning have devoted much attention to walkability studies; they have tried to improve the effective factors in the choice of walking mode in city neighborhoods. In this study, effective factors in walkability that have proven to have significant impact on the choice of walking mode, are studied at the same time in work trips. The data for the study is collected from the employees in their workplaces by well-instructed people using questionnaires; the statistical population of the study consists of 117 employed people who commute daily from work to home in Rasht city of Iran during the beginning of spring 2015. Results of the study which are found through the linear regression modeling, show that people who do not have freedom of choice for choosing their living locations and need to be present at their workplaces in certain hours have lower levels of walking. Additionally, unlike some of the previous studies which were conducted in developed countries, coincidental effects of Body Mass Index (BMI) and the income level of employees, do not have a significant effect on the walking level in work travels.

Keywords: BMI, linear regression, transportation, walking, work trips

Procedia PDF Downloads 184

Authors: Wipanee Maen-In

Abstract:

The objectives of the research are i) to study the motivations of european and scandinavian tourists who select Ranong province as their destinations ii) to study their perception towards the Ranong Province and iii) to study the visitors’ decision making while visiting Ranong Province. The samples of the study are 220 European and Scandinavian tourists’ visitors at the Ranong by accidental sampling and in clouding online questionnaires for 53 sampling. The data analysis includes Percentage, Frequency and One-way ANOVA. The findings from the research are the motivation level of the visitors is considered prominent, the average score of the motivational factors ranks higher than the average of the pull factors to visit the Ranong province when considering the factors analysis, the research shows that the reason that most tourists visit the Ranong is for relaxation while the purity of the natural mineral hot springs is the most important pull factor.

Keywords: European and Scandinavian, Ranong province, tourists’ perceptions, visitors’ decision making

Procedia PDF Downloads 225

Authors: Veronica Sri Lestari, Asmuddin Natsir, Hasmida Karim, Ian Patrick

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The research aimed at investigating the factors affecting consumers’ willingness to pay for chicken meat from biosecure farms. The research was conducted in Makassar City, South Sulawesi Province, Indonesia. Samples were taken using random sampling technique in two supermarkets namely Lotte Mart and Gelael. Total samples were 50 respondents which comprised the chicken meat consumers. To find out the consumers’ willingness to pay for chicken meat from the biosecure farms, the contingent valuation method was utilized. Data were collected through interviews and questionnaires. Probit Logistic was estimated to examine the factors affecting the consumers’ willingness to pay for at the premium price for chicken meat from the biosecure farms. The research indicates that the education and income affect significantly the consumers’ willingness to pay for chicken meat from the biosecure farms (P < 0.05). The results of the study will be beneficial for the policy makers, producers, consumers and those conducting research.

Keywords: biosecure, chicken, farms, consumer, willingness-to-pay

Procedia PDF Downloads 267