Holistic Assessment Research Articles

A Trifecta of Deep Learning Models: Assessing Brain Health by Integrating Assessment and Neuroimaging Data

The investigation of brain health development is paramount, as a healthy brain underpins cognitive and physical well-being, and mitigates cognitive decline, neurodegenerative diseases, and mental health disorders. This study leverages the UK Biobank dataset containing static functional network connectivity (sFNC) data derived from resting-state functional magnetic resonance imaging (rs-fMRI) and assessment data. We introduce a novel approach to forecasting a brain health index (BHI) by deploying three distinct models, each capitalizing on different modalities for training and testing. The first model exclusively employs psychological assessment measures, while the second model harnesses both neuroimaging and assessment data for training but relies solely on assessment data during testing. The third model encompasses a holistic strategy, utilizing neuroimaging and assessment data for the training and testing phases. The proposed models employ a two-step approach for calculating the BHI. In the first step, the input data is subjected to dimensionality reduction using principal component analysis (PCA) to identify critical patterns and extract relevant features. The resultant concatenated feature vector is then utilized as input to variational autoencoders (VAE). This network generates a low-dimensional representation of the input data used for calculating BHI in new subjects without requiring imaging data. The results suggest that incorporating neuroimaging data into the BHI model, even when predicting from assessments alone, enhances its ability to accurately evaluate brain health. The VAE model exemplifies this improvement by reconstructing the sFNC matrix more accurately than the assessment data. Moreover, these BHI models also enable us to identify distinct behavioral and neural patterns. Hence, this approach lays the foundation for larger-scale efforts to monitor and enhance brain health, aiming to build resilient brain systems.

Dynamic answer-dependent multiple-choice questions and holistic assessment analysis in high-enrollment courses.

Many 4-year public institutions face significant pedagogical challenges due to the high ratio of students to teaching team members. To address the issue, we developed a workflow using the programming language R as a method to rapidly grade multiple-choice questions, adjust for errors, and grade answer-dependent style multiple-choice questions, thus shifting the teaching teams' time commitment back to student interaction. We provide an example of answer-dependent style multiple-choice questions and demonstrate how the output allows for discrete analysis of questions based on various categories such as Fundamental Statements or Bloom's Taxonomy Levels. Additionally, we show how student demographics can be easily integrated to yield a holistic perspective on student performance in a course. The workflow offers dynamic grading opportunities for multiple-choice questions and versatility through its adaptability to assessment analyses. This approach to multiple-choice questions allows instructors to pinpoint factors affecting student performance and respond to changes to foster a healthy learning environment.

Volunteer group participation and subsequent health and well-being among older adults in Japan: An outcome-wide longitudinal approach

BackgroundPrior studies have underscored the importance of studying volunteering in the East Asian context. However, no study has conducted a holistic assessment of the relationship between volunteering and the multidimensional health and well-being outcomes of East Asian populations using a strong study design for causal inference. To address this gap, this study examined the associations between volunteer group participation and the subsequent health and well-being of Japanese older adults. MethodsThree waves of data (2013, 2016, and 2019), obtained from the Japan Gerontological Evaluation Study—a nationwide cohort study of physically and cognitively independent older adults, aged ≥ 65 years, in Japan—were utilized. Exposure was evaluated as the frequency of volunteer group participation: ≥ 1/week, 1 − 3 times a month, a few times a year, and none (2016). As outcomes, 40 indicators of health and well-being were assessed across seven domains (2019): physical/cognitive health, health behaviors, mental health, subjective well-being, social well-being, pro-social/altruistic behaviors, and cognitive social capital. We included 47,318 respondents for four outcomes (death, dementia, and functional disability [any level and level 2 or greater]) and 34,187 respondents for the 36 other outcomes. ResultsMore frequent volunteering (≥ 1/week) was associated with higher social well-being outcomes, more frequent pro-social/altruistic behaviors and outings, and fewer depressive symptoms, even after considering multiple testing. ConclusionThroughout the three-year follow-ups, volunteer group participation was beneficial for depressive symptoms, social well-being, and other proximal outcomes.

