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Estimation of Under-5 Child Mortality Rates in 52 Low-migration Countries
Nirmal Sapkota,Nirmal Gautam,Apiradee Lim,Attachai Ueranantasun 한국아동간호학회 2020 Child Health Nursing Research Vol.26 No.4
Reduction of the under-5 mortality rate is a target of the Sustainable Development Goals. Therefore, this study aimed to estimate under-5 child mortality rates in 52 low-migration countries using population data. The study utilized population data from the US Census Bureau from 1990 to 2015. The method involved first estimating mortality rates for countries with negligible net migration and then applying these rates to countries with matching mortality profiles, where it is reasonable to assume that migration is negligible for children under the age of 5 years. The highest child mortality was concentrated in the African region, followed by Asia and the Western region. However, steady progress in child mortality trends was concentrated in low-income countries. This simple method demonstrated that child mortality has significantly improved in high-income countries, followed by middle- and low-income countries. To reduce the under-5 mortality rates even further in these 52 countries, there is a need to accelerate equitable plans and policies related to child health to promote children's longevity and survival.
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A multiobjective model of wholesaler-retailers' problem via genetic algorithm
Nirmal Kumar Mahapatra,Asoke Kumar Bhunia,Manoranjan Maiti 한국전산응용수학회 2005 Journal of applied mathematics & informatics Vol.19 No.1-2
In the existing literature, most of the purchasing models were developed only for retailers problem ignoring the constraint of storage capacity of retailers shop/showroom. In this paper, we have developed a deterministic model of wholesaler-retailers’ problem of single product. The storage capacity of wholesaler’s warehouse/showroom and retailers’ showroom/shop are assumed to be finite. The items are transported from wholesaler’s warehouse to retailers’ Own Warehouse (OW) in a lot. The customer’s demand is assumed to be displayed inventory level dependent. Demands are met from OW and that spaces of OW will immediately be filled by shifting the same amount from the Rented Warehouse (RW) till the RW is empty.The time duration between selling from OW and filling up its space by new ones from RW is negligible. According to relative size of the retailers’ existing (own) warehouse capacity and the demand factors, different scenarios are identified. Our objectives are to optimize the cost functions of wholesaler and two retailers separately. To solve this problem, a real coded Genetic Algorithm (GA) with roulette wheel selection/ reproduction, whole arithmetic crossover and non-uniform mutation is developed. Finally a numerical example is presented to illustrate the results for different scenarios. To compare the results of GA, Generalised Reduced Gradient Method has been used for the problem. Also, a sensitivity analysis has been performed to study the variations of the optimal average cost with respect to the different parameters.
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“Free Hand” or Wire Guide: To the Editor
Nirmal Kumar Sinha,Amit Bhardwaj 대한정형외과학회 2019 Clinics in Orthopedic Surgery Vol.11 No.4
We read with interest the article “Learning curve of internal fixation for nondisplaced femoral neck fractures: a cumulative sum analysis.”1) Stability of fracture depends upon the parallelity of the cancellous screws that fixes the fractured neck of femur. It is not easy to insert guidewire at the right position and in parallel orientation.2) We all know from our experience that there is a learning curve involved in the passing of parallel screws, much more so if it is done “free hand.” Even a parallel wire guide requires passing of a central guide wire in exact central position. The paper does not mention if any wire guide was used during fixation. We are curious to know about the cause of significant difference of operating time between the early and late experience group (52.2 ± 15.2 vs. 38.4 ± 13.0 minutes). Which part of the surgical procedure required more time in the early group and has learning improved the operating time in the late group?
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Key Attitude Indicators (KAI) for Measuring Attitude of Contractors in Construction Projects
Nirmal Kumar Acharya,Young Dai Lee,Dal Sik Choi 대한토목학회 2006 KSCE journal of civil engineering Vol.10 No.3
Timely completion and a satisfied owner are the prime objectives of a construction project. The success to achieve these project objectives is fully depends on the working approaches (attitude) of a contractor company. Attitude is abstract, which is very difficult to measure directly; therefore it must be inferred from the assumed relationship with observable indicators. Commonly, behavior shown by a person or organization represents its attitude about things or persons or issues. The aim of this paper is to develop a framework for measuring attitude of a Contractor Company in an ongoing construction project. In this paper a set of key attitude indicators (KAIs) measured both objectively and subjectively have been developed through a field survey. The validity of the proposed KAIs is also tested by four case studies. The results of the study show that the KAIs stated in the paper can reasonably measure the attitude of Contractor Company and can be helpful for the owners and project managers to control their projects effectively. This study also provides few significant insights into developing a general and comprehensive base for further study.
