A life-cycle cost model for green commercial office buildings with optimal green star credits

The green building is a widely discussed topic worldwide as a solution to increasing adverse impacts on the environment. The paradigm shift from conventional to green buildings is expected to yield environmental, social, and economic benefits. However, green building implementation is adversely affected by initial cost premiums although there are significant savings throughout the life-cycle of green buildings in terms of water, energy, and so on. Therefore, there is a clear need to analyse the initial stages of green building development regarding life-cycle impacts, capturing massive savings in energy, water, and other resources. Although it may be cheaper to select inappropriate technologies during the initial decision-making stages, more importantly, this may preclude life-cycle savings and the desired outcomes of green buildings. In order to aid the initial decision-makers with the selection of credit points considering the lowest life-cycle costs of green buildings, this research develops a life-cycle cost model that incorporates developer constraints while maximising the number of credit points achieved when using the Green Star Australia environmental rating system. The model is based on Green Star Design and As-Built version 1.1 rating tool. Initially, an extensive analysis is carried out for all the key criteria and credits of Green Star Design and As-Built version 1.1 rating tool. Based on the identification of different types of credits, certain credits were eliminated. Afterwards, interdependencies among various credits were established. For all the selected credits, life-cycle cost is calculated considering six main central business districts (CBDs) of Australia. The life-cycle cost calculation followed ‘Building and construction assets – service life planning – Part 5: Life-cycle costing standard’ published by the International Organisation for Standards (ISO) as a guideline. The net present value (NPV) technique is used to calculate life-cycle costs. Further, a sensitivity analysis is also carried out for selected credits to identify the changes to life-cycle cost to the changes in discount rate. Once all the life-cycle cost data is calculated, the proposed model was developed. The proposed model is developed considering a set of rules for exclusions, selections, and inter-dependencies. It initially collects user information and user constraints. Based on the user information, the model provides customised solutions to the users. The user can define the discount rate and even select the regional areas, and based on that information, the life-cycle cost is calculated by the proposed model. The user constraints select or eliminate credits, consider inter-dependencies, and calculate the optimum solutions for a specific green certification level. This model can provide optimum solutions for four-star or five-star certification levels considering Green Star rating. Finally, the proposed life-cycle cost model is validated in terms of cost and optimum credit selections. Cost is validated using costs comparisons with cost databases, industry reports, and actual green-certified buildings and interviews. To validate the credit selections, four case study buildings with Green Star certifications are considered. Based on the validation results, the cost calculations are within the range accepted by various sources. Further, the optimum credits proposed by the life-cycle cost model coincide with the credits obtained by the certified green buildings except for minor changes. Most of the credits that are proposed by the model yet not implemented by the case study buildings happen to have higher initial costs and lower life-cycle costs. This further strengthens the importance of using life-cycle costs during the initial decision-making stages for green building implementation. Further, credits with lower life-cycle costs are mostly eliminated owing to higher initial costs, which can be addressed by using the proposed life-cycle cost model. The model identified green building credits with cost savings, such as the use of photovoltaic panels, which are ignored during the initial stages owing to high initial costs. Further, this model proposed passive methods such as natural ventilation in buildings, using daylight and rainwater tanks to be considered for green building implementations. Out of all the key criteria in Green Star Design and As-Built v1.1, credits representing management criterion are widely achieved in green building implementation. This perfectly coincides with the proposed life-cycle cost model

Statin induced myopathy: a case report

Statin-induced necrotizing autoimmune myopathy is an immune-mediated necrotizing myopathy related to the use of statins. It is a very rare disease, which usually presents with proximal muscle weakness and frank elevation in creatine kinase levels. Stopping statin and the use of immunosuppressive therapy are considered the mainstay therapy. Herein, we present a case of a 75-year-old patient with statin-induced myopathy based on the presence of proximal muscle weakness, magnetic resonance findings. The patient was treated with IVIg and corticosteroid therapy with a particularly good response to intravenous immunoglobulin. However, medications are accompanied by the not so friendly adverse events. Through this report we highlight the importance of understanding. This report highlights the importance of timely diagnosis and early use of combined immunosuppressive therapy to improve patients' outcome affected by this rare disease