The slow implementation of sustainable innovations in the asphalt paving sector: the role of actors and their interactions

International climate agreements and government policies, push the road construction industry towards more sustainable practices using alternative materials, new production techniques, and more efficient construction processes. Despite the broad availability of these sustainable solutions, their adoption is slow and uncertain. The reasons behind this remain unclear. This study employs a system innovation perspective to analyze the process that leads to the implementation of sustainable innovations in the Dutch asphalt paving sector. By exploring actors’ roles and their interactions at different stages of the process, we aim to identify key aspects influencing the pace and outcome of the innovation implementation process in the industry. The results highlight that (1) the asphalt paving sector is anchored in a project perspective that often overlooks long-term sustainability goals, (2) several key innovation roles are not fully fulfilled, and the absence of a coordinating role is leading to misunderstandings, and (3) monitoring at both the project and sector levels is lacking; there is no holistic assessment of the overall impact of innovations. Overall, the findings suggest that sustainable innovation processes in Dutch asphalt paving remain confined to the niche level, which can be overcome by redistributing actors' responsibilities, addressing the lack of system monitoring, and overcoming the project perspective could help address the challenges in the process.

Compression therapy in patients with venous leg ulcers: a best practice implementation project.

Venous leg ulcers are the most common ulcerations of the lower extremities. Compression is the most important consideration and the gold standard treatment for venous leg ulcers. This implementation project aimed to promote best practices in the management of venous leg ulcers in a rural community-care setting. This project was guided by the JBI Evidence Implementation Framework, which is grounded in audit and feedback processes, along with a structured approach to identifying and managing barriers to compliance with recommended best practices. Compliance with best practices increased for most audit criteria. The use of compression therapy increased from 16.7% to 60%, documentation increased from 6.7% to 50%, replacement of compression bandages from 6.7% to 60%, patient education from 0% to 46.7%, and holistic assessment from 0% to 13%. However, compliance for individualized interventions to promote adherence remained at 0%. This project succeeded in introducing compression therapy as a basic treatment for venous ulcers. However, continued improvement in the care for venous ulcers and guarantee of long-term implementation of evidence are necessary. http://links.lww.com/IJEBH/A212.

Empirical comparison of assembly complexity assessment approaches in manufacturing

AbstractInvestigating assembly complexity is a continuing concern within the manufacturing field, as it may impact the quality and costs of products. A growing body of literature is aimed at developing novel and reliable methods to assess assembly complexity. The first aim of this paper is to provide an extensive literature review, identifying the main approaches to this problem. Three main approaches emerged: product-centred approach, information-centred approach and system-centred approach. A second goal is to conduct a comparative analysis of these approaches, highlighting their advantages and limitations and providing guidance for process and product designers seeking to control assembly complexity. For each approach, a representative method was chosen, analysed in detail, and applied to five different real products. As concluding findings it was observed that product-centred approaches provide a more objective analysis, focusing strictly on product features. On the other hand, information-centred approaches focus on quantity and variety of information handled by assembly operators, thus proposing a valuable link between complexity and effort required. Finally, system-centred approaches provide a holistic assessment of assembly complexity which is typically only qualitative.

The stable sulfur isotope and abundance fluxes of reduced inorganic sulfur and organic sulfur phases recorded in the Permian-Triassic transition of the Meishan type section