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( Nirmal Prasad Bhatt ),( Nirajan Shrestha ),( Sudimna Daha ),( Rojeet Shrestha ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Alanine aminotransferase ( ALT) and aspartate aminotransferase AST) are commonly used markers of liver-disorders. Non-alcoholic fatty liver disease (NAFLD) is associated with lipid abnormalities and type 2 Diabetes. Previous studies have suggested elevation in levels of ALT and AST which may serve as markers for NAFLD. However, correlation of liver enzymes and lipid profile has not been well established. Hence, current study was performed to observe the association between aminotransferases and HDL-C in type-2 diabetic patients. Methods: The study was carried out in Department of Pathology, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal. A total of 103 type 2 diabetic patients, 41 males (mean age: 55.9±13.4) and 62 females (mean age: 49.9±10.6) were included in this study. Patient’s anthropometric measurements were performed before collecting the fasting blood for aminotransferases and lipid profile analysis. The results were shown as mean ± SD. P-values less than 0.05 were considered as statistically significant. Results: In the present study, serum ALT and AST levels were correlated with fasting HDL (r= -0.419, P < 0.05 and r= -0.354, P < 0.05 respectively) in women with type 2 diabetes. However, there was no such correlation among these parameters in men diabetic patients. Furthermore, there was no correlation between aminotransferase and fasting TC, TG and LDL levels. Conclusions: This finding suggests the correlation between aminotransferase and FHDL in diabetic patients. Hence, measurement of aminotransferase and lipid profile has clinical significance in diabetic patients.
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Hepatic Association with Increased ALT and GGT in Type 2 Diabetic Patients
( Nirmal Prasad Bhatt ),( Nirajan Shrestha ),( Sudimna Dahal ),( Rojeet Shrestha ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Diabetes mellitus (DM) has been associated with liver dysfunction and dyslipidemia, is a leading cause of global mortality, inducing various secondary complications, such as coronary heart disease, neuropathy and chronic kidney disease. DM is associated with non-alcoholic fatty liver disease (NAFLD), including its severe form, non-alcoholic steatohepatitis. NAFLD among diabetic patients in western countries is highly prevalent. However, there is a paucity of data showing such an association in Nepalese patients with DM. Thus, the current study was conducted for a better understanding of liver dysfunction in Nepalese patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective study to determine if any correlation exists between serum liver enzymes in T2DM and different confounding factors. One hundred and five patients (male:female= 0.6) with a median age of 52±1.09 years, newly diagnosed as having T2DM, were recruited from the outpatient department of tertiary hospital during one year. Results: We observed a marginal, yet statistically significant, increase of serum alanine transaminase and γ-glutamyl in the diabetic patients compared to healthy controls. However, elevation of serum AST was statistically insignificant. Conclusions: Elevation of the liver enzymes, ALT and GGT, within the normal range in T2DM may indicate initiation of pathological processes in the liver. Hence, regular monitoring of liver function is advantageous to prevent advanced liver injury in T2DM.
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Critical Construction Conflicting Factors Identification Using Analytical Hierarchy Process
Nirmal Kumar Acharya,Young Dai Lee,Jung Ki Kim 대한토목학회 2006 KSCE journal of civil engineering Vol.10 No.3
The construction industry is dynamic in nature due to increase in uncertainties in technology, budgets, and development processes. Claims and litigation are on a dramatic rise throughout the construction industry. If disputes are not resolved promptly, they tend to drag on and escalate and can cause project delays, lead to claims, require litigation proceedings for resolution, and ultimately destroy business relationships. The purpose of this study is to find out the magnitude of the identified six major construction conflicting factors and responsible parties for those problems. Out of six identified conflicting factors, this study has detected four major factors contributing construction conflict using AHP tool. These four major contributors are: 'change of site condition', 'people interruptions', 'change order evaluation', and 'defective design'. The survey has also revealed the owner as a more responsible party for these conflicting factors and then followed by the consultant. The paper has suggested taking lead role by the owner to manage the conflicts in the construction sites and driving the project toward accomplishment by best planning. A construction conflict prevention model (CCPM) is suggested.
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