Analyzing historical and future acute neurosurgical demand using an AI-enabled predictive dashboard

Characterizing acute service demand is critical for neurosurgery and other emergency-dominant specialties in order to dynamically distribute resources and ensure timely access to treatment. This is especially important in the post-Covid 19 pandemic period, when healthcare centers are grappling with a record backlog of pending surgical procedures and rising acute referral numbers. Healthcare dashboards are well-placed to analyze this data, making key information about service and clinical outcomes available to staff in an easy-to-understand format. However, they typically provide insights based on inference rather than prediction, limiting their operational utility. We retrospectively analyzed and prospectively forecasted acute neurosurgical referrals, based on 10,033 referrals made to a large volume tertiary neurosciences center in London, U.K., from the start of the Covid-19 pandemic lockdown period until October 2021 through the use of a novel AI-enabled predictive dashboard. As anticipated, weekly referral volumes significantly increased during this period, largely owing to an increase in spinal referrals (p < 0.05). Applying validated time-series forecasting methods, we found that referrals were projected to increase beyond this time-point, with Prophet demonstrating the best test and computational performance. Using a mixed-methods approach, we determined that a dashboard approach was usable, feasible, and acceptable among key stakeholders

Sizing and Lifecycle Assessment of Electrochemical Batteries for Electric Vehicles and Renewable Energy Storage Systems

Electrochemical batteries have demonstrated quality performances in reducing emissions in Electric Vehicles (EV) and Renewable Energy Storage (RES) systems. These chemistries, although most of them commercialized, contribute to ecological toxicity and global warming in their lifecycle phases. With the addition of new energy storage chemistries, sizing uncertainty and resulting environmental damage are increasing. This chapter presents a comprehensive comparative exploration of 14 electrochemical batteries, including chemistries in the research and development phase. To identify the appropriate chemistry, the capacity range sizing criteria, and formulations are presented with case studies of Environmental Protection Agency (EPA) approved driving profiles for EVs, and consumption load profiles for RES systems, dependent on a given set of operational constraints. Furthermore, a lifecycle impact assessment (LCA) metric, the Cradle-to-Gate technique, is computed to evaluate the sized storage chemistries’ environmental impact supported by five case studies considering short-, medium-, and long-term duration operations and storage services

Analysis of morphological traits in different host plants associated with resistance to Phenacoccus solenopsis- an invasive pest in Pakistan

Phenacoccus solenopsis Tinsley (Pseudococcidae: Hemiptera) is a sucking insect pest and is polyphagous in nature. Twenty five (25) different host plants were screened against P. solenopsis and their  physicomorphic traits were determined to correlate their role against pest population. Among the tested plant species, most favorable host plants of mealy bug on the basis of population were Gossypium hirsutum (69.74±10.5), Solamum melongena (62.41±10.0), Helianthus annuus (61.83±10.0), Hibiscus rosa-sinensis (61.1±10.0) and Lantana camara (55.83±9.75), but the least preferred plants were tandla Digera arvensis (1.57±1.00) and Conyza bonariensis (3.83±1.75). Significant variations were observed in all the morphological plant characters recorded from different plant species. The maximum leaf thickness per plant was 2.04±0.23 ìm in plant species S. melongena while minimum thickness of leaf was recorded from lehli (0.25±0.02 ìm). Maximum trichome density per plant was 444±72.4 in sunflower followed by 411.6±19.6, 399±52, 391.6±22.0, in C. bonariensis, Abelmoschus esculentus and Withania somnifera respectively but minimum were 2.33±1.45 in Chinopodium morale, followed by 2.66±1.4, and 3±2.08 in Portulaca oleracea and Trianthema portulacastrum respectively. The maximum hair length per plant (2.62±0.07 mm) was of sunflower followed by 2.55±0.03 mm in okra, 2.53±0.06 mm in both S. melongena and G. hirsutum. It was concluded that plant characters including trichome density and hair length favor mealy bug population showing r-values of 0.357* and 0.190 respectively but leaf size and leaf width (leaf area and leaf thickness) exerted negative effect on pest population showing r-values of -0.172 and -0.285 respectively.Key words: Phenacoccus solenopsis, invasive species, physicomorphic traits, resistance

Ultrasound Histotripsy on a Viable Perfused Whole Porcine Liver: Histological Aspects, Including 3D Reconstruction of the Histotripsy Site

Non-invasive therapeutic-focused ultrasound (US) can be used for the mechanical dissociation of tissue and is described as histotripsy. We have performed US histotripsy in viable perfused ex vivo porcine livers as a step in the development of a novel approach to hepatocyte cell transplantation. The histotripsy nidus was created with a 2 MHz single-element focused US transducer, producing 50 pulses of 10 ms duration, with peak positive and negative pressure values of P+ = 77.7 MPa and P- = -13.7 MPaat focus, respectively, and a duty cycle of 1%. Here, we present the histological analysis, including 3D reconstruction of histotripsy sites. Five whole porcine livers were retrieved fresh from the abattoir using human transplant retrieval and cold static preservation techniques and were then perfused using an organ preservation circuit. Whilst under perfusion, histotripsy was performed to randomly selected sites on the live. Fifteen lesional sites were formalin-fixed and paraffin-embedded. Sections were stained with Haematoxylin and Eosin and picro-Sirius red, and they were also stained for reticulin. Additionally, two lesion sites were used for 3D reconstruction. The core of the typical lesion consisted of eosinophilic material associated with reticulin loss, collagen damage including loss of birefringence to fibrous septa, and perilesional portal tracts, including large portal vein branches, but intact peri-lesional hepatic plates. The 3D reconstruction of two histotripsy sites was successful and confirmed the feasibility of this approach to investigate the effects of histotripsy on tissue in detail