Sulfur cycle fluxes implicated in the Permian-Triassic mass extinction have traditionally been studied by the sulfur phase abundances in sedimentary rocks and the stable sulfur isotopic value (δ34S) of seawater sulfate inferred from mineral sulfate analyses. This information might be complemented by studies of the reduced inorganic sulfur and organic sulfur produced following bacterial sulfate reduction. To explore this potential the δ34S and concentration analyses of total reduced inorganic sulfur (TRIS) and organic sulfur – separately in the forms of kerogen (Ker) and individual organosulfur compounds, specifically dibenzothiophenes (DBTs) – has been conducted on sediments across the Late Permian to Early Triassic marine type section of Meishan-1 (South China). The relatively steady δ34S profiles (e.g., < 5 ‰ variation) of all sulfur phases measured through much of the late Permian were indicative of a primary seawater sulfate control, but other biogeochemical modulators caused prominent δ34S fluctuations of TRIS and DBT adjacent to the extinction event. The late Triassic δ34STRIS profile of Meishan-1 displayed a notable 34S enrichment (+15 ‰ increase) in bed 22–24 sediments concomitant with lower δ34SDBT values (−7 ‰ decrease), whereas co-eval δ34SKerS values remained relatively constant. The contrasting δ34SDBT and δ34SKerS data suggests the dynamic behavior of specific diagenetic sulfurisation processes may be resolved by the δ34S of discrete organic sulfur compounds (i.e., dibenzothiophenes, DBTs), but dissipated by the sulfurisation collective represented by the bulk kerogen fraction. The inverse isotopic trend observed between DBT and TRIS resulted in negative Δδ34SDBT-TRIS values identifying an organic sulfurisation pathway(s) with an unusual preference over pyrite (FeS2) for the lighter stable sulfur isotope. A redox control of the δ34SDBTs and δ34STRIS deviations in the bed 22–24 extinction interval was confirmed by coincident variation in TRIS/(TRIS + KerS) and pyrite (Py) and highly reactive (HR) iron ratios (FePy/FeHR). The iron (Fe) speciation data indicated a transition to ferruginous conditions, ruling out Fe2+ limitation as a factor in the bias against 34S evident in DBT formation. The 34S depletion of the DBTs promoted by the ferruginous setting may arise from the rapid and irreversible reaction of organic substrates with labile sulfur anions (e.g. HS-) or be supported by an especially localised sediment–water depositional microenvironment. Our study highlights the potential of incorporating stable sulfur isotope analytics of reduced and organic sulfur phases, particularly of specific organic compounds, into a holistic assessment of the dynamic sulfur biochemical periods of Earth’s past.

The specialist community practitioner district nurse's role in optimising COPD.

Chronic obstructive pulmonary disease (COPD) is a long-term condition affecting all aspects of an individual's life. Specialist Community practitioner district nurses (SCPDN) manage patients with multiple co morbidities on their caseload, and as such require an extensive clinical knowledge base. COPD is a highly prevalent and complex disease; therefore, individualised holistic assessments are required to ensure patients receive personalised and evidence-based care. Care delivery must include an awareness of health interventions encompassing, screening, health promotion and prevention. The SCPDN's consideration of the physical, mental and social determinants which adversely affect the health of the individual with COPD is imperative to deliver high quality care to the individuals, families and communities.

Conceptual approach for a holistic low‐flow risk analysis

AbstractLow‐flow events, characterized by a significant water deficiency in river systems, have profound impacts on various water users and river ecology. Recent low‐flow events in Europe have had severe economic and ecological consequences such as disruptions to hydropower production, irrigation bans, constraints on navigation and complete river drying. These events highlight the urgent need for effective low‐flow risk management and demand a holistic risk analysis as a basis. The existing approaches to low‐flow analysis often focus on hydrological aspects, utilizing indices such as the Standardized Runoff Index (SRI) or Low‐flow Index. However, these indices lack information regarding consequences and impacts. Other approaches consider parts of a risk approach but often focus on special aspects, such as the economy; in general, no holistic assessment is made. This study introduces a conceptual approach to a holistic low‐flow risk analysis. The approach provides a continuous long‐term simulation to capture the special long‐term behaviour of low‐flow events and therefore avoids the complex definition of scenarios. In this conceptual approach, the low‐flow risk is analysed using a combination of various analyses that cover all aspects from occurrence to consequences. Meteorological analysis is used to generate synthetic long‐term weather data time series, which are transformed into runoff time series in hydrological analysis. Based on these results, hydrodynamic analysis quantifies the water levels, water temperatures, and flow velocities along the river. The consequences are analysed in terms of socio‐economic and ecological consequences. The results represent a long‐term series of damage values. Finally, the damage values are summed in the risk analysis and divided by the number of years considered in the analysis. For testing and demonstration purposes, the presented conceptual risk approach is partly applied to a proof‐of‐concept at the Selke catchment, a small river catchment in Germany. Finally, the results are presented, evaluated, and discussed.

