Search results for: center and periphery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2100

Search results for: center and periphery

1830 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines

Authors: Ella Abaev, Shany Segal, Miri Gabay

Abstract:

Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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1829 Translingual English: New languages and new identities

Authors: Sender Dovchin

Abstract:

The recent bi/multilingual scholarship shows that the knowledge of ‘translingual English’ is understood in terms of transcultural flows of linguistic, semiotic and cultural resources, where these resources re-transform and are recontextualised to form new specific languages and perform new identities in diverse societal contexts. Drawing on linguistic ethnographic data from contemporary popular music artist in Mongolia, this paper addresses two main critical questions: (1) how new forms of specific languages are created when English becomes translingual English in local contexts; and (2) how new varieties of local identities are constructed and performed when English transforms into translingual English. The paper argues that popular music artists in post-socialist Mongolia should better be understood as active cultural producers, contrary to those dominant discourses which position artists in the periphery as passive recipients of popular culture. Positioned within the creative nature of the global digital resources and the increasing transcultural spread of linguistic and cultural modes and features, these young Mongolian popular music artists produce not only new forms of linguistic practices in the local contexts but also create varied new forms of identities of what it means to be a young Mongolian person in the modern society.

Keywords: multilingualism, translingualism, mongolia, english

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1828 Development of Tourism Infrastructure and Cultural Heritage: Case of Gobustan Preserve

Authors: Rufat Nuriyev

Abstract:

Located in the eastern part of the Republic of Azerbaijan and on the western shore of the Caspian Sea, Gobustan National Reserve was inscribed as Gobustan Rock Art Cultural Landscape into the World Heritage List in 2007. Gobustan is an outstanding rock art landscape, where over 6000 rock engravings were found and registered, since the end of Upper Paleolithic up to the Middle Ages. Being a rock art center, the Gobustan seeks to stimulate public awareness and disseminate knowledge of prehistoric art to enrich educational, cultural and artistic communities regionally, nationally and internationally. Due to the Decree of the President of the Republic of Azerbaijan and the “Action Plan” , planned actions started to realize. Some of them implemented before of stipulated date. For the attraction of visitors and improvement of service quality in the museum-reserve, various activities are organized. The building of a new museum center at the foot of the Beyukdash Mountain has been completed in 2011. Main aims of the new museum building and exhibition was to provide better understanding of the importance of this monument for local community, Azerbaijanian culture and the world. In the Petroglyph Museum at Gobustan, digital and traditional media are closely integrated to reveal the complexity of historical, cultural and artistic meaning of prehistoric rock carvings of Gobustan. Alongside with electronic devices, the visitor gets opportunity of direct contact with artifacts and ancient rock carvings.

Keywords: Azerbaijan, Gobustan, rock art, museum

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1827 An Archaeological Approach to Dating Polities and Architectural Ingenuity in Ijebu, South Western Nigeria

Authors: Olanrewaju B. Lasisi

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The position of Ijebu-Ode, the historical capital of the Ijebu Kingdom, at the center of gravity of Ijebu land is enclosed by the 180-km-long earthwork and suggests a centrally controlled project. This paper reflects on the first stratigraphic drawing of the banks and ditches of this earthwork, and place its construction mechanism in a chronological framework. Nine radiocarbon dates obtained at the site suggest that the earthwork was built in the late 14th or early 15th century. This suggests a relationship with the Ijebu Kingdom, which pre-existed the opening of the Atlantic trade but first became visible only in the Portuguese records in the 1480s. In June 2017, more earthworks were found but within the core of Ijebu Land. This most recent finding points to an extension of territory from the center to the outlying villages. One central question about this discovery of monumental architectures that was functional around the 14th century or before is in its mode of construction. Apparently, iron tools must have been used in the construction of ‘a 20m deep ditch that runs 180km in circumference.’ Thus, the discovery of iron-working sites around the vicinity of the earthwork is a pointer to this building process that is up till now shrouded in mystery. By comparing the chronology of Ijebu earthworks with the evidence of Iron working in south western Nigeria around the first half of the first millennium AD, it can be thought that the rise in polity triggered the knowledge of metallurgy in the region.

