Multi-objective decision analytics for short-notice bushfire evacuation: An Australian case study

This paper develops a multi-objective optimisation model to compute resource allocation,shelter assignment and routing options to evacuate late evacuees from affected areas to shelters.Three bushfire scenarios are analysed to incorporate constraints of restricted time-window and potential road disruptions.Capacity and number of rescue vehicles and shelters are other constraints that are identical in all scenarios.The proposed mathematical model is solved by ?-constraint approach.Objective functions are simultaneously optimised to maximise the total number of evacuees and assigned rescue vehicles and shelters.We argue that this model provides a scenario-based decision-making platform to aid minimise resource utilisation and maximise coverage of late evacuees

Renal Transplantation and Pregnancy

Introduction: Although pregnancy after kidney transplantation is feasible, complications are relatively common and this needs to be considered in patient counseling and clinical decision making.Review: Fertility generally returns after renal transplantation. Approximately 74% of pregnancies in kidney transplant recipients end successfully in life births. Published reports suggest that pregnancy has no adverse affects on graft survival although patients with higher pre-pregnancy serum creatinine have a trend toward increased post-pregnancy serum creatinine. There is, however, a significantly increased risk of preeclampsia, gestational diabetes, cesarean section and preterm delivery compared to the general population. Almost half life births are preterm, and low birth weight is very common. Immunosuppressive medications are required to be continued during pregnancy in transplant recipients to prevent graft rejection, except for  sirolimus and mycophenolate mofetil (MMF) which are contraindicated during pregnancy. The incidence of birth defects in the live born is similar to the general population, except for pregnancies exposed to MMF which have a high incidence of birth defects. Every female in the reproductive age group should be counseled regarding pregnancy including the potential risks to the graft, to the mother and to the child. Timing pregnancy should be based upon whether graft function is optimal, but the general recommendation is to wait one year post transplantation before conception.Conclusion: Pregnancy in renal transplant patients should be planned with combined care from surgeons, nephrologists, obstetricians, pediatricians and dietitians which offers the best chance of a favorable outcome in the mother and the fetus

Climate-driven differences in growth performance of cohabitant fir and birch in a subalpine forest in Dhorpatan Nepal

Himalayan Silver Fir (Abies spectabilis) and Himalayan Birch (Betula utilis) are tree species often found coexisting in sub-alpine forests of the Nepal Himalayas. To assess species-specific growth performances of these species, tree-ring samples were collected from the subalpine forest in the Dhorpatan Hunting Reserve, Nepal. Standard ring width chronologies of both species were correlated with climatic variables in both static and running windows. Differential and contrasting temporal responses of radial growth of these species to climate were found. Warmer and drier springs appeared to limit birch radial growth. Whereas radial growth of fir showed weakened climate sensitivity. Moving correlation analyses revealed divergent influences of spring climate on both fir and birch. Significant warming that occurred in the 1970s coincided with growth declines in birch and an increase in fir, as indicated by basal area increment. In summary, recent warming has been unfavorable for birch, and favorable to fir radial growth.publishedVersio

Upper Gastrointestinal Endoscopy in Lumbini Medical College and Teaching Hospital

