33 research outputs found
A Review of Strategies to Prevent On-Site Construction Waste
One of the most important concerns that improves building profitability is the implementation of a positive approach to minimize construction waste. This paper will discuss the roots of construction waste, current waste reduction strategies, and lastly the possible use of waste management. Furthermore, the key environmental priority for this issue should be to control and mitigate construction waste generation. The purpose of this study is to provide prevention measures, and the rising tide of public awareness is all conspiring to modify the face of waste management. Clients, contractors, suppliers, and designers Architects & Engineers all have opportunities and duties to reduce construction waste. The outcomes of this study will assist academics in furthering their research into important management strategies for reducing on-site building waste
Troubled Waters: Threats and Extinction Risk of the Sharks, Rays and Chimaeras of the Arabian Sea and Adjacent Waters
The extinction risk of sharks, rays and chimaeras is higher than that for most other vertebrates due to low intrinsic population growth rates of many species and the fishing intensity they face. The Arabian Sea and adjacent waters border some of the most important chondrichthyan fishing and trading nations globally, yet there has been no previous attempt to assess the conservation status of species occurring here. Using IUCN Red List of Threatened Species Categories and Criteria and their guidelines for application at the regional level, we present the first assessment of extinction risk for 153 species of sharks, rays and chimaeras. Results indicate that this region, home to 15% of described chondrichthyans including 30 endemic species, has some of the most threatened chondrichthyan populations in the world. Seventy-eight species (50.9%) were assessed as threatened (Critically Endangered, Endangered or Vulnerable), and 27 species (17.6%) as Near Threatened. Twenty-nine species (19%) were Data Deficient with insufficient information to assess their status. Chondrichthyan populations have significantly declined due to largely uncontrolled and unregulated fisheries combined with habitat degradation. Further, there is limited political will and national and regional capacities to assess, manage, conserve or rebuild stocks. Outside the few deepsea locations that are lightly exploited, the prognosis for the recovery of most species is poor in the near-absence of management. Concerted national and regional management measures are urgently needed to ensure extinctions are avoided, the sustainability of more productive species is secured, and to avoid the continued thinning of the regional food security portfolio
Harmonics elimination based on curve fitting method for modular multilevel converters
This paper presents the additional ways to figure out the switching angles for eliminating harmonic in Modular Multilevel Converters, MMCs. The switching angles equation is written in terms of nonlinear equation system, in general, one of the numerical method, named Newton-Raphson method, is used for this calculation procedure but the Newton-Raphson method takes more time for calculation that is difficult to implement the MMCs in a real-time control application. So that, numerous previous calculation methods are proposed to address this issue. To reduce the calculated time of switching angles, the Curve Fitting method is selected to assist the Newton-Raphson method and the idea of this combination method is presented in this paper. The calculation result of this combination and original Newton-Raphson method are compared and implemented in the 3-phase 7-level MMCs simulation to validate the calculation results. The Curve-Fitting can be used for calculation assisting of Newton-Raphson Method and obtains the calculation results faster than the using of lone Newton-Raphson method
Somalia’s medical education and regulation: a review of the health regulatory landscape
Background: Medical education and regulations are pivotal to achieving universal health coverage and Sustainable Development Goals, contributing significantly to health outcomes and public trust in the healthcare workforce. However, low- and middle-income countries, especially in sub-Saharan Africa, face challenges, such as inadequate resources, outdated curricula, and weak governance. Somalia in particular grapples with a fragmented health system and a critical shortage of skilled health professionals, exacerbated by decades of civil war and political instability.
Methods: This study employed a mixed-method approach that incorporated both qualitative and quantitative data collection and analysis. A comprehensive literature review was conducted, along with semi-structured interviews with 44 key informants, including representatives from professional health schools and officials from the Ministry of Health. Additionally, five focus group discussions were held with young professionals and an online survey was administered to students enrolled in professional health courses. The data analysis employed descriptive for quantitative data, and thematic analysis for qualitative data, guided by the HRH maturity model framework.
Results: This study identified 94 medical schools across Somalia, with a significant concentration in urban areas, particularly in Benadir. However, only 25 of these schools are internationally accredited, raising concerns about the quality of medical education. The health workforce analysis revealed a pronounced urban-rural disparity and a density of health professionals below the WHO's recommended threshold. Focus group discussions and surveys highlighted the employment challenges faced by young physicians and students' perceptions of their training and future employment opportunities.
Conclusion: The proliferation of medical schools without adequate quality control, the critical shortage and maldistribution of skilled health professionals, and the absence of a comprehensive regulatory framework are significant challenges facing Somalia's healthcare system. The establishment of the National Health Professionals' Council (NHPC) Act in 2020 marks a step towards addressing these issues. This study emphasizes the need for accreditation of medical schools, capacity building of HRH teams, and collaboration among stakeholders to improve healthcare workforce development and regulation. Addressing urban-rural disparities and combating professional misconduct are also crucial for achieving universal health coverage and improving health outcomes in Somalia
Impact of the COVID-19 Pandemic on Acute Stroke Care, Time Metrics, Outcomes, and Racial Disparities in a Southeast Michigan Health System
BACKGROUND: COVID-19 has impacted acute stroke care with several reports showing worldwide drops in stroke caseload during the pandemic. We studied the impact of COVID-19 on acute stroke care in our health system serving Southeast Michigan as we rolled out a policy to limit admissions and transfers.
METHODS: in this retrospective study conducted at two stroke centers, we included consecutive patients presenting to the ED for whom a stroke alert was activated during the period extending from 3/20/20 to 5/20/20 and a similar period in 2019. We compared demographics, time metrics, and discharge outcomes between the two groups.
