Search results for: risk assessment

Authors: Osama Zayed

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Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal

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Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

Keywords: urology, endourology, prostate, bladder outlet obstruction, laser

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Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas

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The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.

Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy

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Authors: A. Banovcinova, M. Zakova

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Labor market activity and paid employment should be a key factor in protecting individuals and families from falling into poverty and providing them with sufficient resources to meet the needs of their members. However, due to various processes in the labor market as well as the influence of individual factors and often insufficient social capital, there is a relatively large group of households that cannot eliminate paid employment and find themselves in a state of so-called working poverty. The aim of the research was to find out what strategies families use in managing poverty and meeting their needs and which of these strategies prevail in the Slovak population. A quantitative research strategy was chosen. The method of data collection was a structured interview focused on finding out the use of individual management strategies and also selected demographic indicators. The research sample consisted of members of families in which at least one member has a paid job. The condition for inclusion in the research was that the family's income did not exceed 60% of the national median equalized disposable income. The analysis of the results showed 5 basic areas to which management strategies are related - work, financial security, needs, social contacts and perception of the current situation. The prevailing strategies were strategies aimed at increasing and streamlining labor market activity and the planned and effective management of the family budget. Strategies that were rejected were mainly related to debt creation. The results make it possible to identify the preferred ways of managing poverty in individual areas of life, as well as the factors that influence this behavior. This information is important for working with families living in a state of working poverty and can help professionals develop positive ways of coping for families.

Keywords: copying strategies, family, in-work poverty, quantitative research

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Authors: María Reveles-Miranda, Daniella Pacheco-Catalán

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Sierra Papacal commissary is located north of Merida, Yucatan, México, where the indigenous Maya population predominates. Due to its location, the region has an elevation of fewer than 4.5 meters above sea level, with a high risk of flooding associated with storms and hurricanes and a high vulnerability of infrastructure and housing in the presence of strong gusts of wind. In environmental contingencies, the challenge is providing an autonomous electrical supply using renewable energy sources that cover vulnerable populations' health, food, and water pumping needs. To address this challenge, a hybrid energy storage module is proposed for the emergency photovoltaic (PV) system of the community shelter in Sierra Papacal, Yucatán, which combines high-energy-density batteries and high-power-density supercapacitors (SC) in a single module, providing a quick response to energy demand, reducing the thermal stress on batteries and extending their useful life. Incorporating SC in energy storage modules can provide fast response times to power variations and balanced energy extraction, ensuring a more extended period of electrical supply to vulnerable populations during contingencies. The implemented control strategy increases the module's overall performance by ensuring the optimal use of devices and balanced energy exploitation. The operation of the module with the control algorithm is validated with MATLAB/Simulink® and experimental tests.

Keywords: batteries, community shelter, environmental contingencies, hybrid energy storage, isolated photovoltaic system, supercapacitors

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Authors: Idrissa Kayijuka

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The logistic regression and Cox regression models (proportional hazard model) at present are being employed in the analysis of prospective epidemiologic research looking into risk factors in their application on chronic diseases. However, a theoretical relationship between the two models has been studied. By definition, Cox regression model also called Cox proportional hazard model is a procedure that is used in modeling data regarding time leading up to an event where censored cases exist. Whereas the Logistic regression model is mostly applicable in cases where the independent variables consist of numerical as well as nominal values while the resultant variable is binary (dichotomous). Arguments and findings of many researchers focused on the overview of Cox and Logistic regression models and their different applications in different areas. In this work, the analysis is done on secondary data whose source is SPSS exercise data on BREAST CANCER with a sample size of 1121 women where the main objective is to show the application difference between Cox regression model and logistic regression model based on factors that cause women to die due to breast cancer. Thus we did some analysis manually i.e. on lymph nodes status, and SPSS software helped to analyze the mentioned data. This study found out that there is an application difference between Cox and Logistic regression models which is Cox regression model is used if one wishes to analyze data which also include the follow-up time whereas Logistic regression model analyzes data without follow-up-time. Also, they have measurements of association which is different: hazard ratio and odds ratio for Cox and logistic regression models respectively. A similarity between the two models is that they are both applicable in the prediction of the upshot of a categorical variable i.e. a variable that can accommodate only a restricted number of categories. In conclusion, Cox regression model differs from logistic regression by assessing a rate instead of proportion. The two models can be applied in many other researches since they are suitable methods for analyzing data but the more recommended is the Cox, regression model.