  Introduction: Upper gastrointestinal (UGI) endoscopy includes visualization of the oropharynx, esophagus, stomach, and proximal duodenum, with real time assessment and interpretation of the findings encountered. An upper endoscopy is indicated in the diagnostic evaluation of signs and symptoms of a wide variety of gastrointestinal disorders. Besides there are some therapeutic implication of the endoscopy. This study was conducted to study the spectrum of diseases found during the upper gastrointestinal endoscopy in patient presenting in Lumbini Medical College and Teaching Hospital (LMCTH).   Methods: This was a retrospective observational study carried out in LMCTH. The endoscopic record book of the patients who underwent UGI endoscopy for various reasons from February 2011 to 2013 was analysed. The risk factor of smoking and alcohol was also included and analysed in the study.   Results: All together 550 upper GI endoscopy was performed in the two years. There were 290 males (52.72%) and females were 260 (47.38%). The mean age was 45.7 years (SD=17.9). Most of the patient belonged to the age group 41 to 80 years (71%). Among total patients, 209 (38%) of them were found to be macroscopically normal. Of those who had positive endoscopic findings; 165 (48.4%) had gastritis and 36 (10.6%) had duodenal ulcer, esophageal varices was in 30 (8.8%), gastric carcinoma in nine (2.6%) of cases. Cigarette smoking was significantly associated with the presence of peptic ulcer disease (p=0.01) and malignancy of gastrointestinal tract (p=0.03). Alcohol intake was non-significantly related to peptic ulceration (p=0.07) and malignancy of gastrointestinal tract (p=0.09).   Conclusion: Upper gastrointestinal endoscopy is a safe and useful procedure for investigating patients with gastrointestinal complains. Gastritis was the most common finding among the patients who had abnormal endoscopy followed by duodenal ulcer and esophageal varices

Characteristics of Patients with Tuberculous Pleural Effusion in Rural Nepal

  Introduction: Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries. TubercularPleural effusion is the second most common form of extra pulmonary tuberculosis (EPTB), superseded in Prevalence only by lymph node tuberculosis. Pleural effusion occurs in approximately 5% of patients with TB. The purpose of this study was to assess the demographic characteristics of patients presenting with pleural effusion in rural Nepal.   Methods: A retrospective study was conducted with all the cases diagnosed and admitted with pleural effusion at Lumbini Medical College And Teaching Hospital from April 2011 to March 2013 of all the cases diagnosed andadmitted with pleural effusion were included in the study. Hundred cases diagnosed with pleural effusion by clinical Examination or chest X-ray or ultrasonography’s (USG) of the chest were included in the studied. The following parameters patients demographic profile, causes of pleural effusion, location (unilateral/bilateral), hemoglobin and complete blood count, sputum stain and culture sensitivity, Monteux test, chest X-ray and USG findings and Pleural fluid analysis (biochemical, hematological, microbiological and cytological) were analyzed by using SPSS 21.   Results: Out of 100 cases, the cause of pleural effusion in 59 patients was tuberculosis, 14 by malignancy, next 14 by Para pneumonic Effusion, 12 by congestive cardiac failure and three cases by alcoholic liver disease. Patients with tuberculous pleural effusion were younger, predominantly males, had unilateral effusion, lower blood hemoglobin, lower Pleural fluid neutrophils, higher pleural fluid Adenosine Deaminase (ADA) levels and higher level of pleural fluid to serum protein ratio as compared to the patients with non-tuberculous effusion.   Conclusion: Tuberculosis is the most common cause of pleural effusion in patients of rural Nepal

Allocative Efficiency of Resource use on Beekeeping in Chitwan District of Nepal

Agriculture is facing with increasing pollinators decline all over the world affecting the functioning of regulatory and production service of pollination in adverse manner. Study on ways to conserve pollinating agents like bee is crucial in modern intensive agriculture. In this context a study was conducted to estimate the productivity and resource use efficiency of bee keeping in Chitwan district of Nepal. The study used data collected from randomly selected 48 bee keepers using face to face interview technique in the year 2014. Descriptive statistics, gross margin analysis, benefit cost analysis and multiple regression analysis using Cob-Douglas form were employed to achieve study objectives. It was found that farmers were rearing honey bee on an average of about 34 hives per farm with annual productivity of bee products equivalent to 36 Kg honey per hive. Gross margin of beekeeping in the research area was found to be NRs. 3111.55 per hive with undiscounted benefit cost ratio of 1.71. Human labour use, expenditure on sugar, drugs and comb foundation and; migration cost were significantly contributing to the productivity of beekeeping and were required to increase their use by 39%, 34% and 74%, respectively to achieve optimum profit. It was suggested to increase the level of all variable inputs through loan, subsidy and insurance to promote beekeeping enterprise in the study area for ensuring optimum profit to farmers and conservation of the most important agent of pollination