Suggest Management Strategies Research Articles

ANALYSIS OF TRAFFIC FLOW AND MANAGEMENT STRATEGIES IN YENAGOA, NIGERIA

The purpose of this paper is to examine the flow of vehicular traffic and suggest management strategies to be adopted in Yenagoa to ease flows and congestions. The gravity model provided the theoretical basis for this study. A survey research design involving volumetric count restricted to Melford Okilo Way, Isaac Boro Road, Etegwe/Tombia Road and SaniAbacha and Azikoro Way was adopted. Result of vehicular traffic flow showed that tricycles and cars generate more through traffic across all traffic corridors in Yenagoa. Using Principal Component Analysis (PCA), the extracted three components showed 20.95%, 14.08% and 11.78% of the total variance. The extracted components were subjected to further analysis using multiple regression analysis. The result of the regression model revealed that the extracted components explained 0.614 (61.4%) of influence on vehicular traffic in Yenagoa at 0.05 significance level. There is the need for an efficient traffic management such as zoning of land uses and introduction of off-street parking and parking lots at affordable rates to ease traffic flow in Yenagoa.

'The day you start lifting is the day you become forever small': Bodybuilders explain muscle dysmorphia.

Muscle dysmorphia (MD) is a pathological preoccupation with muscularity characterised by negative body image, compulsive behaviours, and obsessive thoughts. Since its first identification academics have suggested that it is caused by sociocultural factors. Despite this there has been very little research exploring the role of sociocultural factors in the development and maintenance of MD, and no research that examines MD from within its cultural context. Instead the medical model of MD has dominated understanding. This model presents professionals as the experts on this disorder, and sufferers as pathological individuals in need of expert treatment. This renders cultural context largely irrelevant to understandings of MD. In this paper we present a different kind of expertise with regards MD. We describe the expertise of those most likely to suffer from MD, and upon whom medical descriptions of MD are based: bodybuilders. Specifically, we describe how bodybuilders explain MD (their definition, theory of aetiology and experience of MD, as well as their suggested management strategies), and compare these explanations to the dominant medical model. Through a consideration of the expertise of bodybuilders we break the tunnel vision of medicine, and suggest ways we can move beyond our current under-developed understanding of MD. This paper examines MD from within its cultural context, and in so doing it lays the foundation for a sociocultural explanatory model of MD. If we are to significantly reduce the harms of this disorder we cannot rely solely on treating the few individuals who present to clinicians. Rather we must develop ways to help sufferers to manage their disorder, and to prevent the development of this disorder among those at risk in the first place. To do this we must understand the sociocultural dimensions of MD, and collaborate with bodybuilding communities.

Estimating Carbon Budget from Growth and Management of Urban Street Trees in South Korea

Although street trees take up carbon by vegetation growth, they emit carbon directly or indirectly into the atmosphere due to the need for regular management, such as pruning and, irrigation, etc. This study estimates the annual carbon budget from the growth and management of urban street trees in South Korea and suggests management strategies to minimize the degree of management and annual carbon emissions. Annual carbon emissions from management practices such as pruning, irrigation, pesticide and fungicide application, and fertilization were estimated based on maintenance data, interviews with managers, and actual measurements. Annual carbon emissions from the management of urban street trees were calculated to be 2.4 kg/tree/year. From this total, pruning was the largest contributor at 91%. The average net carbon uptake for each street tree was 5.5 kg/tree/year. The street trees included in this study played an important role in carbon uptake, which was equivalent to 90–550% of the annual carbon emissions from street tree management. Based on these results, suggested management strategies include pruning, irrigation, pesticide and fungicide application, and fertilization. These study results will be useful for designing practical low-carbon landscapes with minimal management and carbon emissions.