Keywords: logistic regression model, Cox regression model, survival analysis, hazard ratio

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Authors: Kumar Kanudkuri, A. Sandhya

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Typically, in a MRI clinical setting, there are several protocols run, each indicated for a specific anatomy and disease condition. However, these protocols or parameters within them can change over time due to changes to the recommendations by the physician groups or updates in the software or by the availability of new technologies. Most of the time, the changes are performed by the MRI technologist to account for either time, coverage, physiological, or Specific Absorbtion Rate (SAR ) reasons. However, giving properly guidelines to MRI technologist is important so that they do not change the parameters that negatively impact the image quality. Typically a standard American College of Radiology (ACR) MRI phantom is used for Quality Control (QC) in order to guarantee that the primary objectives of MRI are met. The visual evaluation of quality depends on the operator/reviewer and might change amongst operators as well as for the same operator at various times. Therefore, overcoming these constraints is essential for a more impartial evaluation of quality. This makes quantitative estimation of image quality (IQ) metrics for MRI quality control is very important. So in order to solve this problem, we proposed that there is a need for a robust, open-source, and automated MRI image control tool. The Designed and developed an automatic analysis tool for measuring MRI image quality (IQ) metrics like Signal to Noise Ratio (SNR), Signal to Noise Ratio Uniformity (SNRU), Visual Information Fidelity (VIF), Feature Similarity (FSIM), Gray level co-occurrence matrix (GLCM), slice thickness accuracy, slice position accuracy, High contrast spatial resolution) provided good accuracy assessment. A standardized quality report has generated that incorporates metrics that impact diagnostic quality.

Keywords: ACR MRI phantom, MRI image quality metrics, SNRU, VIF, FSIM, GLCM, slice thickness accuracy, slice position accuracy

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Authors: Ikpesu, Thomas Ohwofasa, Babtunde Ilesanmi

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The effects of anthropogenic activities on fish and fisheries products in Niger Delta water bodies were investigated. The rivers were selected based on their close proximity to contaminants and dredging activities. Three stations were chosen per river. The stations chosen to depicting downstream and upstream stations were visited and samples collected on monthly basis. The down streams stations are the polluted and heavily dredged sites, where the upstream station is far, without any evidence of pollution or human activities. During these periods, the fishes of the same species were collected and analyzed for morphological and physiological changes, after which they were returned back to the rivers. The physico-chemicals parameters of these stations were also taken. Morphological changes such as skin ulcerations and other lesions, as well as fungi infections were observed in the down streams fishes. The fish in up streams look healthier and bigger (though the age could not be affirmed) than the downstream fishes. The physico-chemical parameters between the up streams and down streams stations vary significantly (p < 0.01). These anthropogenic effects must have interfere with the normal migration pattern of these fishes, because there were changes in the composition of population and species diversity in the samples sites, with the upstream having true species diversity. The release of pollutants into the water in the Niger Delta areas may triggers off naturally occurring bio toxicity cycles and other fish poisoning. There is risk of biomagnifications of these poisons along the tropic level. This makes the normally valuable food resource dangerous for human consumption and thereby instances of human death caused by such poisoning.

Keywords: anthropogenic, dredging, fisheries, niger delta, pollution, rivers

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Authors: P. V. S. Mascarenhas, B. C. P. Albuquerque, D. J. F. Campos, L. L. Almeida, V. R. Domingues, L. C. S. M. Ozelim

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Retaining slope structures are increasingly considered in geotechnical engineering projects due to extensive urban cities growth. These kinds of engineering constructions may present instabilities over the time and may require reinforcement or even rebuilding of the structure. In this context, statistical analysis is an important tool for decision making regarding retaining structures. This study approaches the failure probability of the construction of a retaining wall over the debris of an old and collapsed one. The new solution’s extension length will be of approximately 350 m and will be located over the margins of the Lake Paranoá, Brasilia, in the capital of Brazil. The building process must also account for the utilization of the ruins as a caisson. A series of in situ and laboratory experiments defined local soil strength parameters. A Standard Penetration Test (SPT) defined the in situ soil stratigraphy. Also, the parameters obtained were verified using soil data from a collection of masters and doctoral works from the University of Brasília, which is similar to the local soil. Initial studies show that the concrete wall is the proper solution for this case, taking into account the technical, economic and deterministic analysis. On the other hand, in order to better analyze the statistical significance of the factor-of-safety factors obtained, a Monte Carlo analysis was performed for the concrete wall and two more initial solutions. A comparison between the statistical and risk results generated for the different solutions indicated that a Gabion solution would better fit the financial and technical feasibility of the project.

