ADVECTION-DIFFUSION MODEL WITH TIME DEPENDENT FOR AIR POLLUTANTS DISTRIBUTION IN UNSTABLE ATMOSPHERIC CONDITION

Air pollution levels are quite high in urban areas. They are emitted from various sources and have an impact on humans and the environment. There are some physical processes that occur when pollutants disperse in the atmosphere. The main processes are advection and diffusion. Therefore, a two-dimensional mathematical model is presented to study the dispersion of air pollution under the effect of mesoscale wind as an effect of urban heat islands. This model is solved by using the implicit Crank-Nicolson finite difference scheme under stability-dependent meteorological parameters involved in large scale wind, mesoscale wind and eddy diffusivity. The main goal of this research is to analyze air pollution distribution using the advection-diffusion model. The results of this model have been analyzed for the dispersion of air pollutants in an urban area in the downwind and vertical direction for unstable atmospheric conditions.Key words : Advection, Diffusion, Mesoscale Wind, Pollutant Dispersio

Neonatal mortality at the neonatal unit: the situation at a teaching hospital in Ghana

Background: The first 28 days of life- the neonatal period is the most vulnerable time for a child’s survival. Globally, neonatal mortality has seen a downward trend in recent years. The main objective of this study was to determine the percentage of neonatal mortality and to provide information on factors associated with neonatal mortality at the neonatal unit of a tertiary health facility or teaching hospital.Methods: Data of neonates admitted to the neonatal in-patient unit of the Komfo Anokye Teaching Hospital (KATH) in Ghana from January 2013 to May 2014 were analyzed. Logistic regression model was performed to assess the association between neonatal mortality and predictors.Results: A total of 5,195 neonatal admissions were recorded. The overall percentage of neonatal mortality was 20.2%. Infants with very low birth weight, having 5-minute Apgar score lower than 4, newborns with pre-term delivery, being referred from other health facilities, and being diagnosed with respiratory distress and birth asphyxia had a higher percentage of neonatal mortality.Conclusion: The mortality at the neonatal in-patient unit at the Komfo Anokye Teaching Hospital in Ghana is very high. There is the need for continuous attention and interventions to help reduce the risk of mortality among neonates admitted to the facility.Keywords: Logistic regression, neonatal mortality, Kumasi

Neonatal mortality at the neonatal unit: the situation at a teaching hospital in Ghana

Background: The first 28 days of life- the neonatal period is the most vulnerable time for a child\u2019s survival. Globally, neonatal mortality has seen a downward trend in recent years. The main objective of this study was to determine the percentage of neonatal mortality and to provide information on factors associated with neonatal mortality at the neonatal unit of a tertiary health facility or teaching hospital. Methods: Data of neonates admitted to the neonatal in-patient unit of the Komfo Anokye Teaching Hospital (KATH) in Ghana from January 2013 to May 2014 were analyzed. Logistic regression model was performed to assess the association between neonatal mortality and predictors. Results: A total of 5,195 neonatal admissions were recorded. The overall percentage of neonatal mortality was 20.2%. Infants with very low birth weight, having 5-minute Apgar score lower than 4, newborns with pre-term delivery, being referred from other health facilities, and being diagnosed with respiratory distress and birth asphyxia had a higher percentage of neonatal mortality. Conclusion: The mortality at the neonatal in-patient unit at the Komfo Anokye Teaching Hospital in Ghana is very high. There is the need for continuous attention and interventions to help reduce the risk of mortality among neonates admitted to the facility

Forging connections: anthologies, arts collectives, and the politics of inclusion

The changing social and political landscape of twentieth-century Britain catalysed a remarkable rise in collaborative activity by artists and activists of black and Asian heritage. Creative communities began to gather in both local and regional contexts, with the aim of sharing resources and securing an audience. This chapter records some of these many activities, tracing the groups’ genesis, manifest objectives, and key contributions. It argues that anthologising should be understood as a specifically motivated activity. Literary anthologies of poetry and fiction served to showcase the diversity of contemporary writing, while also suggesting its coherence. Drawing on the concept of “strategic essentialism” elucidated by Gayatri Chakravorty Spivak, I show that the anthology acts to ensure the visibility of a group, bannered as a unified and singly-titled selection of texts, while also insisting on the differences within: the heterogeneous multiplicity of black and Asian British experiences and creative practices

'Vernacular Voices: Black British Poetry'