Optimal heuristic economic management strategy for microgrids based PEM fuel cells

This paper provides a cost-effective energy management method for the microgrid's standalone and on-grid operational modes. The considered microgrid based on Green-to-Green systems such as a photovoltaic array (PV), wind turbine (WT) as renewable generators, hydrogen fuel cell (FC) system, microturbine (MT), and battery storage system. The suggested technique is based on the marine predator algorithm (MPA) that and created for a scheduling horizon of one day. The main objective of this paper is to reduce operating costs while satisfying the demand power. To approve the performance of the suggested management strategy, the simulation results are compared with other recent optimization algorithms. These algorithms include particle swarm optimization (PSO), salp swarm algorithm (SSA), and coot optimization algorithm (COOT). To approve the performance of the proposed EMS, the system will be evaluated for three cases: free renewable generation, restricted generation mode, and unlimited main grid power mode. For the first case, the proposed EMS reduces the operating costs by 0.8732%. For case 2, the economic benefits have been raised by 1.0815% and by 0% for the last case because of the reduced problem complexity.

Peripartum hemorrhage: Two cases of ruptured ovarian artery aneurysms with additional multifocal intact aneurysms.

We report two cases of peripartum ruptured ovarian artery aneurysms (OAA). One patient was treated through endovascular embolization and the other with percutaneous thrombin injection. Multiple additional unruptured OAAs were incidentally discovered in each patient. We describe the pathophysiologic basis for OAA rupture, approaches to treatment, and suggest management strategies for incidentally discovered ovarian aneurysms.

Lower Back Pain in Athletes and Non-Athletes; A Group Comparison of Risk Factors and Pain Management

Back pain is a common complaint among people. This study aimed to evaluate lower back pain (LBP) in athletes and non-athletes, identify the associated risk factors, and suggest management strategies. A cross-sectional study was conducted in Saudi Arabia from September 3 to October 15, 2020. The sample size was 1,446 individuals, random sampling was performed. It included individuals between 18 and 50 years. Participants with a congenital anomaly or a history of trauma or previous surgery were ex

POLICY GAPS ON SOLID WASTE MANAGEMENT: CASE OF CHEGUTU MUNICIPALITY ZIMBABWE

The purpose of this study was to explore policy gaps on urban solid waste management in Zimbabwe and suggest management strategies to close these gaps. This was motivated by the observation that there is no policy in Chegutu Municipality which deals holistically with solid waste management. A qualitative research design was adopted to analyze policies and establish gaps. A descriptive survey based on a case study of Chegutu Municipality was used. A survey of a purposive sample of 44 residents, 5 Council employees, and 2 EMA officials was conducted. Questionnaire, Interviews and document analysis were employed. The study found that, there is no policy in Chegutu Municipality which deals holistically with solid waste management. The study recommends that citizens should be educated as a matter of national policy on waste minimization. Policies with a holistic view of solid waste management should be drafted in Chegutu Municipality. Since there is lack of enforcement and responsibility in solid waste management policies, roles of stakeholders and institutions should be clearly defined.

Roadsides are key habitats for birds in the Argentine Pampas: conservation and management implications

SummaryUnexploited public areas such as roadsides could provide habitat to help preserve biodiversity in South America, as in other regions. Our objective was to determine the importance of the roadsides of the Argentine Pampas for native birds and to suggest management strategies. We surveyed birds inhabiting roadsides in all seasons and determined whether roadsides were used as habitat. We recorded a total of 95 species on roadsides, which represents 55% of those species described from the area. Species included specialists of grassland, wetland and woodland, 4 vulnerable species and 19 declining species. Bird richness decreased in winter, as well as grassland specialists’ abundances. Most individuals used roadsides for foraging and performing reproduction-related behaviours, mainly on native trees; these and tall grass were the main substrates. We conclude that many species of birds use the habitat provided by roadsides, and we recommend management strategies such as favouring seed availability in winter, restoring trees and tall grass and increasing vegetation diversity to maximize roadside conservation value.