Keywords: economical analysis, probability of failure, retaining walls, statistical analysis

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Authors: Joshua Loiselle

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This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

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Authors: Sayed Ali Garossi, Azar Heidarizadi, Shahla Mohammad Ganji

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Context: Colorectal cancer is the second type of cancer-related mortality globally. Expression of cas8 (caspase 8) is closely connected to growth and metastasis of colorectal cancer.Cas8/Rip1 plays a vital role in the apoptosis pathway and resistance to chemotherapy. The aim of the present study is to investigate the pattern of gene expression in colorectal cancer and compare the differences using Real-Time PCR to find a potential biomarker candidate for colorectal cancer. Methodology: This study conducted real-time PCR to evaluate gene expression of Cas8 in colorectal cancer patients. The gene-specific primer sequences exon–exon junction was designed by OLIGO7 software for the expression of the gene under investigation. Forty-six patient samples without any chemotherapy were selected, including tumoral tissue and adjacent normal tissue samples. The age of the patients was 50 and the size of the tumors was 5.5 cm. The categories were before and after age 50. Findings: Here, we found that Caspase 8 was overexpressed in CRC tissues compared to corresponding adjacent colon tissues (Cas8: 5.2 vs. 1 ratio); high expression of Cas8 was associated with poor overall survival and independent risk factors for the prognosis of CRC patients. Conclusion: In conclusion, our study pioneered the reporting of high Casp8 expression as a predictor of poor prognosis and chemical resistance in CRC patients.Cas8 overexpression suppressed Cas 8 / Rip1-dependent apoptosis and activated the proliferation of tumor cells by activating necroptosis. The necroptosis pathway has also emerged as a new approach to anti-tumor in cancer treatment.

Keywords: Cas8, necroptosis, apoptosis, Real-Time PCR

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le, Chi V. Phan

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Wilson’s disease (WD) is an autosomal recessive disorder of the copper metabolism, which is caused by a mutation in the copper-transporting P-type ATPase (ATP7B). The mechanism of this disease is the failure of hepatic excretion of copper to bile, and leads to copper deposits in the liver and other organs. The ATP7B gene is located on the long arm of chromosome 13 (13q14.3). This study aimed to investigate the gene mutation in the Vietnamese patients with WD, and make a presymptomatic diagnosis for their familial members. Forty-three WD patients and their 65 siblings were identified as having ATP7B gene mutations. Genomic DNA was extracted from peripheral blood samples; 21 exons and exon-intron boundaries of the ATP7B gene were analyzed by direct sequencing. We recognized four mutations ([R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G) in the sum of 20 detectable mutations, accounting for 87.2% of the total. Mutation S105* was determined to have a high rate (32.6%) in this study. The hotspot regions of ATP7B were found at exons 2, 16, and 8, and intron 14, in 39.6 %, 11.6 %, 9.3%, and 7 % of patients, respectively. Among nine homozygote/compound heterozygote siblings of the patients with WD, three individuals were determined as asymptomatic by screening mutations of the probands. They would begin treatment after diagnosis. In conclusion, 20 different mutations were detected in 43 WD patients. Of this number, four novel mutations were explored, including [R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G. The mutation S105* is the most prevalent and has been considered as a biomarker that can be used in a rapid detection assay for diagnosis of WD patients. Exons 2, 8, and 16, and intron 14 should be screened initially for WD patients in Vietnam. Based on risk profile for WD, genetic testing for presymptomatic patients is also useful in diagnosis and treatment.