Keywords: archaeology, earthworks, Ijebu, metallurgy

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1826 Data Recording for Remote Monitoring of Autonomous Vehicles

Authors: Rong-Terng Juang

Abstract:

Autonomous vehicles offer the possibility of significant benefits to social welfare. However, fully automated cars might not be going to happen in the near further. To speed the adoption of the self-driving technologies, many governments worldwide are passing laws requiring data recorders for the testing of autonomous vehicles. Currently, the self-driving vehicle, (e.g., shuttle bus) has to be monitored from a remote control center. When an autonomous vehicle encounters an unexpected driving environment, such as road construction or an obstruction, it should request assistance from a remote operator. Nevertheless, large amounts of data, including images, radar and lidar data, etc., have to be transmitted from the vehicle to the remote center. Therefore, this paper proposes a data compression method of in-vehicle networks for remote monitoring of autonomous vehicles. Firstly, the time-series data are rearranged into a multi-dimensional signal space. Upon the arrival, for controller area networks (CAN), the new data are mapped onto a time-data two-dimensional space associated with the specific CAN identity. Secondly, the data are sampled based on differential sampling. Finally, the whole set of data are encoded using existing algorithms such as Huffman, arithmetic and codebook encoding methods. To evaluate system performance, the proposed method was deployed on an in-house built autonomous vehicle. The testing results show that the amount of data can be reduced as much as 1/7 compared to the raw data.

Keywords: autonomous vehicle, data compression, remote monitoring, controller area networks (CAN), Lidar

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1825 An Assessment of Potentials, Challenges, and Opportunities of Ethiopian Cultural Centers for Tourism Product Development

Authors: Berie Abebe Getahun

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The tourism sector has been identified by the Ethiopian government as one of the priority economic sectors and planned to make Ethiopia among the top five African destinations by 2020. It is obvious international tourism demand for Ethiopia lags behind other African countries like South Africa, Egypt, Morocco, Tanzania, and Kenya. Meanwhile, the number of international tourists’ arrival to Ethiopia increases continuously. The main purpose of this study was to find out potentials, challenges, and opportunities of Ethiopian Cultural Center for tourism product development. Therefore, an attempt has been made to identify potentials over which tourism product development can be enhanced, and opportunities that promote tourism product development in Ethiopia. To achieve this objective, data have been collected by using observation, interview and focus group discussion with selected informants working the ministry of tourism and culture. The collected data has been analyzed by transcribing materials, and by using thematic analysis method based on the research objective. Likewise, the analyzed data has been discussed in the context of prevailing literature. As revealed in finding, Ethiopian cultural center has untapped potential for tourism product development that includes: meetings, incentives, conferences, events, availability of concerned stakeholders and demand of visitors. On the other hand, lack of awareness about tourism product development, financial constraints, skilled manpower, absence of tour guiding service and interpretation of heritages have been identified as the major challenges that hindering tourism product development in the cultural center. Moreover, the growth of domestic tourism, distinctive presence and rich culture of Ethiopia, and policy of Ethiopia that promotes the growth and preservation of indigenous cultures are deemed important opportunities for tourism product development in the country. And lastly, conducting a research based on tourism product development, reviewing the existing marketing and promotion strategies, training manpower, working harmoniously with the concerned stakeholders, and a careful examination of opportunities present in order to best utilize resources were implications drawn for future intervention.