A prospective longitudinal study of medication errors in private hospital of metropolitan city of Gujarat

To identify occurrence rate and to suggest management strategies for medication errors in a multi-speciality private hospital of metropolitan city of Gujarat. A prospective, longitudinal study was conducted in surgery and medicine ward of the hospital, during 15th July’2014 to 15th Jan’2015 after approval from human ethics committee. Medication errors (MEs) were categorized as prescription error (PE) and administration error (AE). The case records and treatment charts were reviewed and root causes were identified. The investigator also accompanied the staff nurse during the ward rounds and interviewed patients or care taker to gather information, if necessary. A total of 230 geriatric patients (81 in Medical and 149 in surgical ward) were included. Total 23 (10.5%) in medicine and 82(37.43%) in surgical wards MEs were reported. Greater number of MEs were found in female patients 68(64.76%) as compared to male 37(35.24%). The most common ME was PEs 98 (93.33%) followed by AEs 7 (6.67%). On second day of stay higher 99(68.28%) number of MEs were found. Incomplete patient information and miscommunication were common cause of PE. Moreover, lack of communication and requisition errors was common to AEs. A high occurrence rate (45.65%) of MEs was observed with no serious outcome. The root causes of errors were identified and training was provided to minimized errors in future.

Effectiveness of carp seed stocking in large reservoir ecosystems of India

AbstractTropical reservoir ecosystems cover more than 3.51 million ha in India which are the major sources of fish production from inland open waters and supports rich diversity of fish. The present study quantifies fisheries enhancement and evaluates the impact of stocking of Indian major carp fingerlings in six large reservoir ecosystems of India. Analysis of time series data revealed a significant increase (p < 0.05) in fish yield from 12.3 kg ha−1 year−1 in 2004–2005 to 52.4 kg ha−1 year−1 in 2016–2017 due to stocking. The average fish yield of these six reservoirs was estimated to be higher than the national average of 33 kg ha−1 year−1 recorded for large Indian reservoirs. Fingerling stocking had a significant positive impact on fish yield (r = 0.238, p = 0.035). The reservoir water storage level was positively correlated (r = 0.621, p < 0.05) to fish production. The study also shows that the reservoir habitat support 99 finfish species in the central Indian reservoirs of which two species belong to endangered category warranting conservation efforts. This study is the first of its kind on assessing the impact of stocking in large number of tropical reservoirs including the largest reservoir in the country revealing positive effect on fish yield. The fish yield of 85.8 kg ha−1 year−1 obtained in Gandhisagar reservoir (72,300 ha), India revealed that fisheries enhancement is effective and remunerative. The study also highlights the global status of stocking impact in large reservoirs and deliberates issues and suggests management strategies for sustainable fisheries enhancement in large tropical reservoirs.

Biologic behavior of resected BRCA-mutated pancreatic cancer: Comparison with sporadic pancreatic cancer and other BRCA-related cancers

Since margin-negative resection is essential for the cure of pancreatic cancer (PC), early detection of PC is important. Although PC is the third most common cancer associated with BRCA1/2 mutations, clinical research regarding BRCA mutations in resected PC are rare. In this study, we investigated the oncologic characteristics of resected PC with BRCA mutation to suggest management strategies. We retrospectively reviewed data from 493 patients who were confirmed to be pathogenic BRCA1/2 mutation carriers between January 2007 and December 2019. We investigated the oncologic characteristics of PC patients by comparing them with resected sporadic PC and other BRCA-related cancer groups (breast cancer, ovarian cancer, and others). Ten BRCA mutation carriers (2.0%) experienced PC, and PC onset was significantly later than that of BRCA-related breast cancer (age: breast vs. pancreas, 45.0 vs. 53.5 years; p = 0.050). Six patients underwent pancreatectomy and their long-term survival outcomes did not differ from those of sporadic PC patients (disease free survival: BRCA1/2 vs. sporadic, 10.0 months vs. 9.0 months; p = 0.504; overall survival: BRCA1/2 vs. sporadic, 29.0 months vs. 35.0 months; p = 0.520). BRCA-mutated PC occurs later than BRCA-mutated breast cancer. Active genetic testing to identify BRCA1/2 mutation carriers at the onset of breast cancer and continuous long-term surveillance of these patients can provide opportunities to detect BRCA-mutated PC at a resectable stage.

