Management of chronic spontaneous urticaria: Real-world Indian perspective

Objectives: There are multiple guidelines for chronic spontaneous urticaria (CSU) by various dermatological associations, but in real-world practice in India, different approaches have been noted. In this paper, we courted to determine these different approaches in CSU management, adherence to various CSU guidelines, and the reasons for deviation from guidelines amidst dermatologists in India. Materials and Methods: A net-based questionnaire was created and validated by five panelists experienced in CSU management and then was circulated to all dermatologists in India in August 2020 for real-world management scenario. Results: We received 880 completed response out of 2235 response. Most of the dermatologists (97%) were aware of some urticaria guidelines. Although many of them follow guidelines about three forth of them reported to deviate from it sometimes. The most common reason for deviation was rely on clinical experience as opted by 53% of respondents. Dermatologists who follow guidelines also investigate routinely in terms of complete blood count, the erythrocyte sedimentation rate, and thyroid-stimulating hormone as compared to those who do not. About 70.5% of the dermatologist prescribe second-generation antihistamine (SGAH) at approved dose as the first line of treatment whereas 63.6% up dose it as second line of treatment. Surprisingly, 68% prescribe first-generation antihistamine in the evening and SGAH in the morning as combination therapy in CSU. Conclusion: From the findings of the present study, it can be strongly implied that guidelines play a vital role in delivering superior attributes of patient care although 75% of dermatologists deviated from it. Main reasons for deviance are reliability on self-clinical proficiency and consideration of economic impediments. Both these factors need to be worked upon by continuous medical education of dermatologists and more pharmaco-economic research.

Sustainable water resources management under water-scarce and limited-data conditions

Urbanization and population growth increase the demand for freshwater abstraction, food production, rising thus the agricultural, economic, and productivity expectations. The need for improved water services, sustainable and resilient management under changing climate, are major drivers to set forth the redesigning of water planning. Water scarcity combined with the limited expansion of new infrastructure create competition among water uses and further stress the satisfactory coverage of the increasing needs. Integrated modeling is a way to simulate and address the above challenges, however, poor monitoring, incomplete databases, and complexity make its applications difficult. Questions such as what data to use, how to best exploit the (limited) available databases, what parameters to calculate, and how to satisfy both economic and environmental objectives, occur. This study presents a novel Decision Support System (DSS), combining hydrology, economics, engineering, and social aspects, aimed to participatory management, using simple concepts, and discussing assumptions for working with limited data, and useful parameters to estimate. Water availability and demand, water quality, profits, costs, and management scenario analysis, including nature-based solutions, are explored under climate change scenarios, and alternative policies are evaluated. The combination of the above and the useful modeling insights, under water- and data-scarcity conditions are novel elements, while the aim is to encourage integrated and sustainable water resources management through understandable and user-friendly DSSs.

A behavioural study of obedience in health professional students

Interprofessional Education and Collaborative Practice (IPECP) is a field of study suggested to improve team functioning and patient safety. However, even interprofessional teams are susceptible to group pressures which may inhibit speaking up (positive deviance). Obedience is one group pressure that can inhibit positive deviance leading to negative patient outcomes. To examine the influence of obedience to authority in an interprofessional setting, an experimental simulated clinical scenario was conducted with Respiratory Therapy (RT) (n = 40) and Advanced Care Paramedic (ACP) (n = 20) students. In an airway management scenario, it was necessary for students to challenge an authority, a senior anesthesiologist, to prevent patient harm. In a 2 × 2 design cognitive load and an interventional writing task designed to increase positive deviance were tested. The effect of individual characteristics, including Moral Foundations, and displacement of responsibility were also examined. There was a significant effect for profession and cognitive load: RT students demonstrated lower levels of positive deviance in the low cognitive load scenario than students in other conditions. The writing task did not have a significant effect on RT or ACP students’ behaviour. The influence of Moral Foundations differed from expectations, In Group Loyalty was selected as a negative predictor of positive deviance while Respect for Authority was not. Displacement of responsibility was influential for some participants thought not for all. Other individual variables were identified for further investigation. Observational analysis of the simulation videos was conducted to obtain further insight into student behaviour in a compliance scenario. Individual differences, including experience, should be considered when providing education and training for positive deviance. Simulation provides an ideal setting to use compliance scenarios to train for positive deviance and for experimentation to study interprofessional team behaviour.