RESULTS: of 385 patients presented to the ED during the two time periods, 58% were African American. There was a significant decrease in the number of stroke patients presenting to the ED and admitted to the hospital between the two periods (p \u3c0.001). In 2020, patients had higher presenting NIHSS (median: 2 vs 5, p = 0.012), discharge NIHSS (median: 2 vs 3, p = 0.004), and longer times from LKW to ED arrival (4.8 vs 9.4 h, p = 0.031) and stroke team activation (median: 10 vs 15 min, p = 0.006). In 2020, stroke mimics rates were lower among African Americans. There were fewer hospitalizations (p \u3c0.001), and transfers from outside facilities (p = 0.015).
CONCLUSION: a trend toward faster stroke care in the ED was observed during the pandemic along with dramatically reduced numbers of ED visits, hospitalizations and stroke mimics. Delayed ED presentations and higher stroke severity characterized the African American population, highlighting deepening of racial disparities during the pandemic
Dynamic load modeling for bulk load-using synchrophasors with wide area measurement system for smart grid real-time load monitoring and optimization
Bulk data modeling in a smart grid dynamic network has been performed using an automated load modeling tool (ALMT), an on-load tap changer, and exponential dynamic load modeling. However, studies have observed that a small parameter variation may lead to considerable variations in measuring grid big data. Therefore, this study presents dynamic real-time load modeling, monitoring, and optimization method for the bulk load. The case study was conducted on Sarawak Energy Berhad (SEB), Malaysia. The grid system’s real-time data and load modeling achieved the objectives. Dynamic load model was achieved by using load response in MATLAB
Simulink environment. This paper also includes new parameter estimations of the load composition at the selected bus. The simulation results of load models were compared with the recorded data by applying an event of bus tripping time interval. The Least Square Error Method was used to converge the estimated parameter values on load composition and compared with the actual recorded data until optimized load models were achieved. This work is a precious and significant contribution to utility research to identify, monitor, and optimize the most appropriate representation of system loads
Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey
Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020
Change requirement management issues for a large software development projects
There are no major organizations that are free from the challenges of initiating, developing and implementing effective software changes management. Only few project managers got the ability to manage the change efficiently. As a result, software practitioners recognize that strategic change is not temporary issues but it is continued process. Software Change requirement management approach is required for constantly evolving systems to support the comprehension, implementation, and evaluation of changes. A lot of research efforts have been spent on this subject over the last twenty years, and many approaches were published likewise. But, there has not been an extensive attempt made to develop an approach that can support current software change requirement management in practice. Therefore, this paper examines issues of software change requirement management approach and investigates and compares current practice issues of a software change requirement management approach, examining their strengths and weaknesses. It also reviews existing popular tools and models of software change requirement management and how it supports to the current software change managements. Finally, it will identify existing issues of current processes and suggests the need of proper approach that can support to the current practice
Identifying challenges of change impact analysis for software projects
Project changes are difficult since the impacts of the changes are not readily known in advance. Changing customer needs and technology are driving factors influencing project evolution. Consequently, there is a need to assess the impact of these changes on existing software systems. For safety-critical system, the changes can even introduce hazards to bug down the system, particularly for larger systems, it quickly become difficult to comprehend what impact of requirement change might have on the overall system or parts of the system. Impact analysis is identifying the potential impact of disruption caused by a change to one or more components in the requirement on other components. The significant behind impact analysis is to identify requirement elements that may be affected by the change. However, this paper deals with impact analysis approach during project changes and identifies issues of impact analysis and where change impact analysis applied during software development projects
Bacteriological study of wound infections and their antimicrobial susceptibility pattern of isolates from patients at shaafi hospital Mogadishu, Somalia
Abstract
Background: Wound infection is one of the public health problems worldwide associated with the colonization of bacterial pathogens and resistance to commonly used antibiotics. The study aimed to identify the most common bacterial pathogens that cause wound infections and their antimicrobial susceptibility of isolates from patients at shaafi Hospital in Mogadishu, Somalia. Methods: This study was a descriptive cross-sectional design conducted from January to June - 2020 at shaafi Hospital in Mogadishu –Somalia. A total of 80 patients were taken from wound swab; all specimens were directly cultured on standard media, then Gram stain and Biochemical tests were also done antimicrobial susceptibility test was performed following Standards guidelines and procedures of (CLSI). Results: A total of 80 patients were taken from the wound swab; of these, 25 samples shown significant growth, isolating 38 bacteria strains. The most bacteria that isolated was Staphylococcus aureus 15 (39.47%), followed by Escherichia coli 12 (32%), Klebsiella pneumonia 8 (21%), Proteus Vulgaris 2 (5%), and Pseudomonas aeruginosa 1(3%). Staphylococcus aureus was entirely resistant to penicillin G, Ampicillin, and Methicillin, less sensitive to amoxicillin, and strongly sensitive to gentamicin. Moreover, All isolates of Escherichia coli, Klebsiella pneumonia, Proteus Vulgaris were sensitive to gentamicin and norfloxacin. In contrast, all isolates of Pseudomonas aeruginosa were resistant to gentamicin and norfloxacin. Conclusions: The study revealed that bacterial pathogens of wound infection were resistant to commonly used antibiotics in Mogadishu, Somalia, showing an increasing trend of antibiotic-resistant. The study suggested that timely diagnosis with antimicrobial susceptibility is necessary before prescribing appropriate antibiotics. Keywords: Antimicrobial susceptibility test; Antibiotic resistance, Wound infection; Bacteria, Somali