Keywords: challenges and opportunities of tourism, Ethiopian tourism potential, tourism product, tourism product development

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1824 Schools of Thought in the Field of Social Entrepreneurship

Authors: Cris Bravo

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Social entrepreneurship is a new and exciting topic that holds a great promise in helping alleviate the social problems of the world. As a new subject, the meaning of the term is too broad and this is counterproductive in trying to build understanding around the concept. The purpose of this study is to identify and compare the elements of social entrepreneurship as defined by seven international organizations leading social entrepreneurship projects: Ashoka Foundation, Skoll Foundation, Schwab Foundation and Yunus Center; as well as from three other institutions fostering social entrepreneurship: Global Social Benefit Institute, BRAC University, and Socialab. The study used document analysis from Skoll Foundation, Schwab Foundation, Yunus Center and Ashoka Foundation; and open ended interview to experts from the Global Social Benefit Institute at Santa Clara University in United States, BRAC University from Bangladesh, and Socialab from Argentina. The study identified three clearly differentiated schools of thought, based on their views on revenue, scalability, replicability and geographic location. While this study is by no means exhaustive, it provides an indication of the patterns of ideas fostered by important players in the field. By clearly identifying the similarities and differences in the concept of social entrepreneurship, research and practitioners are better equipped to build on the subject, and to promote more adequate and accurate social policies to foster the development of social entrepreneurship.

Keywords: replicability, revenue, scalability, schools of thought, social entrepreneurship

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1823 Chest Trauma and Early Pulmonary Embolism: The Risks

Authors: Vignesh Ratnaraj, Daniel Marascia, Kelly Ruecker

Abstract:

Purpose: Pulmonary embolism (PE) is a major cause of morbidity and mortality in trauma patients. Data suggests PE is occurring earlier in trauma patients, with attention being turned to possible de novo events. Here, we examine the incidence of early PE at a level 1 trauma center and examine the relationship with a chest injury. Method: A retrospective analysis was performed from a prospective trauma registry at a level 1 trauma center. All patients admitted from 1 January 2010 to 30 June 2019 diagnosed with PE following trauma were included. Early PE was considered a diagnosis within 72 hours of admission. The severity of the chest injury was determined by the Abbreviated Injury Score (AIS). Analysis of severe chest injury and incidence of early PE was performed using chi-square analysis. Sub-analysis on the timing of PE and PE location was also performed using chi-square analysis. Results: Chest injury was present in 125 of 184 patients diagnosed with PE. Early PE occurred in 28% (n=35) of patients with a chest injury, including 24.39% (n=10) with a severe chest injury. Neither chest injury nor severe chest injury determined the presence of early PE (p= > 0.05). Sub-analysis showed a trend toward central clots in early PE (37.14%, n=13) compared to late (27.78%, n=25); however, this was not found to be significant (p= > 0.05). Conclusion: PE occurs early in trauma patients, with almost one-third being diagnosed before 72 hours. This analysis does not support the paradigm that chest injury, nor severe chest injury, results in statistically significant higher rates of early PE. Interestingly, a trend toward early central PE was noted in those suffering chest trauma.

Keywords: trauma, PE, chest injury, anticoagulation

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1822 Improving Diagnostic Accuracy in Rural Medicine

Authors: Kelechi Emmanuel, Kyaw Thein Aung, William Burch

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Introduction: Although rewarding in more ways than one, rural medicine can be challenging. The factors that lead to the challenges experienced in rural medicine include but are not limited to scarcity of resources, poor patient education inadequately trained professionals. This is the first single center study done on the challenges of and ways to improve diagnosis in rural medicine. Materials and Methods: Questionnaires were given to providers in a single hospital in rural Tennessee USA. In which providers were asked the question ‘In the past six months, what measures have you taken to improve your diagnostic accuracy given limited resources. Results: The questionnaire was passed to ten physicians working in a two hundred and twentyfive hospital bed. Physicians who participated included physicians in hospital medicine, emergency medicine, surgery, cardiology and gastroenterology. The study found that improved physical examination skills, access to specialist especially via telemedicine and affiliation to centers with more experienced professionals improved diagnosis and overall patient outcome in rural medicine. Conclusion: From this single center study, there is evidence to show that in addition to honing physical examination skills and having access to immediate results of testing done; hospital collaborations and access to highly trained specialist via telemedicine does improve diagnosis in rural medicine.