ABSTRACT Black British poetry is the province of experimenting with voice and recording rhythms beyond the iambic pentameter. Not only in performance poetry and through the spoken word, but also on the page, black British poetry constitutes and preserves a sound archive of distinct linguistic varieties. In Slave Song (1984) and Coolie Odyssey (1988), David Dabydeen employs a form of Guyanese Creole in order to linguistically render and thus commemorate the experience of slaves and indentured labourers, respectively, with the earlier collection providing annotated translations into Standard English. James Berry, Louise Bennett, and Valerie Bloom adapt Jamaican Patois to celebrate Jamaican folk culture and at times to represent and record experiences and linguistic interactions in the postcolonial metropolis. Grace Nichols and John Agard use modified forms of Guyanese Creole, with Nichols frequently constructing gendered voices whilst Agard often celebrates linguistic playfulness. The borders between linguistic varieties are by no means absolute or static, as the emergence and marked growth of ‘London Jamaican’ (Mark Sebba) indicates. Asian British writer Daljit Nagra takes liberties with English for different reasons. Rather than having recourse to established Creole languages, and blending them with Standard English, his heteroglot poems frequently emulate ‘Punglish’, the English of migrants whose first language is Punjabi. Whilst it is the language prestige of London Jamaican that has been significantly enhanced since the 1990s, a fact not only confirmed by linguistic research but also by its transethnic uses both in the streets and on the page, Nagra’s substantial success and the mainstream attention he receives also indicate the clout of vernacular voices in poetry. They have the potential to connect with oral traditions and cultural memories, to record linguistic varieties, and to endow ‘street cred’ to authors and texts. In this chapter, these double-voiced poetic languages are also read as signs of resistance against residual monologic ideologies of Englishness. © Book proposal (02/2016): The Cambridge History of Black and Asian British Writing p. 27 of 4