Keywords: ATP7B gene, mutation detection, presymptomatic diagnosis, Vietnamese Wilson’s disease

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Authors: Panita Wannapiroon, Prachyanun Nilsook

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This paper is a report on the findings of a Research and Development (R&D) aiming to develop the model of Research-Based Blended Learning Model Using Adaptive Scaffolding (RBBL-AS) to enhance graduate students’ research competency and analytical thinking skills, to study the result of using such model. The sample consisted of 10 experts in the fields during the model developing stage, while there were 23 graduate students of KMUTNB for the RBBL-AS model try out stage. The research procedures included 4 phases: 1) literature review, 2) model development, 3) model experiment, and 4) model revision and confirmation. The research results were divided into 3 parts according to the procedures as described in the following session. First, the data gathering from the literature review were reported as a draft model; followed by the research finding from the experts’ interviews indicated that the model should be included 8 components to enhance graduate students’ research competency and analytical thinking skills. The 8 components were 1) cloud learning environment, 2) Ubiquitous Cloud Learning Management System (UCLMS), 3) learning courseware, 4) learning resources, 5) adaptive Scaffolding, 6) communication and collaboration tolls, 7) learning assessment, and 8) research-based blended learning activity. Second, the research finding from the experimental stage found that there were statistically significant difference of the research competency and analytical thinking skills posttest scores over the pretest scores at the .05 level. The Graduate students agreed that learning with the RBBL-AS model was at a high level of satisfaction. Third, according to the finding from the experimental stage and the comments from the experts, the developed model was revised and proposed in the report for further implication and references.

Keywords: research based learning, blended learning, adaptive scaffolding, research competency, analytical thinking skills

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Authors: Mohammad Reza Dousti, Yaman Boluk, Vivek Bindiganavile

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During the past few decades, oil and natural gas consumption have increased significantly. The limited amount of hydrocarbon resources on earth has led to a stronger desire towards efficient drilling, well completion and extracting, with the least time, energy and money wasted. Well cementing is one of the most crucial and important steps in any well completion, to fill the annulus between the casing string and the well bore. However, since it takes place at the end of the drilling process, a satisfying and acceptable job is rarely done. Hence, a large and significant amount of time and energy is then spent in order to do the required corrections or retrofitting the well in some cases. Oil well cement paste needs to be pumped during the cementing process, therefore the rheological and flow behavior of the paste is of great importance. This study examines the use of innovative cellulose-based nanomaterials on the flow properties of the resulting cementitious system. The cementitious paste developed in this research is composed of water, class G oil well cement, bentonite and cellulose nanocrystals (CNC). Bentonite is used as a cross contamination component. Initially, the influence of CNC on the flow and rheological behavior of CNC and bentonite suspensions was assessed. Furthermore, the rheological behavior of oil well cement pastes dosed with CNC was studied using a steady shear parallel-plate rheometer and the results were compared to the rheological behavior of a neat oil well cement paste with no CNC. The parameters assessed were the yield shear stress and the viscosity. Significant changes in yield shear stress and viscosity were observed due to the addition of the CNC. Based on the findings in this study, the addition of a very small dosage of CNC to the oil well cement paste results in a more viscous cement slurry with a higher yield stress, demonstrating a shear thinning behavior.

Keywords: cellulose nanocrystal, flow behavior, oil well cement, rheology

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Authors: Samar Mousa, Rebecca Shirley

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Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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Authors: Omolola A. Tajelawi, Hari L. Garbharran

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Revenue leakages are one of the major challenges manufacturers face in production processes, as most of the input materials that should emanate as products from the lines are lost as waste. Rather than generating income from material input which is meant to end-up as products, losses are further incurred as costs in order to manage waste generated. In addition, due to the lack of a clear view of the flow of resources on the lines from input to output stage, acquiring information on the true cost of waste generated have become a challenge. This has therefore given birth to the conceptualization and implementation of waste minimization strategies by several manufacturing industries. This paper reviews the principles and applications of three environmental management accounting tools namely Activity-based Costing (ABC), Life-Cycle Assessment (LCA) and Material Flow Cost Accounting (MFCA) in the manufacturing industry and their effectiveness in curbing revenue leakages. The paper unveils the strengths and limitations of each of the tools; beaming a searchlight on the tool that could allow for optimal resource utilization, transparency in production process as well as improved cost efficiency. Findings from this review reveal that MFCA may offer superior advantages with regards to the provision of more detailed information (both in physical and monetary terms) on the flow of material inputs throughout the production process compared to the other environmental accounting tools. This paper therefore makes a case for the adoption of MFCA as a viable technique for the identification and reduction of waste in production processes, and also for effective decision making by production managers, financial advisors and other relevant stakeholders.