Spatial and temporal responses of swamp wallabies to roads in a human-modified landscape

Roads can have significant impacts on wildlife populations by impeding movement, restricting access to resources and causing wildlife–vehicle collisions. In particular, wildlife–vehicle collisions represent a substantial conservation and social problem, and although mitigation measures are available, an increased understanding of the temporal and spatial patterns of animal movement around roads will enhance their effectiveness. We analysed GPS telemetry data from 47 swamp wallabies Wallabia bicolor on Phillip Island, south-east Australia, within patches of native vegetation dissected by roads. Our aims were to determine if (a) road crossing frequency was influenced by time period (day, night) or sex, (b) wallabies avoided roads, and if avoidance was influenced by time period or sex and (c) road crossing locations were associated with dense vegetation, and other habitat characteristics. We found that males crossed roads more often at night than during the day while females showed the opposite pattern. Further, wallabies avoided roads, with some evidence that avoidance increased at night (p = 0.07). The chance of a wallaby crossing roads with high speed limits (80–100 km h-1) increased with vegetation density during the day but not at night. In contrast, vegetation density had no influence on crossing locations along roads with lower (50–70 km h-1) speed limits during the day or night. Both vegetation density and vehicle speed may influence wallaby–vehicle collisions and suggest management strategies targeting these factors. Partial fencing guiding wallabies towards safer crossing locations, combined with other measures such as reduced speed limits and signage, could reduce collisions between vehicles and swamp wallabies on Phillip Island.

Biologic behavior of resected BRCA-mutated pancreatic cancer: Comparison with sporadic pancreatic cancer and other BRCA-related cancers

BackgroundSince margin-negative resection is essential for the cure of pancreatic cancer (PC), early detection of PC is important. Although PC is the third most common cancer associated with BRCA1/2 mutations, clinical research regarding BRCA mutations in resected PC are rare. In this study, we investigated the oncologic characteristics of resected PC with BRCA mutation to suggest management strategies. MethodsWe retrospectively reviewed data from 493 patients who were confirmed to be pathogenic BRCA1/2 mutation carriers between January 2007 and December 2019. We investigated the oncologic characteristics of PC patients by comparing them with resected sporadic PC and other BRCA-related cancer groups (breast cancer, ovarian cancer, and others). ResultsTen BRCA mutation carriers (2.0%) experienced PC, and PC onset was significantly later than that of BRCA-related breast cancer (age: breast vs. pancreas, 45.0 vs. 53.5 years, p = 0.050). Six patients underwent pancreatectomy and their long-term survival outcomes did not differ from those of sporadic PC patients (disease free survival: BRCA1/2 vs. sporadic, 10.0 months vs. 9.0 months, p = 0.504; overall survival: BRCA1/2 vs. sporadic, 29.0 months vs. 35.0 months, p = 0.520). ConclusionBRCA-mutated PC occurs later than BRCA-mutated breast cancer. Active genetic testing to identify BRCA1/2 mutation carriers at the onset of breast cancer and continuous long-term surveillance of these patients can provide opportunities to detect BRCA-mutated PC at a resectable stage.

Drivers of nitrogen and phosphorus dynamics in a groundwater-fed urban catchment revealed by high-frequency monitoring