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

แบบจำลองการตายของทารกแรกเกิดในโรงเรียนแพทย์ประเทศกานา

Thesis (M.Sc.(Applied Mathematics))--Prince of Songkla University, 2016The first 28 days of life- the neonatal period is the most vulnerable time for a child’s survival. Neonatal mortality has seen a downward trend in recent years. Understanding the risk factors associated with neonatal mortality at the neonatal unit is important because it allows inferences about the quality of care. The main objective of this study was to determine the neonatal mortality rate and to provide information on the risk factors that affects the survival of neonates at the neonatal unit of a tertiary health facility and to present a mathematical model for explaining such factors. Secondary data were obtained from the neonatal unit of a hospital over a seventeen-month period, from January 2013 through to May 2014. The data was classified into two, based on the place of delivery of these neonates. Logistic regression models were fitted to the two datasets to assess the association between neonatal death and its risk factors. Another logistic regression model was fitted to the combined dataset in order to investigate the general risk factors of neonatal death at the neonatal unit. The probability density functions and likelihood functions associated with the logistics regression models were verified for regularity. Fisher’s scoring optimization algorithm was used to estimate the parameters of the logistic regression models and Newton Raphson’s method with Marquardt damping algorithm was used to estimate adjusted proportions of the variables. Each logistic regression model was further assessed for asymptotic normality using the normal quantile-quantile plots. Using Receiver Operating Characteristics plots, the predictive power of the models were also estimated. Asymptotic analysis of the likelihood function for the logistic regression model, showed that, the function satisfied all the regularity conditions for the existence and uniqueness of maximum likelihood estimates. The estimates were also found to be asymptotically normal and consistent for interpreting the neonatal mortality for the different datasets. Birth weight, 5 minute Apgar score and discharge diagnosis were found to be the main risk factors associated with neonatal death among babies who were delivered at different health facilities and referred to the unit. These three variables together with gestational age were significantly associated with mortality of babies who were not referred from different facilities. The place of delivered of the neonates also had significant effect on their survival chances at the neonatal unit. The overall mortality rate at the neonatal unit is very high. There is the need for urgent attention and interventions to help reduced the risk associated with these neonates. ยี่สิบแปดวันแรกของทารกแรกเกิด คือช่วงเวลาที่เสี่ยงมากที่สุดสำหรับการรอดชีวิตของทารก อัตราการตายของทารกแรกเกิดมีแนวโน้มลดลงเมื่อไม่กี่ปีที่ผ่านมา สิ่งสำคัญคือความเข้าใจในปัจจัยเสี่ยงที่มีความสัมพันธ์กับอัตราการตายของทารกแรกเกิด ณ หน่วยบริบาลทารกแรกเกิด เพราะแสดงถึงคุณภาพของการดูแลทารกแรกเกิด วัตถุประสงค์หลักของการศึกษาในครั้งนี้ คือ เพื่อระบุอัตราการตายของทารกแรกเกิดและค้นหาปัจจัยเสี่ยงที่ส่งผลต่อการอยู่รอดของทารก ในระดับตติยภูมิสถานพยาบาลที่เข้ารับการรักษา ด้วยการนำตัวแบบทางคณิตศาสตร์มาใช้ในการอธิบายความสัมพันธ์ของปัจจัยดังกล่าว ข้อมูลทุติยภูมิได้รับจากหน่วยบริบาลทารกแรกเกิด ในช่วงเวลา 17 เดือน จากมกราคม ปี 2556 ถึง พฤษภาคม ปี 2557 จำแนกข้อมูลออกเป็น 2 กลุ่ม ตามกับสถานที่คลอดของทารก สร้างตัวแบบการถดถอยลอจิสติกสำหรับข้อมูลทั้ง 2 กลุ่ม เพื่อหาความสัมพันธ์ระหว่างการตายของทารกแรกเกิดและปัจจัยเสี่ยง และสร้างตัวแบบการถดถอยลอจิสติกสำหรับข้อมูลทั้งหมด เพื่อหาปัจจัยเสี่ยงต่อการตายของทารกแรกเกิด ณ หน่วยบริบาลทารกแรกเกิด ตรวจสอบฟังก์ชันความน่าจะเป็น และฟังก์ชันความควรจะเป็นที่สัมพันธ์กับตัวแบบการถดถอยลอจิสติก ใช้กระบวนการ Fisher’s scoring เพื่อหาค่าเหมาะสมที่สุดในการประมาณค่าพารามิเตอร์ของตัวแบบการถดถอยลอจิสติก และวิธี Newton Raphson’s ด้วยขั้นตอนวิธีการของ Marquardt damping ในการประมาณค่าสัดส่วนที่ปรับค่าของตัวแปร ตัวแบบลอจีสติกแต่ละตัวแบบ ตรวจสอบข้อตกลงของการแจกแจงปกติของค่าความคลาดเคลื่อนด้วยการสร้าง Normal quantile-quantile plot และตรวจสอบความกลมกลืนและการทำนายของตัวแบบด้วยการสร้าง Receiver Operating Characteristics plots การวิเคราะห์เชิงเส้นกำกับสำหรับฟังก์ชันความควรจะเป็นสำหรับตัวแบบการถดถอยลอจิสติก แสดงให้เห็นว่าเป็นไปตามข้อตกลงของตัวแบบในทุกเงื่อนไข ที่ได้จากการประมาณค่าเดียวของค่าความควรจะเป็นสูงสุด การประมาณค่าที่ได้ถือว่าเป็นเชิงเส้นกำกับปกติ และมีความสอดคล้องสำหรับการอธิบายการตายของทารกในกลุ่มข้อมูลที่แตกต่างกัน น้ำหนักทารกแรกคลอด คะแนนการประเมินสภาวะทารกแรกเกิดใน 5 นาที และผลการวินิจฉัยก่อนออกจากหน่วยสถานพยาบาล พบว่าเป็นปัจจัยเสี่ยงที่มีความสัมพันธ์กับการตายของทารกที่คลอดในสถานพยาบาลต่าง ๆ แล้วถูกส่งต่อมาที่หน่วยบริบาลทารกแรกเกิด ตัวแปรดังกล่าวข้างต้นทั้ง 3 ตัวแปร และอายุครรภ์มีความสัมพันธ์อย่างมีนัยสำคัญกับการตายของทารกที่ไม่ได้ส่งต่อจากสถานพยาบาลอื่น สถานที่คลอดของทารกแรกเกิดเป็นปัจจัยหนึ่งที่มีผลอย่างมีนัยสำคัญต่อโอกาสการรอดของทารกในหน่วยบริบาลทารกแรกเกิด อัตราการตายทารกแรกเกิดในภาพรวม ณ หน่วยบริบาลทารกแรกเกิดยังคงสูงมาก จึงจำเป็นที่จะต้องคำนึงและให้การช่วยเหลือเพื่อลดภาวะเสี่ยงที่จะเกิดขึ้นกับทารกแรกเกิ