Keywords: MFCA, environmental management accounting, resource efficiency, waste reduction, revenue losses

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Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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Authors: S. A. Salau, I. F. Ayanda, I. Afe, M. O. Adesina, N. B. Nofiu

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Food insecurity is still a critical challenge among rural and urban households in Nigeria. The country’s food insecurity situation became more pronounced due to frequent conflict between pastoralist and crop farmers. Thus, this study assesses pastoralist-crop farmers’ conflict and food security of farming households in Kwara state, Nigeria. The specific objectives are to measure the food security status of the respondents, quantify pastoralist- crop farmers’ conflict, determine the effect of pastoralist- crop farmers conflict on food security and describe the effective coping strategies adopted by the respondents to reduce the effect of food insecurity. A combination of purposive and simple random sampling techniques will be used to select 250 farming households for the study. The analytical tools include descriptive statistics, Likert-scale, logistic regression, and food security index. Using the food security index approach, the percentage of households that were food secure and insecure will be known. Pastoralist- crop farmers’ conflict will be measured empirically by quantifying loses due to the conflict. The logistic regression will indicate if pastoralist- crop farmers’ conflict is a critical determinant of food security among farming households in the study area. The coping strategies employed by the respondents in cushioning the effects of food insecurity will also be revealed. Empirical studies on the effect of pastoralist- crop farmers’ conflict on food security are rare in the literature. This study will quantify conflict and reveal the direction as well as the extent of the relationship between conflict and food security. It could contribute to the identification and formulation of strategies for the minimization of conflict among pastoralist and crop farmers in an attempt to reduce food insecurity. Moreover, this study could serve as valuable reference material for future researches and open up new areas for further researches.

Keywords: agriculture, conflict, coping strategies, food security, logistic regression

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Authors: Georgios Psakis, Imren Rahbay, David Spiteri, Jeanice Mallia, Martin Polidano, Vasilis P. Valdramidis

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Absence of surface water and progressive groundwater quality deterioration have exacerbated scarcity rapidly, making the Mediterranean island of Malta one of the most water-stressed countries in Europe. Water scarcity challenges have been addressed by reverse osmosis desalination of seawater, 60% of which is blended with groundwater to form the current potable tap-water supply. Chlorination has been the adopted method of water disinfection prior to distribution. However, with the Malteseconsumer chlorine sensory-threshold being as low as 0.34 ppm, presence of chorine residuals and chlorination by-products in the distributed tap-water impacts negatively on its organoleptic attributes, deterring the public from consuming it. As part of the PURILMA initiative, and with the aim of minimizing the impact of chlorine residual on the quality of the distributed water, UV-C, and hydrosonication, have been identified as cost- and energy-effective decontamination alternatives, paving the way for more sustainable water management. Bench-scale assessment of the decontamination efficiency of UV-C (254 nm), revealed 4.7-Log10 inactivation for both Escherichia coli and Enterococcus faecalis at 36 mJ/cm2. At >200 mJ/cm2fluence rates, there was a systematic 2-Log10 difference in the reductions exhibited by E. coli and E. faecalis to suggest that UV-C disinfection was more effective against E. coli. Hybrid treatment schemes involving hydrosonication(at 9.5 and 12.5 dm3/min flow rates with 1-5 MPa maximum pressure) and UV-C showed at least 1.1-fold greater bactericidal activity relative to the individualized UV-C treatments. The observed inactivation appeared to have stemmed from additive effects of the combined treatments, with hydrosonication-generated reactive oxygen species enhancing the biocidal activity of UV-C.