Abstract. Eutrophication of water bodies has been a problem causing severe degradation of water quality in cities. To gain mechanistic understanding of the temporal dynamics of nitrogen (N) and phosphorus (P) in a groundwater-fed low-lying urban polder, we applied high-frequency monitoring in Geuzenveld, a polder in the city of Amsterdam. The high-frequency monitoring equipment was installed at the pumping station where water leaves the polder. From March 2016 to June 2017, total phosphorus (TP), ammonium (NH4), turbidity, electrical conductivity (EC), and water temperature were measured at intervals of less than 20 min. This paper discusses the results at three timescales: annual scale, rain event scale, and single pumping event scale. Mixing of upwelling groundwater (main source of N and P) and runoff from precipitation on pavements and roofs was the dominant hydrological process governing the temporal pattern of the EC, while N and P fluxes from the polder were also regulated by primary production and iron transformations. In our groundwater-seepage controlled catchment, NH4 appeared to be the dominant form of N with surface water concentrations in the range of 2–6 mg N L−1, which stems from production in an organic-rich subsurface. The concentrations of NH4 in the surface water were governed by the mixing process in autumn and winter and were reduced down to 0.1 mg N L−1 during the algal growing season in spring. The depletion of dissolved NH4 in spring suggests uptake by primary producers, consistent with high concentrations of chlorophyll a, O2, and suspended solids during this period. Total P and turbidity were high during winter (range 0.5–2.5 mg P L−1 and 200–1800 FNU, respectively, where FNU represents Formazin Nephelometric Unit) due to the release of P and reduced iron from anoxic sediment to the water column, where Fe2+ was rapidly oxidized and precipitated as iron oxides which contributed to turbidity. In the other seasons, P is retained in the sediment by sorption to precipitated iron oxides. Nitrogen is exported from the polder to the receiving waters throughout the whole year, mostly in the form of NH4 but in the form of organic N in spring. P leaves the polder mainly during winter, primarily associated with Fe(OH)3 colloids and as dissolved P. Based on this new understanding of the dynamics of N and P in this low-lying urban catchment, we suggested management strategies that may effectively control and reduce eutrophication in urban polders and receiving downstream waters.

Forest decline differentially affects trophic guilds of canopy-dwelling beetles

Decline can affect the structure, resources, and microclimates of the forest canopy, and potentially have cascading effects on canopy-dwelling species. Our survey shows that an oak decline can promote saproxylic beetles, especially xylophagous ones, and generalist phyllophagous weevils. However, it negatively affects specialist leaf-eating species and has no effect on seed-eating weevils. Decline in a context of climate change is expected to induce considerable changes in forest structure, potentially affecting habitat opportunities and trophic resources for numerous species. Nonetheless, the consequences of decline in forest biodiversity have rarely been studied. We aimed to characterize the impact of oak decline on different guilds of canopy-dwelling beetles. Beetles were sampled for three consecutive years in oak stands exhibiting different levels of decline. Several guilds were considered: (i) Buprestidae, (ii) other saproxylic beetles split into wood-boring species and non-wood-boring species, (iii) seed-eating weevils, and (iv) specialist and generalist leaf-eating weevils. Overall, decline had positive effects on the abundance and biomass of beetles, though contrasting variations were observed at the species or guild levels. Wood-boring species, especially the main oak-associated buprestids, and other saproxylic species benefitted from decline conditions. However, at odds with the insect performance hypothesis, decline had a positive effect on generalist leaf-eating species, a negative effect on specialist leaf-eating species, and a null effect on seed-eating species. The increase in species richness for saproxylic and leaf-eating beetle communities suggests that decline might promote forest biodiversity. Our results call for further studies to thoroughly assess the functional outcomes of forest decline and to suggest management strategies for conservation biologists.

Water-level controlled reservoir as refugia for waterbirds in an urban landscape

Artificial wetlands can play an important role in waterbird conservation due to habitat loss and degradation of natural wetlands. Urban reservoirs can harbor waterbird communities, but they usually have lower biological diversity than natural wetlands. However, the value of reservoirs for waterbird conservation in urban areas needs further exploration. Here, we surveyed the waterbird community in a water-level controlled reservoir of an urban area in southeastern Brazil. We evaluate the seasonal variation in species composition, richness, and abundance. Monthly samplings were carried out between July 2017 and February 2018, through a boat line transect. A total of 7762 waterbirds were recorded, belonging to 32 species and 16 families. There were significant differences in species composition and abundance between dry and rainy seasons. The community was dominated by generalist and resident species, which Gallinula galeata and Jacana jacana were the most abundant species. We did not register migratory shorebirds during the surveys. Our results highlight the importance of reservoirs in urban areas, as they harbor feeding areas and breeding sites and may serve as refuges during dry seasons for resident waterbirds. We suggest management strategies to improve the importance of water-level controlled reservoirs as breeding areas for resident species and migratory stopover for shorebirds. Our results may also be considered for urban planning and waterbird conservation in urban areas.

