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\"Profitability is the major objective of any farm or firm. The high wage rate in the state and the rapid rise in the cost of cultivation have raised questions regarding the profitability of crop cultivation in Kerala. The post reform period has been a period of agrarian distress with falling prices and declining income of the farmers There has been a tendency for the farmer to withdraw from paddy cultivation in Kerala due to uneconomic returns.. Cultivation of paddy and other annual crops is a losing proposition. In the background of this context, this study attempts to compute the profitability of crop cultivation of seven selected crops in the state. The data published in the Cost of Cultivation reports of the Department of Economics and Statistics, Government of Kerala is used in this study. Though there has been a rapid increase in wage rate and the cost of cultivation, the study shows that the gross value of output has increased faster. The farmer being rational has resorted to coping strategies like reducing the percentage of hired human labour in the total operational cost. When considering Cost A, crop cultivation has been profitable, but while considering cost B, crop cultivation has been highly unprofitable. The rapid increase in the value of land is the prime cause for the spiraling increase in cost B. Banana, Pepper and tapioca has been the most profitable crops in the state. The profitability of paddy crop has not been commensurate when compared to the profit accruing to other crops in Kerala. Any effort to increase the area under paddy cultivation must provide price and non-price incentives to the farmers.\"

This study is an attempt to model the movements of the Indian stock market by examining the impact of seven macroeconomic variables on the Indian stock market. The study also analyses the cause and effect relationship between these variables. The empirical study is based on a multiple regression model computed on Standard Ordinary Least Square (OLS) Method and Granger Causality test for a period of 12 years from January 2006 to December 2017. The results show that Foreign Portfolio Investments (FPIN), lagged index values (NIFTYt-1) and Oil Price (OIL) have significant positive and domestic interest rate (CMR) and Exchange Rate (ER) has a significant negative impact on market movements. The Industrial Production (IIP) and Inflation (CPI) have no significant impact on stock market movement. It means that the market has already adjusted with the past information related to these variables. It also shows the efficiency of the Indian market in relation to these variables. The significant positive coefficient of the past Nifty values (NIFTYt-1) shows that past market return significantly affects the present return or investors purchase or sell the securities based on the past market movements. The positive relationship between the market return and oil price is inconsistent with the common literature. It is mainly because during the study period the Indian economy showed an upward trend and the demand for goods and services increased, hence though the prices including Oil Price increased market return also increased. Since the Indian market is integrated to the US and other developed markets the return spillover further added to the intensity. The results of the causality study to identify the direction of causality reveal that the Exchange Rate, Foreign Portfolio Investments, Oil Price and Inflation cause Nifty movements. There is bidirectional causality between market return and Exchange Rate.

BackgroundOne simple means to measuring capacity1 to undertake Quality Improvement (QI) is straightforward: how many have been trained formally? This represents a process measure. However, demonstrating capability is more challenging (outcome measure). One approach is to survey application of QI Tools and data visualisation on posters. Jay Arthur, Developer of QI Macros, audited posters at a number of Quality Conferences.2 The proportion displaying QI Tools was relatively low. Our study aimed to assess QI capability by analysing usage of QI tools in posters at an International Healthcare Quality Conference.MethodsThe survey assessed all displayed posters for a series of QI Tools and appropriate data visualisation.Results100 posters were assessed (figure 1). 36% of posters were presented run charts, 33% included use of PDSA, 19% used a Fishbone diagram, 14% a Driver Diagram, 13% included Process Maps. Only 7% of posters contained at least one Statistical Process Control (SPC) chart and 5% included a Pareto chart. These findings are consistent with those from other Quality Conferences.ConclusionThis study revealed poor usage of QI tools at poster presentation sessions at an international healthcare quality event, prompting a necessary revision of QI educational approaches within these systems. One approach to measure the impact of QI capability building was to assess the use of QI Tools and appropriate data visualisation in posters or papers. Use of key QI tools, such as process mapping, Driver and Fishbone Diagrams, Pareto and SPC charts should be the next focus of QI capability building. This is ideally performed during a QI project to help embed the knowledge. Additional methods of assessing QI capability should be considered in the evaluation of the impact of QI training. Improvement Advisors and Coaches have a role to play in reinforcing any initial training in QI.Abstract 12 Figure 1Use of quality improvement tools in 100 posters[Figure omitted. See PDF]ReferencesMery G, Dobrow MJ, Baker GR, Im J, Brown A. Evaluating investment in quality improvement capacity building: a systematic review. BMJ Open 2017;7:e012431. Doi: 10.1136/bmjopen-2016-012431Arthur, J. Healthcare data analytics webinar. [Internet] 2023 [updated 2023 Feb 02; cited 2023 Nov 13]; Available from: https://www.qimacros.com/lean-six-sigma-blog/2-14-23-healthcare-data-analytics-webinar/Ethical Approval/IRB StatementThis project is exempt as a Quality Improvement Audit.Disclosures and AcknowledgmentsNo relevant disclosures. We acknowledge Mr Jay Arthur for his personal communication supporting his webinar. We acknowledge the team members who participated in the data collection.