Potential Utilization of Municipal Solid Waste of Gwalior City, India

This paper aims at determining the recent composition of municipal solid waste of Gwalior city and provide sa notion to take action and proposed economical & viable waste management technologies and techniques for effective utilization of waste. In this study, MSW samples were collected from the Kedarpur landfill site situated at Shivpuri link road and were analyzed for physical composition. The study reveals that Gwalior city produces a high quantity of biodegradable waste (58.03%) with high moisture content (68.60%) and plastic waste (15.96%). Waste composition and characterization disclosed that vigorous segregation is required before dispatching the waste for different treatment processes or landfilling. Based on this study, we may conclude that the combined mechanism of planning and implementation of waste-to-energy (WTE) technologies and treatment such as Anaerobic Digestion/ Bio-methanation, Material recovery facility (MRF), and Bio-remediation/Bio-mining for old existing waste and new generating waste is needed for upgrading the waste management scenario of the city. Keywords: Municipal solid waste (MSW), Kedarpur Landfill site, Composition & Characteristics, Waste to Energy, Anaerobic Digestion, Bio-Mining, Recycling & Materials Recovery Facility (MRF)

Can Circular Entrepreneurship Save the World Economy?

Global polarization and linear economy models has for generations been the servant of ruthless capitalism and bourgeoisie ventures. In such ruthless circumstance there has been alarming situation both globally and locally to challenge prevailing linear economy structures to question and create a sustainable platform for protecting the resources and user structures of our future generations. Life cycle assessments globally has been a case study which has shown the minimal usage of products in value based propositions and bringing the environmental ecosystem in a balanced structure irrespective of political or governmental interventions. From the birth of the Paris Agreements on Climate changes, scientists and technologists globally has stressed upon the importance of sustainability and resilience on global food security as well as natural resource management. In such scenario resource allocations even in advanced countries like Europe and America has fallen prey to gross inequality, gender gaps and faulty resource transitions even in most advanced regions. Shocking Gini coefficient figures across boundaries have led scientists and economists globally to rethink and restrategise the way strategic business management hovers globally and to better revisualise globalization and utilize the resources our earth has endowed us upon. This paper challenges prevailing notions and even best practices in current management scenario and principles of economics of entrepreneurship to jump start a society based on values, tradition and value based usage proposition; in other terms from a linear based economy to a sustainable resilient circular economy model with greater emphasis on environmental protection, poverty eradication with better integration of triple line bottom of pyramid and better community disciplines to foster a vibrant shared economy model. There is a persistent gap lying across various parameters of a linear economy which has in turn been the causal effect of human impoverishment, poverty and vast scale ecological destructions. A case based approach and exploratory study in this research paper tries to answer rising question in addressing this burning topic of circular entrepreneurship which is quite different in structure and outcome to normative economical falsifications arising out of entrepreneurship models which has till now failed to create a functional economy devoid of hazards and wastes.

Surveys of Large Waterfowl and Their Habitats Using an Unmanned Aerial Vehicle: A Case Study on the Siberian Crane

Waterfowl surveys, especially for endangered waterfowl living in wetlands, are essential to protect endangered waterfowl and to create a management scenario of their habitats. Unmanned aerial vehicles (UAVs) are powerful new tools for waterfowl surveys. In this paper, we propose one method for a habitat survey and another for a waterfowl species distribution survey. The habitat survey method obtained the waterfowl’s habitat and spatial distribution with a UAV automatic flight plan in the aggregation area. The waterfowl species distribution survey was used to detect and identify waterfowl species with high-spatial-resolution images from a free UAV flight plan in the aggregation area or areas where individuals were suspected to be present. The UAV-based data showed not only the area where waterfowl were found, but also additional ground surveys. The results showed that the species and locations of the waterfowl were recorded more accurately and efficiently using the distribution method based on the images from the UAV. The waterfowl habitat type and the number of waterfowl were obtained in detail using the habitat survey method. UAV-derived counts of waterfowl were greater (+37%) than ground counts. The results indicated the feasibility and advantages of using a low-cost UAV survey of large waterfowl in wetland regions with complex vegetation. This study provides one case study of large waterfowl numbers and habitat surveys. The UAV-based methods also provide a feasible and scientific way to obtain basic data for the protection and management of waterfowl.