Keywords: rural medicine, diagnostic accuracy, diagnosis, telemedicine

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1821 Investigating the Post-Liver Transplant Complications and Their Management in Children Referred to the Children’s Medical Center

Authors: Hosein Alimadadi, Fatemeh Farahmand, Ali Jafarian, Nasir Fakhar, Mohammad Hassan Sohouli, Neda Raeesi

Abstract:

Backgroundsː Regarding the important role of liver transplantation as the only treatment in many cases of end-stage liver disease in children, the aim of this study is to investigate the complications of liver transplantation and their management in children referred to the Children's Medical Center. Methods: This study is a cross-sectional study on pediatric patients who have undergone liver transplants in the years 2016 to 2021. The indication for liver transplantation in this population was confirmed by a pediatric gastroenterologist, and a liver transplant was performed by a transplant surgeon. Finally, information about the patient before and after the transplantation was collected and recorded. Results: A total of 53 patients participated in this study, including 25 (47.2%) boys and 28 (52.8%) girls. The most common causes of liver transplantation were cholestatic and metabolic diseases. The most common early complication of liver transplantation in children was acute cellular rejection (ACR) and anastomotic biliary stricture. The most common late complication in these patients was an infection which was observed in 56.6% of patients. Among the drug side effects, neurotoxicity (convulsions) was seen more in patients, and 15.1% of the transplanted patients died. Conclusion: In this study, the most common early complication of liver transplantation in children was ACR and biliary stricture, and the most common late complication was infection. Neurotoxicity (convulsions) was the most common side effect of drugs.

Keywords: liver transplantation, complication, infection, survival rate

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1820 Early Outcomes and Lessons from the Implementation of a Geriatric Hip Fracture Protocol at a Level 1 Trauma Center

Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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1819 Promoting Environmental Sustainability in Rural Areas with CMUH Green Experiential Education Center

Authors: Yi-Chu Liu, Hsiu-Huei Hung, Li-Hui Yang, Ming-Jyh Chen

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introduction: To promote environmental sustainability, the hospital formed a corporate volunteer team in 2016 to build the Green Experiential Education Center. Our green creation center utilizes attic space to achieve sustainability objectives such as energy efficiency and carbon reduction. Other than executing sustainable plans, the center emphasizes experiential education. We invite our community to actively participate in building a sustainable, economically viable environment. Since 2020, the China Medical University Hospital has provided medical care to the Tgbin community in Taichung City's Heping District. The tribe, primarily composed of Atayal people, the elderly comprise 18% of the total population, and these families' per capita income is relatively low compared to Taiwanese citizens elsewhere. Purpose / Methods: With the experiences at the Green Experiential Education Center, CMUH team identifies the following objectives: Create an aquaponic system to supply vulnerable local households with food. Create a solar renewable energy system to meet the electricity needs of vulnerable local households. Promote the purchase of green electricity certificates to reduce the hospital's carbon emissions and generate additional revenue for the local community. Materials and Methods: In March 2020, we visited the community and installed The aquaponic system in January 2021. CMUH spent 150,000NT (approximately 5000US dollars) in March 2021 to build a 100-square-meter aquaponic system. The production of vegetables and fish caught determines the number of vulnerable families that can be supported. The aquaponics system is a kind of Low energy consumption and environmentally friendly production method, and can simultaneously achieve energy saving, water saving, and fertilizer saving .In September 2023, CMUH will complete a solar renewable energy system. The system will cover an area of 308 square meters and costs approximately NT$240,000 (approximately US$8,000). The installation of electricity meters will enable statistical analysis of power generation. And complete the Taiwan National Renewable Energy Certificate application process. The green electricity certificate will be obtained based on the monthly power generation from the solar renewable energy system. Results: I Food availability and access are crucial considering the remote location and aging population. By creating a fish and vegetable symbiosis system, the vegetables and catches produced will enable economically disadvantaged families to lower food costs. In 2021 and 2022, the aquaponic system produced 52 kilograms of vegetables and 75 kilograms of catch. The production ensures the daily needs of 8 disadvantaged families. Conclusions: The hospital serves as a fortress for public health and the ideal setting for corporate social responsibility. China Medical University Hospital and the Green Experiential Education Center work to strengthen ties with rural communities and offer top-notch specialty medical care. We are committed to assisting people in escaping poverty and hunger as part of the 2030 Sustainable Development Goals.