BackgroundHamad Medical Corporation (HMC) has been utilising the Occurrence, Variance, and Accident (OVA) reporting system to monitor, investigate, and improve potential or occurred adverse events. Pre-hospital emergency care is time-critical, and reporting OVAs is essential whilst ensuring ambulance availability for access to effective out-of-hospital care. This project aimed to reduce the average time consumed in incident reporting using the OVA system by HMC Ambulance Service (HMCAS) personnel from six minutes on 13 September 2022 to three minutes on 08 October 2022.MethodsA new incident reporting access icon with items customised to HMCAS operational needs was developed and integrated into the OVA reporting system. A sample of 483 OVAs (168 baselines; 315 following the streamlined process) reported to the HMCAS quality and patient safety department between 13 September and 08 October 2022 was considered. The time elapsed to fill an OVA was recorded. A sample of 22 OVAs before and after the intervention was used to create Shewhart’s t-chart, which assessed the impact of the HMCAS-specified incident reporting icon created in the OVA system on reducing the reporting time. Student t-tests for paired groups and bivariate regression analyses were conducted to evaluate the impact of the ‘Lean’ reporting process.1ResultsThe mean time of reporting an OVA dropped from 328.90 to 145.09 seconds. In table 1, the p-values <0.05 indicate a significant impact of the implemented intervention on the OVA reporting process. The Shewhart’s t-chart visually demonstrated the impact of the ‘Lean’ reporting process with fewer data points (figure 1).ConclusionsImplementing the new icon helped identify the new intervention’s significant impact on reducing time wasted reporting an OVA. This converges with the Lean principle by optimising internal procedures to reduce time wasted during incident reporting. It also helped ensure ambulances’ availability to respond to pre-hospital emergency calls.2Abstract 72 Figure 1Reduction in time spent completing OVA since the introduction of the new HMCASG RL-Datix icon and form[Figure omitted. See PDF]Abstract 72 Table 1Student-t-test for paired groups and bivariate regression analysest-Test: Paired Two Sample for Means Pre-intervention observations samplePost-intervention observations sampleP(T<=t) two-tailObservations 11 11 0.003 Mean 328.909 145.109 Variance 26041.091 16774.651 df 10 Bivariate Regression analysis Coefficients R Square Adjusted R Square p-value Lower 95% Upper 95% Time to complete OVAs 247.597 0.202 0.114 0.007 87.705 407.488 ReferencesDeming WE. Out of the crisis. MIT Press 2018;450.Akmal A, Greatbanks R, Foote J. Lean thinking in healthcare – findings from a systematic literature network and bibliometric analysis. Health Policy [Internet] 2020 Jun 1[Accessed 2023 Jan 8];124(6):615–27. Available from: https://www.sciencedirect.com/science/article/pii/S0168851020300932Ethical Approval/IRB StatementThis project was approved by the Hamad Medical Corporation Ambulance Service, Doha, Qatar, as a Quality Improvement project on 15/03/2022.Disclosures and AcknowledgmentsWe want to thank all of the Hamad Medical Corporation Corporate Quality and Patient Safety Department for their support of this project.