Keywords: disinfection, groundwater, hydrosonication, UV-C

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Authors: Odey Moses Ogah, Felix Terhemba Ikyereve

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The study was carried out to analyzed risks in financing agriculture by agricultural cooperatives in Benue State, Nigeria. The study made use of research questionnaires for data collection. A multistage sampling technique was used to select a sample of 210 respondents from 21 agricultural cooperatives. Both descriptive and inferential statistics were employed in data analysis. Loan defaulting (66.7%) and reduction in savings by members (51.4%) were the major causes of risks faced by agricultural cooperatives in financing agriculture in the study area. Other causes include adverse changes in commodity prices (48.6%), disaster (45.7%), among others. It was found that risks adversely influence the profitability and competition of agricultural cooperatives (82.9%). Multiple regression analysis results showed that the coefficient of multiple determinations was 0.67, implying that the explanatory variables included in the model accounted for 67% of the variation in the level of profitability of agricultural cooperatives. The number of loans, average amount of loan and the interest rate were significant and important determinants of profitability of the cooperatives. The majority of the respondents (88.6%) made use of loan guarantors as a strategy of managing loan default/no repayment. It was found that the majority (70%) of the respondents were faced with the challenge of lack of insurance cover. The study recommends that agricultural cooperative officials should be encouraged to undergo formal training and education to easily acquire administrative skills in the management of agricultural loans; Farmer's loan size should be increased and released on time to enable them to use it effectively. Policies that enhance insuring farm activities should be put in place to discourage farmers from risk aversion.

Keywords: agriculture, analysis, cooperative, finance, risks

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Zouhair Haddi, Stephane Delliaux, Jean-Francois Pons, Ismail Kechaf, Jean-Claude De Haro, Mustapha Ouladsine

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Atrial fibrillation (AF) has been considered as the most common cardiac arrhythmia, and a major public health burden associated with significant morbidity and mortality. Nowadays, telemedical approaches targeting cardiac outpatients situate AF among the most challenged medical issues. The automatic, early, and fast AF detection is still a major concern for the healthcare professional. Several algorithms based on univariate analysis have been developed to detect atrial fibrillation. However, the published results do not show satisfactory classification accuracy. This work was aimed at resolving this shortcoming by proposing multivariate data analysis methods for automatic AF detection. Four publicly-accessible sets of clinical data (AF Termination Challenge Database, MIT-BIH AF, Normal Sinus Rhythm RR Interval Database, and MIT-BIH Normal Sinus Rhythm Databases) were used for assessment. All time series were segmented in 1 min RR intervals window and then four specific features were calculated. Two pattern recognition methods, i.e., Principal Component Analysis (PCA) and Learning Vector Quantization (LVQ) neural network were used to develop classification models. PCA, as a feature reduction method, was employed to find important features to discriminate between AF and Normal Sinus Rhythm. Despite its very simple structure, the results show that the LVQ model performs better on the analyzed databases than do existing algorithms, with high sensitivity and specificity (99.19% and 99.39%, respectively). The proposed AF detection holds several interesting properties, and can be implemented with just a few arithmetical operations which make it a suitable choice for telecare applications.

Keywords: atrial fibrillation, multivariate data analysis, automatic detection, telemedicine

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Authors: Zhaopeng Zhu, Xianzhi Song, Gensheng Li, Shuo Zhu, Shiming Duan, Xuezhe Yao

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Accurate calculation of wellbore pressure is of great significance to prevent wellbore risk during drilling. The traditional mechanism model needs a lot of iterative solving procedures in the calculation process, which reduces the calculation efficiency and is difficult to meet the demand of dynamic control of wellbore pressure. In recent years, many scholars have introduced artificial intelligence algorithms into wellbore pressure calculation, which significantly improves the calculation efficiency and accuracy of wellbore pressure. However, due to the ‘black box’ property of intelligent algorithm, the existing intelligent calculation model of wellbore pressure is difficult to play a role outside the scope of training data and overreacts to data noise, often resulting in abnormal calculation results. In this study, the multi-phase flow mechanism is embedded into the objective function of the neural network model as a constraint condition, and an intelligent prediction model of wellbore pressure under the constraint condition is established based on more than 400,000 sets of pressure measurement while drilling (MPD) data. The constraint of the multi-phase flow mechanism makes the prediction results of the neural network model more consistent with the distribution law of wellbore pressure, which overcomes the black-box attribute of the neural network model to some extent. The main performance is that the accuracy of the independent test data set is further improved, and the abnormal calculation values basically disappear. This method is a prediction method driven by MPD data and multi-phase flow mechanism, and it is the main way to predict wellbore pressure accurately and efficiently in the future.