Nursing Experience Caring for a Premature Infant With Bronchopulmonary Dysplasia

A nursing experience supporting parents experiencing anxiety related to their 26+2 weeks preterm infant on continued ventilator assistance at home due to bronchopulmonary dysplasia is described in this article. Data were collected from March 21st to June 1st, 2021 via observation, interviews, clinical care, medical record reviews, and discharge preparation services. A holistic nursing assessment identified the main health issues as: gas exchange disorder, inefficient infant feeding patterns, and caregiver role stress. The parents were encouraged to participate in care activities, create individualized discharge plans, and view health education videos and caregiving skill demonstrations. Kangaroo care, comfortable positioning and soothing techniques were used to stabilize the emotions of the infant and to strengthen the parent-child bond. Psychological support was provided to alleviate parental anxiety and to enhance parenting ability and confidence. This experience supports the importance of tailoring clinical care to individual needs, adopting a family-centered approach, assessing family interactions, and making early preparations to obtain appropriate continuous care after discharge to ensure proper continuum of care.

Advancing Glaucoma Diagnosis: Employing Confidence-Calibrated Label Smoothing Loss for Model Calibration

ObjectiveThe aim of our research is to enhance the calibration of machine learning models for glaucoma classification through a specialized loss function named Confidence-Calibrated Label Smoothing Loss (CC-LS). This approach is specifically designed to refine model calibration without compromising accuracy by integrating label smoothing and confidence penalty techniques, tailored to the specifics of glaucoma detection. DesignThis study focuses on the development and evaluation of a calibrated deep learning model. ParticipantsThe study employs fundus images from both external datasets-ORIGA (482 normal, 168 glaucoma) and REFUGE (720 normal, 80 glaucoma)-and an extensive internal dataset (4,639 images per category), aiming to bolster the model's generalizability. The model's clinical performance is validated using a comprehensive test set (47,913 normal, 1,629 glaucoma) from the internal dataset. MethodsThe CC-LS loss function seamlessly integrates label smoothing, which tempers extreme predictions to avoid overfitting, with confidence-based penalties. These penalties deter the model from expressing undue confidence in incorrect classifications. Our study aims at training models using the CC-LS and comparing their performance with those trained using conventional loss functions. Main Outcome MeasuresThe model's precision is evaluated using metrics like the Brier score, sensitivity, specificity, and the false positive rate, alongside qualitative heatmap analyses for a holistic accuracy assessment. ResultsPreliminary findings reveal that models employing the CC-LS mechanism exhibit superior calibration metrics, as evidenced by a Brier score of 0.098, along with notable accuracy measures: sensitivity of 81%, specificity of 80%, and weighted accuracy of 80%. Importantly, these enhancements in calibration are achieved without sacrificing classification accuracy. ConclusionsThe Confidence-Calibrated Label Smoothing Loss presents a significant advancement in the pursuit of deploying machine learning models for glaucoma diagnosis. By improving calibration, the CC-LS ensures that clinicians can interpret and trust the predictive probabilities, making AI-driven diagnostic tools more clinically viable. From a clinical standpoint, this heightened trust and interpretability can potentially lead to more timely and appropriate interventions, thereby optimizing patient outcomes and safety.

The Relationship Between Patient-Reported Outcome Measures (PROMs) in Patients Undergoing Hip and Knee Joint Replacement Surgery and Social Deprivation on the Wirral.

This study aimed to investigate the associa-tion between patient-reported outcome measures (PROMs), both pre- and post-operatively, and socio-economic deprivation among patients undergoing hip and knee replacement surgeries in the diverse socioeconomic region of Wirral. A retrospective cohort study was conducted, involving 1666 adult patients who underwent hip or knee replacement procedures between 2012 and 2019. Socioeconomic deprivation was assessed using the Index of Multiple Deprivation (IMD). Pre- and post-operative outcomes were measured using the Oxford Hip and Knee scores. The mean scores for both pre-and post-operative assessments (Q1 and Q2) exhibited a strong positive correlation with PROM scores, regardless of gender, across both hip and knee replacements. However, the mean difference in scores between Q1 and Q2 showed no significant correlation with the IMD decile. Notably, patients residing in areas of higher socioeconomic deprivation demonstrated lower PROMs both before and after the surgery. The Oxford Hip and Knee scores are widely employed for evaluating health status in patients. In our study, these scores were influenced by IMD decile, supporting the holistic assessment approach employed by the treating unit, which does not rely solely on PROM scores as a trigger for arthroplasty discussions. Furthermore, our findings align with the practice of NHS Digital, which publishes PROM scores based on changes in PROM scores pre- and post-operation rather than absolute PROM scores. This approach appears to be less influenced by deprivation in the catchment area, as the improvement or change in scores was poorly correlated with socioeconomic factors.