Background Rheumatoid arthritis (RA) is a chronic inflammatory disorder causing cartilage and joint degeneration. In spite of the availability of several robust drugs like biologics, most of the patients are unresponsive, and reports of severe adverse effects following long-term use are also there. Subsequently the use of natural plant-based products in RA therapy is broadening over the years. Tinospora cordifolia is a widely used medicinal plant in Ayurveda against various inflammatory disorders including RA. However, there is very limited knowledge regarding the actual molecular events responsible for its therapeutic effect, and this has limited its acceptance among the professionals. Purpose To explore the anti-inflammatory and anti-arthritic effect of hydro-alcoholic extract from Tinospora cordifolia . Methods The rich polyphenol nature of the extract was elucidated using HPLC. LPS-stimulated murine macrophage cell line RAW 264.7 was used for in vitro studies, and collagen-induced arthritis (CIA) model was used for in vivo studies. Results The polyphenols in TCE were identified using HPLC. TCE effectively downregulated the level of pro-inflammatory mediators (IL-6, TNF-α, PGE2, and NO) in LPS-stimulated RAW 264.7 cells. Subsequently the upregulated expression of COX-2 and iNOS following LPS stimulation were also downregulated by TCE. Furthermore, TCE targeted the upstream kinases of the JAK/STAT pathway, a crucial inflammatory pathway. The expression of VEGF, a key angiogenic factor as well as an inflammatory mediator was also decreased following pre-treatment with TCE. The anti-arthritic effect of TCE (150 mg/kg) was evaluated in the CIA model as well. From the results of histopathology, oral administration of TCE was found to be effective in reducing the clinical symptoms of arthritis including paw edema, erythema, and hyperplasia . In vivo results validated the in vitro results and there was a significant reduction in serum level of pro-inflammatory cytokines and mediators (IL-6, TNF-α, IL-17, NO, and PGE2). The phosphorylation of STAT3 and the expression of VEGF were also downregulated following TCE treatment. Conclusion Our study provided a detailed insight into the molecular events associated with anti-inflammatory and anti-arthritic effect of Tinospora cordifolia .

This retrospective descriptive analysis explores underrepresented minority men in our clinical trial for restorative therapy for erectile dysfunction and to identify strategies to promote diversity and inclusion in the study population. Demographic data were collected from all participants and the prevalence in our population was compared to the source population. The proportion of individuals taking part in our clinical trial was compared to the overall disease population using the participation to prevalence ratio. Among the 61 participants enrolled in the Platelet-Rich Plasma for Erectile Dysfunction trial, 72.1% were Hispanic compared to 39.9% in the national source population. There were 27.9% non-Hispanic participants, and 41.2% non-Hispanic men in the local South Florida population. The racial composition of our study shows 80.3% of PRP participants identify as White, 16.4% as Black, and 3.4% as Asian. In the national source population, 61.8% of patients were White, 27.5% are black, and 1.5% are Asian. Through the implementation of strategies such as having Hispanic team members on the clinical trial staff and providing education and outreach materials both in Spanish and English, we were able to overcome barriers to participation in Hispanic men and potentially improve health outcomes for underrepresented minority men with erectile dysfunction.

Aim: The purpose of this study was to investigate and compare the linear dimensional accuracy of denture bases processed with the conventional heat-polymerization technique and the Rafael and Saide (RS) tension system, taking a multidirectional approach. Materials and Methods: Twenty standard edentulous maxillary casts were randomly assigned into two groups. A uniform denture base of 1.5 mm thickness was fabricated in wax and later processed by two methods: Group I acrylic resin flasked with the conventional technique and Group II acrylic resin flasked with the RS tension system. The dimensional accuracy was assessed using traveling microscope. Results: The linear dimensional changes that occurred between the dentures produced with the new press method and the conventional method were statistically insignificant and ranged from 0.002 to 0.11. The dimensionally stable areas were the canines and the most unstable was the posterior palate. Conclusions: The results of this study suggest that the maximum linear dimensional change occurs around the molars and palatal segment, with the most stable areas being the canines. There was no significant linear dimensional change of the dentures processed between the conventional and the new press technique.