COVID-19 medical management including World Health Organization (WHO) suggested management strategies

Disease-a-Month - Sous presse. Epreuves corrigees par l'auteur. Disponible en ligne depuis le lundi 7 septembre 2020

Myxedema Heart and Pseudotamponade.

ContextThyroid hormone plays a critical role in cardiovascular function. Severe hypothyroidism can be associated with “myxedema heart” characterized by relative bradycardia and pericardial effusion. Effusions associated with severe hypothyroidism can be large. Despite the large volume of effusions, tamponade is not a common consequence. However, with the incorporation of echocardiography into routine practice for evaluation of effusion, echocardiographic findings suggestive of clinical tamponade occur frequently.Case DescriptionWe report a series of 3 patients with large pericardial effusions secondary to severe hypothyroidism. These cases serve to demonstrate the discordance between echocardiographic signs consistent with tamponade with a patient’s stable clinical hemodynamics. We also report the development of bronchial obstruction, a rare complication of a large effusion due to severe hypothyroidism.ConclusionsWhile pericardial effusion associated with severe hypothyroidism has been described for decades, the echocardiographic findings may be less well known and may lead to unnecessary downstream testing or invasive management. We use our case series to facilitate a summary of what is known about the epidemiology, mechanism and physiology, and expected outcomes of myxedema associated pericardial effusion. Finally, in the setting of current paucity of clinical guidelines, we aim to familiarize clinicians with the phenomenon of pseudotamponade and suggest management strategies for myxedema associated pericardial effusion to guide clinicians to use conservative medical management in majority of cases.

Management of Valvular Disease During Pregnancy: Evolving Role of Percutaneous Treatment.

Valvular heart disease (VHD) is encountered in approximately 1% of pregnancies, significantly increasing both maternal and foetal risk. Rheumatic VHD remains the most common form in non-Western countries, whereas congenital heart disease dominates in the Western world. The risk of complications varies according to the type and severity of the underlying VHD. Moreover, pregnancy is a hypercoagulable state associated with increased risk of thromboembolism. The authors review the main VHDs encountered during pregnancy, and suggest management strategies based on the 2018 European Society of Cardiology recommendations for the management of pregnant women with VHD, providing an overview of classical and new transcatheter structural therapeutic options with a special focus on radiation exposure and anticoagulation drug management.

MANAGEMENT OF ENDOCRINE DISEASE Disease burden and treatment challenges in patients with both Addison's disease and type 1 diabetes mellitus.

Concurrent type 1 diabetes (T1D) and Addison's disease (AD) is a rare combination of diseases and, in approximately one third of these patients, it is also combined with an autoimmune thyroid disease. Recently, it was shown that patients with both T1D and AD have a higher risk of premature death compared to patients with T1D alone, the most common causes of death being due to diabetic complications and cardiovascular disease. These patients receiving replacement therapies with both insulin and glucocorticoids face an increased risk of hypo- and hyperglycemia and diabetic ketoacidosis and have a higher risk of adrenal crisis than patients with AD alone. Treatment challenges include the opposing effects of insulin and glucocorticoids on glucose homeostasis and the need to balance and synchronize these two treatments. The rarity of this disease combination may explain the paucity of data on outcome and specific treatment strategies in this patient group. Based on this review, we suggest management strategies for their insulin and glucocorticoid replacement therapies and indicate future areas of research.