Keywords: environmental education, sustainability, energy conservation, carbon emissions, rural area development

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1818 Nasopharyngeal Cancer in Children and Adolescents: Experience of Emir Abdelkader Cancer Center of Oran Algeria

Authors: Taleb L., Benarbia M., Brahmi M., Belmiloud H., Boukerche A.

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Introduction and purpose of the study: Cavum cancer in children and adolescents is rare and represents 8% of all nasopharyngeal cancers treated in our department. Our objective is to study its epidemiological, clinical, therapeutic, and evolutionary particularities. Material and methods: Retrospective study of 39 patients under 20 years old, treated for undifferentiated non-metastatic carcinoma of the nasopharynx at the Emir Abdelkader Cancer Center between 2014 and 2020. Results and statistical analysis: Median age was 14 years [7-19 years], with a sex ratio of 2.9. The median time to diagnosis was 5.6 months [1 to 14 months], the circumstances of the discovery of which were dominated by lymph node syndrome in 43.6% of cases (n=17) followed by a rhinological syndrome in 30.8% of cases (n=13). The tumor stage was T1 for two patients (5.1%), T2 for 8 (20.5%), T3 for 9 (23.1%), T4 for 20 (51.3%), N0 for 2 (5 .1%) N1 for 4 (10.3%), N2 for 28 (71.8%) and N3 for 5 (12.8%). All patients received induction chemotherapy followed by concomitant radiotherapy with cisplatin. The dose of irradiation delivered to the cavum and adenopathies was 66 Gy with fractionation of 2 Gy per session in 69.2% of cases (n=27) and 1.8 Gy in 30.8% of cases (n=12). With a median follow-up of 51 months (15 to 97 months), the locoregional, metastatic, specific, and overall relapse-free survival rates at five years were 91.1%, 73.5%, 66.1%, and 68.4, respectively. Conclusion: Chemotherapy and radiotherapy treatment of cavum cancer in children and adolescents has allowed excellent locoregional control despite the advanced stage of the disease. However, the frequency of metastatic relapses could justify the possible use of systemic maintenance treatment.

Keywords: cancer, nasopharynx, radiotherapy, chemotherapy, survival

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1817 Development and Validation for Center-Based Learning in Teaching Science

Authors: Julie Berame

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The study probed that out of eight (8) lessons in Science Six have been validated, lessons 1-3 got the descriptive rating of very satisfactory and lessons 4-8 got the descriptive rating of outstanding based on the content analysis of the prepared CBL lesson plans. The evaluation of the lesson plans focused on the three main features such as statements of the lesson objectives, lesson content, and organization and effectiveness. The study used developmental research procedure that contained three phases, namely: Development phase consists of determining the learning unit, lesson plans, creation of the table of specifications, exercises/quizzes, and revision of the materials; Evaluation phase consists of the development of experts’ assessment checklist, presentation of checklist to the adviser, comments and suggestions, and final validation of the materials; and try-out phase consists of identification of the subject, try-out of the materials using CBL strategy, administering science attitude questionnaire, and statistical analysis to obtain the data. The findings of the study revealed that the relevance and usability of CBL lessons 1 and 2 in terms of lesson objective, lesson content, and organization and effectiveness got the rating of very satisfactory (4.4) and lessons 3-8 got the rating of outstanding (4.7). The lessons 1-8 got the grand rating of outstanding (4.6). Additionally, results showed that CBL strategy helped foster positive attitude among students and achieved effectiveness in psychomotor learning objectives.