An interaction regression model for crop yield prediction

Crop yield prediction is crucial for global food security yet notoriously challenging due to multitudinous factors that jointly determine the yield, including genotype, environment, management, and their complex interactions. Integrating the power of optimization, machine learning, and agronomic insight, we present a new predictive model (referred to as the interaction regression model) for crop yield prediction, which has three salient properties. First, it achieved a relative root mean square error of 8% or less in three Midwest states (Illinois, Indiana, and Iowa) in the US for both corn and soybean yield prediction, outperforming state-of-the-art machine learning algorithms. Second, it identified about a dozen environment by management interactions for corn and soybean yield, some of which are consistent with conventional agronomic knowledge whereas some others interactions require additional analysis or experiment to prove or disprove. Third, it quantitatively dissected crop yield into contributions from weather, soil, management, and their interactions, allowing agronomists to pinpoint the factors that favorably or unfavorably affect the yield of a given location under a given weather and management scenario. The most significant contribution of the new prediction model is its capability to produce accurate prediction and explainable insights simultaneously. This was achieved by training the algorithm to select features and interactions that are spatially and temporally robust to balance prediction accuracy for the training data and generalizability to the test data.

Artificial intelligence in financial services: a qualitative research to discover robo-advisory services

Purpose The purpose of this study is to gauge the awareness and perception of Indian individual investors about a new fintech innovation known as robo-advisors in the wealth management scenario. Robo-advisors are comprehensive automated online advisory platforms that help investors in managing wealth by recommending portfolio allocations, which are based on certain algorithms. Design/methodology/approach This is a phenomenological qualitative study that used five focussed group discussions to gather the stipulated information. Purposive sampling was used and the sample comprised investors who actively invest in the Indian stock market. A semi-structured questionnaire and homogeneous discussions were used for this study. Discussion time for all the groups was 203 min. One of the authors moderated the discussions and translated the audio recordings verbatim. Subsequently, content analysis was carried out by using the NVIVO 12 software (QSR International) to derive different themes. Findings Factors such as cost-effectiveness, trust, data security, behavioural biases and sentiments of the investors were observed as crucial points which significantly impacted the perception of the investors. Furthermore, several suggestions on different ways to enhance the awareness levels of investors were brought up by the participants during the discussions. It was observed that some investors perceive robo-advisors as only an alternative for fund/wealth managers/brokers for quantitative analysis. Also, they strongly believe that human intervention is necessary to gauge the emotions of the investors. Hence, at present, robo-advisors for the Indian stock market, act only as a supplementary service rather than a substitute for financial advisors. Research limitations/implications Due to the explorative nature of the study and limited participants, the findings of the study cannot be generalised to the overall population. Future research is imperative to study the dynamic nature of artificial intelligence (AI) theories and investigate whether they are able to capture the sentiments of individual investors and human sentiments impacting the market. Practical implications This study gives an insight into the awareness, perception and opinion of the investors about robo-advisory services. From a managerial perspective, the findings suggest that additional attention needs to be devoted to the adoption and inculcation of AI and machine learning theories while building algorithms or logic to come up with effective models. Many investors expressed discontent with the current design of risk profiles of the investors. This helps to provide feedback for developers and designers of robo-advisors to include advanced and detailed programming to be able to do risk profiling in a more comprehensive and precise manner. Social implications In the future, robo-advisors will change the wealth management scenario. It is well-established that data is the new oil for all businesses in the present times. Technologies such as robo-advisor, need to evolve further in terms of predicting unstructured data, improvising qualitative analysis techniques to include the ability to gauge emotions of investors and markets in real-time. Additionally, the behavioural biases of both the programmers and the investors need to be taken care of simultaneously while designing these automated decision support systems. Originality/value This study fulfils an identified gap in the literature regarding the investors’ perception of new fintech innovation, that is, robo-advisors. It also clarifies the confusion about the awareness level of robo-advisors amongst Indian individual investors by examining their attitudes and by suggesting innovations for future research. To the best of the authors’ knowledge, this study is the first to investigate the awareness, perception and attitudes of individual investors towards robo-advisors.