Improving person-centred care for older persons with serious multimorbidity in LMICs.

Few interventions are documented to meet person-centred needs of older people with serious multimorbidity in low- and middle-income countries where access to palliative care is limited. Most of the care in these settings is delivered by primary care health workers. This study reports the development and acceptability testing of a communication skills training and mentorship intervention for primary health care workers in Malawi. This study was conducted at Mangochi District Hospital in the south-eastern region of Malawi. Twelve primary health care workers (four clinical officers and eight nurses) working in the primary care clinics received the intervention. The intervention was designed using modified nominal group technique, informed by stakeholder interviews and a theory of change workshop. Acceptability is reported from thematic analysis of a focus group discussion with primary health care workers who received the intervention using NVivo version 14. Older persons with serious multi-morbidity and their caregivers identified a need for enhanced communication with their healthcare providers. This helped to inform the development of a communication training skills and mentorship intervention package based on the local best practice six-step Ask-Ask-Tell-Ask-Ask-Plan framework. Primary health care workers reported that the intervention supported person-centred communication and improved the quality of holistic assessments, although space, workload and availability of medication limited the implementation of person-centred communication. The Ask-Ask-Tell-Ask-Ask-Plan framework, supported person-centered communication and improved the quality of holistic assessment.Contribution:This intervention offers an affordable, local model for integrating person-centered palliative care in resource-limited primary healthcare settings.

Experiences of community pharmacists in the United Kingdom on the provision of travel health services and associated educational requirements.

Travel health services play a critical role in public health. Previously, travel services were provided solely through GPs or private specialist clinics. In recent years, they have been available from community pharmacists in the UK. This study sought to understand the types of travel health services provided by community pharmacists and to establish the educational needs. Qualitative interviews and focus groups explored current practices and educational needs in travel medicine. Thematic analysis of transcribed interviews and focus groups was conducted to understand how travel services are provided and the training undertaken by community pharmacists in delivering these services. Nine individual interviews and one focus group of seven additional pharmacists was conducted. Pharmacists considered that they provided a comprehensive service and undertook the necessary training for safe delivery. Pharmacists described a 'vaccine centric' approach to travel services, with aspects, such as management of chronic conditions, fitness/preparedness for travel, prevention and self-management of travel-related conditions considered to be of lower priority. This was reflected in the travel medicine education that they had received and their perception of future requirements. Whilst vaccination is a critical aspect of travel health medicine, taking a 'vaccine centric' approach represents a missed opportunity in public health. Future educational opportunities for pharmacists could include training that encourages a broader approach to travel health consultations, to include a co-created, structured, and holistic risk assessment for travellers and recommendations for appropriate prevention and management strategies for travellers prior to, during and after travel.

Reframing acute kidney injury as a pathophysiological continuum of disrupted renal excretory function.

Surrogate measures of glomerular filtration rate (GFR) continue to serve as pivotal determinants of the incidence, severity, and management of acute kidney injury (AKI), as well as the primary reference point underpinning knowledge of its pathophysiology. However, several clinically important deficits in aspects of renal excretory function during AKI other than GFR decline, including acid-base regulation, electrolyte and water balance, and urinary concentrating capacity, can evade detection when diagnostic criteria are built around purely GFR-based assessments. The use of putative markers of tubular injury to detect "sub-clinical" AKI has been proposed to expand the definition and diagnostic criteria for AKI, but their diagnostic performance is curtailed by ambiguity with respect to their biological meaning and context specificity. Efforts to devise new holistic assessments of overall renal functional compromise in AKI would foster the capacity to better personalize patient care by replacing biomarker threshold-based diagnostic criteria with a shift to assessment of compromise along a pathophysiological continuum. The term AKI refers to a syndrome of sudden renal deterioration, the severity of which is classified by precise diagnostic criteria that have unquestionable utility in patient management as well as blatant limitations. Particularly, the absence of an explicit pathophysiological definition of AKI curtails further scientific development and clinical handling, entrapping the field within its present narrow GFR-based view. A refreshed approach based on a more holistic consideration of renal functional impairment in AKI as the basis for a new diagnostic concept that reaches beyond the boundaries imposed by the current GFR threshold-based classification of AKI, capturing broader aspects of pathogenesis, could enhance AKI prevention strategies and improve AKI patient outcome and prognosis.