Keywords: development, validation, center-based learning, science

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1816 Health Care Waste Management Practices in Liberia: An Investigative Case Study

Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia

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1815 Hyperthyroidism in a Private Medical Services Center, Addis Ababa: A 5-Year Experience

Authors: Ersumo Tessema, Bogale Girmaye Tamrat, Mohammed Burka

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Background: Hyperthyroidism is a common thyroid disorder especially in women and characterized by increased thyroid hormone synthesis and secretion. The disorder manifests predominantly as Graves’ disease in iodine-sufficient areas and has increasing prevalence in iodine-deficient countries in patients with nodular thyroid disease and following iodine fortification. In Ethiopia, the magnitude of the disorder is unknown and, in Africa, due to scarcity of resources, its management remains suboptimal. Objective: The aim of this study was to analyze the pattern and management of patients with hyperthyroidism at the United Vision Medical Services Center, Addis Ababa between August 30, 2013, and February 1, 2018. Patients and methods: The study was a retrospective analysis of medical records of all patients with hyperthyroidism at the United Vision Private Medical Services Center, Addis Ababa. A questionnaire was filled out; the collected data entered into a computer and statistically analyzed using the SPSS package. The results were tabulated and discussed with literature review. Results: A total of 589 patients were included in this study. The median age was 40 years, and the male to female ratio was 1.0:7.9. Most patients (93%) presented with goiter and the associated features of toxic goiter except weight loss, sweating and tachycardia were uncommon. Majority of patients presented more than two years after the onset of their presenting symptoms. The most common physical finding (91%), as well as diagnosis, was toxic nodular goiter. The most frequent (83%) derangement in the thyroid function tests was a low thyroid-stimulating hormone, and the most commonly (94%) used antithyroid drug was a propylthiouracil. The most common (96%) surgical procedure in 213 patients was a near-total thyroidectomy with a postoperative course without incident in 92% of all the patients. Conclusion: The incidence and prevalence of hyperthyroidism are apparently on the increase in Addis Ababa, which may be related to the existing severe iodine-deficiency and or the salt iodation program (iodine-induced hyperthyroidism). Hyperthyroidism predominantly affects women and, in surgical services, toxic nodular goiter is more common than diffuse goiter, and the treatment of choice in experienced hands is a near-total thyroidectomy.

Keywords: Ethiopia, grave’s disease, hyperthyroidism, toxic nodular goiter

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1814 Analysis of Sweat Evaporation and Heat Transfer on Skin Surface: A Pointwise Numerical Study

Authors: Utsav Swarnkar, Rabi Pathak, Rina Maiti

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This study aims to investigate the thermoregulatory role of sweating by comprehensively analyzing the evaporation process and its thermal cooling impact on local skin temperature at various time intervals. Traditional experimental methods struggle to fully capture these intricate phenomena. Therefore, numerical simulations play a crucial role in assessing sweat production rates and associated thermal cooling. This research utilizes transient computational fluid dynamics (CFD) to enhance our understanding of the evaporative cooling process on human skin. We conducted a simulation employing the k-w SST turbulence model. This simulation includes a scenario where sweat evaporation occurs over the skin surface, and at particular time intervals, temperatures at different locations have been observed and its effect explained. During this study, sweat evaporation was monitored on the skin surface following the commencement of the simulation. Subsequent to the simulation, various observations were made regarding temperature fluctuations at specific points over time intervals. It was noted that points situated closer to the periphery of the droplets exhibited higher levels of heat transfer and lower temperatures, whereas points within the droplets displayed contrasting trends.