Keywords: multiphase flow mechanism, pressure while drilling data, wellbore pressure, mechanism constraints, combined drive

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Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

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Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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Authors: Maia Kukhaleishvili, Ekaterine Bulauri, Iveta Megrelishvili, Tamar Shamatava, Tamar Chipashvili

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Plant viruses can cause loss of yield and quality in a lot of important crops. Symptoms of pathogens are variable depending on the cultivars and virus strain. Selection of resistant potato varieties would reduce the risk of virus transmission and significant economic impact. Other way to avoid reduced harvest yields is regular potato seed production sampling and testing for viral infection. The aim of this study was to determine the occurrence and distribution of viral diseases according potato cultivars for further selection of virus-free material in Georgia. During the summer 2015- 2016, 5 potato cultivars (Sante, Laura, Jelly, Red Sonia, Anushka) at 5 different farms located in Akhalkalaki were tested for 6 different potato viruses: Potato virus A (PVA), Potato virus M (PVM), Potato virus S (PVS), Potato virus X (PVX), Potato virus Y (PVY) and potato leaf roll virus (PLRV). A serological method, Double Antibody Sandwich-Enzyme linked Immunosorbent Assay (DASELISA) was used at the laboratory to analyze the results. The result showed that PVY (21.4%) and PLRV (19.7%) virus presence in collected samples was relatively high compared to others. Researched potato cultivars except Jelly and Laura were infected by PVY with different concentrations. PLRV was found only in three potato cultivars (Sante, Jelly, Red Sonia) and PVM virus (3.12%) was characterized with low prevalence. PVX, PVA and PVS virus infection was not reported. It would be noted that 7.9% of samples were containing PVY/PLRV mix infection. Based on the results it can be concluded that PVY and PLRV infections are dominant in all research cultivars. Therefore significant yield losses are expected. Systematic, long-term control of potato viral infection, especially seed-potatoes, must be regarded as the most important factor to increase seed productivity.

Keywords: virus, potato, infection, diseases

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Authors: Ana Maria Carmen Ilie, Carmela Vaccaro

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Gas migration through wellbore failure, in particular from abandoned wells, is repeatedly identified as the highest risk mechanism. The vadose zone was subject to monitoring system close to the wellbore in Minerbio, methane storage site. The new technology has been well-developed and used with the purpose to provide reliable estimates of leakage parameters. Of these techniques, soil flux sampling at the soil surface, via the accumulation chamber method and soil flux sampling at the depths of 100cm below the ground surface, have been an important technique for characterizing the gas concentrations at the gas storage site. We present results of soil Radon Bq/m3, CO2%, CH4% and O2% concentration gases. Measurements have been taken for radon concentrations with an Durridge RAD7 Company, Inc., USA, instrument. We used for air and soil quality an Biogas ETG instrument monitoring system, with NDIR CO2, CH4 gas sensor and electrochemical O2 gas sensor. The measurements started in September-October 2015, where no outliers have been identified. The measurements have continued in March-April-July-August-September 2016, almost at the same time in the same place around the gas storage site, values measured 15 minutes for each sampling, to determine their concentration, their distribution and to understand the relationship among gases and atmospheric conditions. At a depth of 100 cm, the maximum soil radon gas concentrations were found to be 1770 ±±582 Bq/m3, the soil consists of 64.31% sand, 20.75% silt and 14.94% clay, and with 0.526 ppm of Uranium. The maximum concentration (September 2016), in soil at 100cm below the ground surface, with 83% sand, 8.96% silt and 7.89% clay, was about 0.06% CH4, and in atmosphere 0.06% CH4 at 40°C (T). In the other months the values have been on the range of 0.01% to 0.03% CH4. Since we did not have outliers in the gas storage site, soil-gas samples for isotopic analysis have not been done.