Statistical Analysis of Long-term Health Effects of Thailand's Oil Spill on the Health of Spill Cleaners

Thesis (Ph.D., Research Methodology)--Prince of Songkla University, 2022The Rayong oil spill was caused by a ruptured pipeline and leaked over 50,000 litres of crude oil into Thailand's Gulf. The clean-up activities included personnel from the PTT Global Chemical (PTTGC), the Thai Navy and civilian volunteers. Annual follow-up visits were conducted in which the oil spill clean-up workers visited the Rayong hospital for health assessment from 2014 to 2018. However, no longitudinal study has been conducted to evaluate the possible long-term adverse effects of the Rayong oil spill exposure on the workers who participated in the clean-up activities. This study aimed to investigate the long-term health effects of the Rayong oil spill on haematological, renal, and hepatic indices of the clean-up workers using the data from Rayong hospital's 5-year health follow-up protocol. Data for this study was obtained from the Rayong hospital and included the haematological, hepatic, and renal indices of 869 workers who participated in the oil spill clean-up and attended at least one follow-up visit between 2014 and 2018. Haemoglobin (HB), haematocrit (HCT), white blood cell (WBC) count, red blood cell (RBC) count, and platelet count for haematological function. Other haematological indices were mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), polymorphonuclear neutrophils (PMN), and Lymphocytes (LYM). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were assessed for hepatic function, creatinine (Cr) and blood urea nitrogen (BUN) for renal function. An endpoint analysis was conducted using analysis of variance (ANOVA) to determine the annual changes of the haematological, hepatic, and renal indices between the baseline in 2013 and the final follow-up in 2018, using the level of exposure to differentiate between subjects. The generalised estimating equations (GEEs) were used to determine the longitudinal trends of the indices, while latent class trajectory analyses were used to assess the presence of latent clusters based on the longitudinal trends. The results showed increasing trends of WBC (0.02 ± 0.01 × 103 cells/μL per year), RBC count (0.008 ± 0.01 cells/μL per year), platelet count (3.44 ± 0.39 × 103/μL per year), BUN (0.22 ± 0.03 mg/dL per year) and CR (0.01 ± 0.00 mg/dL per year). On the other hand, the average trends of LYM (-0.14 ± 0. 07% per year) and AST (-1.63 ± 0.20 IU/L per year) were decreasing. The level of exposure showed no significant effects on the trends of all but one of the haematological, hepatic, and renal indices. Gender and occupation were significantly associated with HB, platelets, MCHC and BUN trends. Clean-up workers from the PTTGC (0.31 ± 0.10) and military personnel (0.42 ± 0.18) had significantly lower trends of HB than civilians. The HB trend among men was 1.94 ± 0.12 times higher than women. The findings from this study indicate significant differences between the levels of some haematological, hepatic, and renal indices at baseline and final follow-up. Long-term trends found in this study, coupled with the significant increasing latent trends of some clean-up workers, indicate worsening renal functions due to oil spill exposure. Furthermore, results from this study show the possibility of cardiovascular effects among some of the oil spill clean-up workers 5 years after the clean-up

Latent Trajectories of Haematological, Hepatic, and Renal Profiles after Oil Spill Exposure: A Longitudinal Analysis

Exposure to polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) in crude oil has carcinogenic effects on various organ systems. This longitudinal cohort study examined the effects of oil spill exposure on the haematological, hepatic, and renal profiles of Rayong oil spill clean-up workers. The sample included 869 clean-up workers from the Rayong oil spill. Latent class mixture models were used to investigate and classify the longitudinal trajectories and trends of the haematological, hepatic, and renal indices. Subgroup analysis was used to evaluate the association between the urinary metabolites of PAHs and VOCs and haematological, hepatic, and renal parameters. Most clean-up workers (97.6%) had increasing levels of white blood cells (WBCs) (0.03 &times; 103 cells/&micro;L), 94.90% of the workers had a significantly increasing trend of blood urea nitrogen (0.31 mg/dL per year), and 87.20% had a significantly increasing trend of serum creatinine (0.01 mg/dL per year). A high&ndash;decreasing trend of WBCs was seen in 2.42% (&minus;0.73 &times; 103 per year). Post-exposure changes in haematological, renal, and hepatic profiles are present in workers exposed to the Rayong oil spill. This indicates possible long-term health complications and worsening renal function after exposure to PAHs and VOCs in crude oil