Comparison of Compressed Sensing algorithms for MIMO-OFDM Systems

Estimation of the channel accurately in a MIMO-OFDM system is crucial to guarantee the performance of the system. In this paper the Subspace Pursuit (SP), Orthogonal Matching Pursuit (OMP), Compressed Sampling Matching Pursuit(CoSaMP) and Distributed Compressed Sensing(DCS) algorithms combined with Minimum Mean Square Error(MMSE) and Least Mean Square (LMS) tools are used to estimate the channel coefficients for MIMO-OFDM system. These algorithms are used for the channel estimation in MIMO-OFDM system to develop the joint sparsity of the MIMO channel. Simulation results shows that SP, OMP, CoSaMP and DCS algorithms combined with MMSE and LMS tools provides significant reduction in Normalized Mean Square Error (NMSE) when compared to SP ,CoSaMP, DCS algorithms with Least Square (LS) tool and also the conventional channel estimation methods such as LS, MMSE and LMS. Moreover DCS combined with LMS tool performs better than SP and OMP techniques with LMS tool with less computational time complexity

Combined Approach for Tooth Whitening: A Case Report

The discolored, non-vital anterior tooth is a common aesthetic concern for many patients.  Discolored non-vital teeth are frequently compromised owing to previous trauma, caries, endodontic therapy and failed restorations. Destructive invasive treatment options are likely to weaken the remaining tooth structure. This can reduce the prognosis and challenge the long-term viability of the tooth, thereby initiating further prosthetic predicaments. This paper discusses modern approaches to the treatment of discolored teeth. The paper presents a case on inside/outside bleaching techniqu

A Review on Mutra Pareeksha in Ayurveda

Examination plays an important role in diagnosis and prognosis of diseases. Since Samhita Kala various methods of examination is explained like Dwividha Pareeksha, Trividha Pareeksha, Dashavidha Pareeksha, Ashtasthana Pareeksha and Dwadasa Pareeksha. In Samhita Kala Mutra Pareeksha was carried out by Pratyaksha (inspection) and Anumana (inference). Hence, from ancient period great attention is given to examine various attributes of urine in order to understand course of disease. Ashta Sthana Pareeksha incorporated by Yogaratnakara represents clinical assessment as well as laboratory investigations of medieval period. Among the Ashta Sthana Pareeksha, Mutra Pareeksha is one which proves to be an important aid in diagnosis as well as assessing prognosis of a disease. Taila Bindu Pareeksha developed in the medieval period is a method of the Mutra Pareeksha utilised in assessing prognosis of diseases. Hence an attempt is made to understand both diagnostic and prognostic importance of Mutra Pareeksha in various diseases as explained in Ayurvedic literature. In this regard references of Mutra Pareeksha are gathered from Bruhatrayi, Yoga Ratnakara, Bhavaprakasha, Vangasena and Basavarajeeyam to understand diagnostic and prognostic importance of Mutra Pareeksha

Body Image Perception among Undergraduate Female Medical Students in Mangalore: A Cross Sectional Study

Background: Body image is the dynamic perception of one’s body. Body image perception depends on anthropometric and psychological factors. Body dissatisfaction is influenced by the socio-cultural environment and is associated with eating disorders and low self-esteem.Ojectives: To study the body image perception among undergraduate female students in a medical college.Materials And Methods: It is a cross-sectional study conducted among 239 undergraduate female medical students. It was conducted during December 2015-January 2016 in one of the medical colleges in Mangalore. A 34 item Body Shape Questionnaire(BSQ) along with the details on socio-demography was collected using a validated questionnaire. The 34-item BSQ measures body image concern through a 6-point Likertscale. The scores are classified into 4 categories: satisfied (not worried) about body shape (140). The data so obtained was entered and analyzed using SPSS version 16.0.Results: Median age of the students was 20 years.64% of them were in the age group of 20-26 years.50% of them were from Karnataka. According to the BSQ it was seen that up to 32.6% were dissatisfied with themselves. No association was noted between the body image perception and place of origin or agegroups of the subjects. But a significant association was noted between body image perception and subjects avoiding communal changing rooms and self consciousness.Conclusion: With adequate health education people can be made aware that being dissatisfied with their body images could lead to adverse health events like anorexia nervosa and bulimia. A number of potential factors that may help to protect against negative body image or prevent negative body image exist

A critical review and comparative analysis of cost management on prefabricated construction research (2000–2022)