Keywords: leakage gas monitoring, lithology, soil gas, methane

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Authors: Massimiliano Frezza, Sergio Bianchi, Augusto Pianese

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Introduced by Shannon in 1948 in the field of information theory as the average rate at which information is produced by a stochastic set of data, the concept of entropy has gained much attention as a measure of uncertainty and unpredictability associated with a dynamical system, eventually depicted by a stochastic process. In particular, the Shannon entropy measures the degree of order/disorder of a given signal and provides useful information about the underlying dynamical process. It has found widespread application in a variety of fields, such as, for example, cryptography, statistical physics and finance. In this regard, many contributions have employed different measures of entropy in an attempt to characterize the financial time series in terms of market efficiency, market crashes and/or financial crises. The Shannon entropy has also been considered as a measure of the risk of a portfolio or as a tool in asset pricing. This work investigates the theoretical link between the Shannon entropy and the multifractional Brownian motion (mBm), stochastic process which recently is the focus of a renewed interest in finance as a driving model of stochastic volatility. In particular, after exploring the current state of research in this area and highlighting some of the key results and open questions that remain, we show a well-defined relationship between the Shannon (log)entropy and the memory function H(t) of the mBm. In details, we allow both the length of time series and time scale to change over analysis to study how the relation modify itself. On the one hand, applications are developed after generating surrogates of mBm trajectories based on different memory functions; on the other hand, an empirical analysis of several international stock indexes, which confirms the previous results, concludes the work.

Keywords: Shannon entropy, multifractional Brownian motion, Hurst–Holder exponent, stock indexes

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Authors: Worku Dejene Bekele, András Marczika Csilla Sörös

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Silver nanoparticles are silver metal with a size of 1-100nm. The most common source of silver nanoparticles is inorganic salts. Nanoparticles can be ingested through our foods and constitute nanoparticles and silver ions, whether as an additive or by migrants and, in some cases, as a pollutant. Silver nanoparticles are the most widely applicable engineered nanomaterials, especially for antimicrobial function. Ag nanoparticles give different advantages in the case of food safety, quality, and overall acceptability; however, they affect the health of humans and animals, putting them at risk of health problems and environmental pollution. Silver nanoparticles have been used widely in food packaging technologies, especially in water treatments, meat and meat products, fruit, and many other food products. This is for bio-preservation from food products. The primary goal of this review is to determine the safety and health impact of Ag nanoparticles application in food packaging and analysis of the human organs more affected by this preservative technology, to assess the implications of a nanoparticle on food safety, to determine the effects of nanoparticles on consumers health and to determine the impact of nanotechnology on product acceptability. But currently, much research has demonstrated that there is cause to believe that silver nanoparticles may have toxicological effects on biological organs and systems. The silver nanoparticles affect DNA expression, gastrointestinal barriers, lungs, and other breathing organs illness. Silver particles and molecules are very toxic. During its application in food packaging, food industries used the thinnest particle. This particle can potentially affect the gastrointestinal tracts-it suffers from mucus production, DNA, lungs, and other breezing organs. This review is targeted to demonstrate the knowledge gap that industrials use in the application of silver nanoparticles in food packaging and preservation and its health effects on the consumer.

Keywords: food preservatives, health impact, nanoparticle, silver nanoparticle

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Authors: Ian Omung'a

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Breast cancer remains to be one of the deadliest cancers for women worldwide, with the risk of developing tumors being as high as 50 percent in Sub-Saharan African countries like Kenya. With as many as 42 percent of these cases set to be diagnosed late when cancer has metastasized and or the prognosis has become terminal, Full Field Digital [FFD] Mammography remains an effective screening technique that leads to early detection where in most cases, successful interventions can be made to control or eliminate the tumors altogether. FFD Mammograms have been proven to multiply more effective when used together with Computer-Aided Detection and Diagnosis [CADe] systems, relying on algorithmic implementations of Deep Learning techniques in Computer Vision to carry out deep pattern recognition that is comparable to the level of a human radiologist and decipher whether specific areas of interest in the mammogram scan image portray abnormalities if any and whether these abnormalities are indicative of a benign or malignant tumor. Within this paper, we review emergent Deep Learning techniques that will prove relevant to the development of State-of-The-Art FFD Mammogram CADe systems. These techniques will span self-supervised learning for context-encoded occlusion, self-supervised learning for pre-processing and labeling automation, as well as the creation of a standardized large-scale mammography dataset as a benchmark for CADe systems' evaluation. Finally, comparisons are drawn between existing practices that pre-date these techniques and how the development of CADe systems that incorporate them will be different.

Keywords: breast cancer diagnosis, computer aided detection and diagnosis, deep learning, whole mammogram classfication, ultrasound classification, computer vision

Procedia PDF Downloads 69