A Comprehensive Review of Life Cycle Cost Assessment of Recycled Materials in Asphalt Pavements Rehabilitation

This paper provides a comprehensive review of the use of life cycle cost assessment (LCCA) and life cycle assessment (LCA) methods for evaluating the sustainability and costs of using recycled materials in asphalt pavement rehabilitation projects. The review begins with an introduction to pavement rehabilitation strategies and the importance of choosing techniques based on thorough engineering and economic analyses. It then explores the different types of recycled materials that can be utilized, including reclaimed asphalt pavement, recycled concrete aggregate, and recycled asphalt shingles, discussing the key characteristics and properties of these materials based on previous laboratory studies. The review also examines the various rehabilitation methods that employ recycled content, such as cold in-place recycling, hot in-place recycling, and full-depth reclamation, providing a detailed breakdown of the construction, maintenance, and rehabilitation costs considered in LCCA and analyzing the environmental benefits of recycled material usage through a review of LCA techniques and criteria like carbon footprint reduction, impacts on air and water quality, and considerations of technological factors. Software tools for conducting LCA are compared and challenges to advancing the adoption of recycled materials are reviewed along with directions for future research efforts. The unique contribution of this work is its holistic assessment of LCCA and LCA methodologies to inform the sustainable and cost-effective deployment of recycled materials in asphalt pavement rehabilitation, a topic of growing importance for transportation infrastructure management. In summary, this current work provides a valuable review of how LCCA and LCA methodologies can assess the sustainability and costs of employing recycled content in asphalt pavement rehabilitation projects.

AI-derived body composition parameters as prognostic factors in patients with HCC undergoing TACE in a multicenter study

Background & AimsBody composition assessment (BCA) parameters have recently been identified as relevant prognostic factors for patients with hepatocellular carcinoma (HCC). Here we aimed to investigate the role of BCA parameters for prognosis prediction in patients with HCC undergoing transarterial chemoembolization (TACE). MethodsThis retrospective multicenter study included a total of 754 treatment-naïve patients with HCC who underwent TACE at six tertiary care centers between 2010–2020. Fully automated artificial intelligence-based quantitative 3D volumetry of abdominal cavity tissue composition was performed to assess skeletal muscle volume (SM), total adipose tissue (TAT), intra- and intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) on pre-intervention computed tomography scans. BCA parameters were normalized to the slice number of the abdominal cavity. We assessed the influence of BCA parameters on median overall survival (OS) and performed multivariate analysis including established estimates of survival. ResultsUnivariate survival analysis revealed that impaired median OS was predicted by low SM volume (p < 0.001), high TAT volume (p = 0.013), and high SAT volume (p = 0.006). In multivariate survival analysis, SM remained an independent prognostic factor (p = 0.039), while TAT and SAT volumes no longer showed predictive ability. ConclusionsSkeletal muscle volume is an independent prognostic factor for survival prediction. Thus, the integration of SM into novel scoring systems could potentially improve survival prediction and clinical decision-making. Fully automated approaches are needed to foster the implementation of this imaging biomarker into daily routine. Impact and implicationsBody composition assessment parameters, especially skeletal muscle mass, have been identified as relevant prognostic factors for many diseases and treatments. In this study skeletal muscle volume has been identified as an independent prognostic factor for patients with HCC undergoing TACE. Therefore, skeletal muscle mass as a metaparameter could play a role as an opportunistic biomarker in holistic patient assessment and be integrated into decision support systems. Workflow integration with AI evaluation is essential for automated body composition assessment quantification output enabling broad availability in multidisciplinary case discussions.