Prefabrication construction has gained attention in the construction industry. The cost of prefabrication has got mixed reviews. Cost management in prefabricated construction (CMPC) includes many cost considerations such as initial design costs, supply chain cost considerations, maintenance costs and assembly costs. These costs are inter-linked and thorough understanding on cost management is essential. It is important to develop a holistic cost management system to capture all the economic, social and environmental aspects of prefabricated construction. The aim of this research is to conduct as a critical review and analysis of cost management in prefabricated construction holistically. The literature review selected 63 articles for this research study from 2000 to 2022. The research showed that there is an uptake in research on this research area since 2005. The study identified four main research categories in CMPC namely 1) cost estimating, 2) cost optimization, 3) economic performance and 4) cost management models. Previous studies mostly focused on estimating costs and comparison studies with conventional construction. Recently studies focused more on developing cost model to integrate supply chains and other considerations into cost evaluation. Based on the literature review, there are several future directions in CMPC. Cost estimating should now focus on identifying the effect of each cost determinant in project scenarios to provide more accurate results. Future studies are also expected to focus on BIM and big-data based optimization models. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

Factors Influencing Infant Morbidity in the Urban Field Practice Area of a Medical College in Bangalore

Background: Infants constitute 2.92% of the total population in India. Health of infants is considered as a sensitive indicator of health status and level of socio-economic development of a country. In India, the infant morbidity and mortality are in decline, but the pace of decline is not sufficient to attain the target goals of National Health Mission. Objective: To assess the factors influencing infant morbidity in the urban field practice area of a medical college in Bangalore. Methods and Material: This was a population based cross sectional study done at an urban poor locality in Bangalore. The study was conducted between April 2018 to September 2019 with a sample size of 300 after obtaining the approval from Institutional ethics committee. Population proportion to size was used to ensure equal representation. Data was collected using pre tested semi structured questionnaire & analysed using open epi like descriptive statistics with univariate & multi variate logistic regression were used. Results: Total of 165(55%) subjects were females, with majority 206(68.7%) Muslim by religion and 161(53.7%) lived in the nuclear family. The prevalence of morbidities among infants was 209(69.7%). The most common infant morbidities reported were 121(40.3%) ARI, 85(28.3%) fever and 45(15%) diarrhea. Infants with perinatal complications, faulty feeding practices like delayed initiation of breast feeding, bottle feeding and immunization had significant association with infant morbidities. Conclusions: To conclude there is a statistically significant association between perinatal complications, bottle feeding & partial immunization with infant morbidity. Keywords: Infant, Immunization, Breast feeding, Morbidit

An unusual case of anti-neutrophilic cytoplasmic autoantibodies associated vasculitis with pauci-immune crescentic glomerulonephritis in young? Wegener’s? Churg Strauss

Anti-neutrophilic cytoplasmic autoantibodies-associated vasculitis (AAV) is very rare in India. It normally affects older population around 6th and 7th decade of life. The management of cases is also complicated. We present a case of 18 year old male patient who came with complaints of epistaxis and had hematuria and pain in the joints. He had sub conjunctival haemorrhage on presentation. On and off he had respiratory symptoms and epistaxis in the past for which he was treated as allergy and bronchial asthma. At admission he had high absolute eosinophil count and had blood 3+ positive in urine. Initially he was treated as post viral vasculitis. But patient had involvement of kidney, lung, skin, joints, eyes and on further evaluation he was found to have AAV. The case was unique due to the age of presentation and patient also had overlapping symptoms of both Wegner’s granulomatosis and Churg-Strauss syndrome

Review on green building rating tools worldwide : recommendations for Australia

Buildings could be led to adverse impacts on environment, such as generation of construction and demolition waste, and emission of greenhouse gases (GHG). Therefore, promotion on development of green buildings is in need. With the increasing awareness in sustainable development, various rating tools are promoted to evaluate the performance of green buildings. Nowadays, these tools function as a guideline for green building development. There are various green building rating tools developed worldwide, and various countries follow different rules, incentives and regulations. However, despite of promotion of green building rating tools, environmental issues from buildings are still significant in Australia. This research compared green building rating tools in Australia and other countries or regions around the world. This research found that rating tools in Australia lack of (1) mandatory criteria and (2) regulations and incentives. This paper recommended that governmental incentives should be promoted