Terrorist Activities, Investor Sentiment, and Stock Returns: Evidence from Pakistan

Motivated by the previous literature on investor sentiment and assuming that terrorist activities affect investor mood, this study attempts to address the psychological impact of terrorism for investors in Pakistan stock market. Apart from a direct economic loss, major terrorist incidents create/exacerbate uncertainty and fear in the market. The investors are likely to over-respond to such incidents and once the dust settles the market tend to recover. The analysis of cumulative abnormal returns in the aftermaths of terrorist incidents and the volume analysis provide strong evidence that the terrorist incidents adversely affect investors' sentiments and confidence in the market as manifested through relatively feeble trading volumes. Keywords:  Sentiment, Terrorism, Stock Market, Pakistan JEL Classifications: C33, E44, G15 DOI: https://doi.org/10.32479/ijefi.959

Improving risk communication: a proof-of-concept randomised control trial assessing the impact of visual aids for neurosurgical consent

IntroductionInformed consent is a fundamental component in the work-up for surgical procedures. Statistical risk information pertaining to a procedure is by nature probabilistic and challenging to communicate, especially to those with poor numerical literacy. Visual aids and audio/video tools have previously been shown to improve patients' understanding of statistical information. In this study, we aimed to explore the impact of different methods of risk communication in healthy participants randomized to either undergo the consent process with visual aids or the standard consent process for lumbar puncture.Material and methodsHealthy individuals above 18 years old were eligible. The exclusion criteria were prior experience of the procedure or relevant medical knowledge, lack of capacity to consent, underlying cognitive impairment and hospitalised individuals. After randomisation, both groups received identical medical information about the procedure of a lumbar puncture in a hypothetical clinical scenario via different means of consent. The control group underwent the standard consent process in current clinical practice (Consent Form 1 without any illustrative examples), whereas the intervention group received additional anatomy diagrams, the Paling Palette and the Paling perspective scale. Anonymised questionnaires were received to evaluate their perception of the procedure and its associated risks.ResultsFifty-two individuals were eligible without statistically significant differences in age, sex, professional status and the familiarity of the procedure. Visual aids were noted to improve the confidence of participants to describe the risks by themselves (p = 0.009) and participants in the intervention group felt significantly less overwhelmed with medical information (p = 0.028). The enhanced consent process was found to be significantly more acceptable by participants (p = 0.03). There was a trend towards greater appropriateness (p = 0.06) and it appeared to have “good” usability (median SUS = 76.4), although this also did not reach statistical significance (p = 0.06)ConclusionVisual aids could be an appropriate alternative method for medical consent without being inferior regarding the understanding of the procedure, its risks and its benefits. Future studies could possibly compare or incorporate multiple interventions to determine the most effective tools in a larger scale of population including patients as well as healthy individuals

Restoring Degraded Landscapes through An Integrated Approach Using Geospatial Technologies in the Context of the Humanitarian Crisis in Cox’s Bazar, Bangladesh

The influx of nearly a million refugees from Myanmar's Rakhine state to Cox's Bazar, Bangladesh, in August 2017 put significant pressure on the regional landscape leading to land degradation due to biomass removal to provide shelter and fuel energy and posed critical challenges for both host and displaced population. This article emphasizes geospatial applications at different stages of addressing land degradation in Cox’s Bazar. A wide range of data and methods were used to delineate land tenure, estimate wood fuel demand and supply, assess land degradation, evaluate land restoration suitability, and monitor restoration activities. The quantitative and spatially explicit information from these geospatial assessments integrated with the technical guidelines for sustainable land management and an adaptive management strategy was critical in enabling a collaborative, multi-disciplinary and evidence-based approach to successfully restoring degraded landscapes in a displacement setting

Compatibility and synergistic interactions of fungi, Metarhizium anisopliae, and insecticide combinations against the cotton aphid, Aphis gossypii Glover (Hemiptera: Aphididae)

Aphids are major pests affecting cereals, vegetables, fruit, forestry and horticultural produce. A multimodal approach may be an effective route to controlling this prolific pest. We assessed the individual and combined effect of eight insecticides and the entomopathogenic fungi, Metarhizium anisopliae (Metschin.) against the cotton aphid, Aphis gossypii Glover (Hemiptera: Aphididae), under laboratory conditions. Six of the insecticides tested were found to be highly compatible (flonicamid, imidacloprid, nitenpyram, dinotefuran, pyriproxyfen and spirotetramat), showing positive integration with the fungus and were selected for bioassays. The combination mixtures (1:1 ratio of M. anisopliae: insecticide) were significantly more toxic to A. gossypii than individual treatments. Maximum mortality (91.68%) of A. gossypii was recorded with combination of flonicamid and M. anisopliae (2.4 × 106 cfu/ml) 72 h after application. While minimum mortality (17.08%) was observed with the individual treatment of M. anisopliae (2.4 × 106 cfu/ml). The insecticides revealed toxicity consistent with their compatibility with M. anisopliae, ranking for efficacy exactly as they did for compatibility. In addition, the synergy factor (SF) and co-toxicity coefficient (CTC) values indicated synergistic interactions at different time intervals. The synergistic efficacy revealed the potential of fungus-insecticide integration against sucking insect pests