Party Politics in West Bengal: Historical and Contemporary Dynamics

Party politics in West Bengal is a complex and ever-evolving phenomenon deeply rooted in the state's socio-cultural history. This overview explores the dynamic landscape of party politics in West Bengal, tracing its historical evolution and examining the key players, ideological underpinnings, electoral strategies, and socio-economic factors that have influenced voter preferences over the years. From the pre-independence era's freedom struggle to the contemporary political dynamics dominated by the All-India Trinamool Congress (AITC) and Bharatiya Janata Party (BJP), West Bengal's political journey reflects its vibrant cultural mosaic and socio-political complexities. This paper also discusses the current scenario in West Bengal, highlighting the role of various political parties in recent local and assembly elections. The methodology involves a comprehensive review of academic papers and journals on various aspects of West Bengal's politics, governance, and societal dynamics. While existing literature touches on governance-related aspects like healthcare policies, decentralisation, and power sector reforms, there is a research gap in integrating these elements to provide a holistic assessment of West Bengal's governance model. The paper identifies this research gap and calls for a more comprehensive study that explores the interplay of political decisions, decentralisation efforts, and policy reforms in shaping the state's development and governance outcomes.

Revving Up or Stalling Out? A Comprehensive SWOC Analysis of BSE listed India's Auto Sector

Purpose: The primary purpose of this research paper is to conduct a comprehensive SWOC (Strengths, Weaknesses, Opportunities, and Challenges) analysis of the Indian automobile sector, which plays a vital role in the economy by contributing to GDP, employment, and technological progress. Amidst globalization, technological changes, and evolving consumer preferences, the industry faces numerous internal and external factors affecting its performance. By systematically evaluating these factors, the research aims to provide insights into the sector's current state and future prospects, informing strategic decisions for stakeholders, policymakers, and investors. This study fills a gap in existing literature by offering a holistic assessment using the SWOC framework, uncovering strengths, weaknesses, opportunities, and challenges to support the industry's competitiveness and sustainability. Design/Methodology/Approach: The study employs a qualitative research approach, utilizing both primary and secondary data sources. Primary data includes industry reports, company publications, and expert interviews, while secondary data encompasses academic journals, government publications, and reputable online sources. SWOC analysis is conducted to identify and evaluate the internal strengths and weaknesses of the industry, as well as external opportunities and challenges it faces. Findings/Results: The SWOC analysis reveals several key insights into the Indian auto industry. Strengths such as a skilled workforce and a growing domestic market are counterbalanced by weaknesses such as infrastructure bottlenecks and regulatory challenges. Opportunities arising from technological advancements and export potential are tempered by threats such as global competition and changing consumer preferences. Originality/Value: This research contributes to the existing literature by offering a comprehensive assessment of the Indian auto industry through the SWOC framework. By synthesizing insights from various data sources, the paper provides valuable insights for industry stakeholders, policymakers, and investors seeking to navigate the complexities of the Indian automotive landscape. Paper Type: Descriptive Research

Vaccine value profile for herpes simplex virus

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are chronic, highly prevalent viral infections that cause significant morbidity around the world. HSV-2 is sexually transmitted and is the leading cause of genital ulcer disease (GUD). It also increases the risk of HIV acquisition, fueling the HIV epidemic. HSV-1 is typically acquired in childhood through nonsexual contact and contributes to oral and ocular disease, but it can also be sexually transmitted to cause GUD. Both HSV-1 and HSV-2 cause neonatal herpes and neurologic disease. Given the ubiquitous nature of HSV-1 and HSV-2 infections and the limited existing prevention and control measures, vaccination would be the most efficient strategy to reduce the global burden of morbidity related to HSV infection. Vaccine strategies include prophylactic vaccination, which would prevent infection among susceptible persons and would likely be given to adolescents, and therapeutic vaccinations, which would be given to people with symptomatic genital HSV-2 infection. This document discusses the vaccine value profile of both types of vaccines.This ‘Vaccine Value Profile’ (VVP) for HSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by subject matter experts from academia, non-profit organizations, government agencies and multi-lateral organizations. All contributors have extensive expertise on various elements of the HSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.