Keywords: CFD, sweat, evaporation, multiphase flow, local heat loss

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1813 Tourism and Urban Planning for Intermediate Cities: An Empirical Approach toward Cultural Heritage Conservation in Damavand, Iran

Authors: M. Elham Ghabouli

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Intermediate cities which also called medium size cities have an important role in the process of globalization. It is argued that, in some cases this type of cities may be depopulated or in otherwise may be transformed as the periphery of metropolitans so that the personal identity of the city and its local cultural heritage could suffer from its neighbor metropolitan. Over the last decades, the role of tourism in development process and the cultural heritage is increased. The effect of tourism in socio-economic growth makes motivation for study on tourism development in regional and urban planning process. Tourism potentially has a specific role in promoting sustainable development especially by its economic and socio-cultural effects. The positive role of tourism in local development and in cultural heritage should be empowered by urban and regional planning. Damavand is an intermediate city located in Tehran province, Iran. Considering its local specific characteristic like social structure, antiquities and natural monuments made a suitable case study for studying on urban tourism planning method. Focusing on recognition of historical and cultural heritage of Damavand, this paper tried to peruse cultural-historical heritage protecting issue through “base plan methodology” which is introduced as a first step of urban planning for intermediate cities.

Keywords: urban planning, tourism, cultural heritage, intermediate cities

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1812 Review Architectural Standards in Design and Development Children's Educational Centers

Authors: Ahmad Torkaman, Suogol Shomtob, Hadi Akbari Seddigh

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In this paper it has been attempted to investigate the lack of attention to how specific spatial characteristics of the children except existing places such as nurseries. In order to achieve the standard center to faster children understanding their mentality is the first issue that must be studied. Exploring the spiritual characteristics and complexities of children cannot be possible except in accordance with the different aspects and background of their growth in various age periods. In order to achieving the standard center for fostering children, the first issue that must be studied understands their mentality. Exploring the spiritual qualities and complexities of children are not provided except in accordance with the characteristics and their different growth backgrounds in different age periods. According to previous researches game or playing is the most important activity that helps children to communicate and educate and sometimes therapy in specific fields. Investigating game as a proper way to train, the variety of games, the various kind of play environment and how to treat some abnormalities thereby are the issues discussed in recent research. Another consideration concerns the importance of artistic activities among children which is very evident in studying identification of their abnormalities. At the end of this study after investigating how to understand child and communicate with him/her, aiming to recognize Specific spatial characteristics for better training children, the physical and physiological criteria and characteristics is Reviewed and ends up to a list of required spaces and dimensional characteristic of spaces and needed children's equipment.

Keywords: children, space, interior design, development, growth

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1811 Pathways and Mechanisms of Lymphocytes Emigration from Newborn Thymus

Authors: Olena Grygorieva

Abstract:

Nowadays mechanisms of thymocytes emigration from the thymus to the periphery are investigated actively. We have proposed a hypothesis of thymocytes’ migration from the thymus through lymphatic vessels during periodical short-term local edema. By morphological, hystochemical methods we have examined quantity of lymphocytes, epitelioreticulocytes, mast cells, blood and lymphatic vessels in morpho-functional areas of rats’ thymuses during the first week after birth in 4 hours interval. In newborn and beginning from 8 hour after birth every 12 hours specific density of the thymus, absolute quantity of microcirculatory vessels, especially of lymphatic ones, lymphcyte-epithelial index, quantity of mast cells and their degranulative forms increase. Structure of extracellular matrix, intrathymical microenvironment and lymphocytes’ adhesive properties change. Absolute quantity of small lymphocytes in thymic cortex changes wavy. All these changes are straightly expressed from 0 till 2, from 12 till 16, from 108 till 120 hours of postnatal life. During this periods paravasal lymphatic vessels are stuffed with lymphocytes, i.e. discrete migration of lymphocytes from the thymus occurs. After rapid edema reduction, quantity of lymphatic vessels decrease, they become empty. Therefore, in the thymus of newborn periodical short-term local edema is observed, on its top discrete migration of lymphocytes from the thymus occurs.

Keywords: lymphocytes, lymphatic vessels, mast cells, thymus

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1810 Architecture, Visual Arts, and Literature in the Light of the Venetian Renaissance and Cyprus (1474–1571)

Authors: Iassen Vanev

Abstract:

The two objectives of the research are to enlighten the significant role of Venice as an agent of “transporting” the features of the Italian Renaissance in Cyprus, as well as to assess the countercheck that the Cypriots might have exercised in opposition to the Venetian influence and to what extent they left they own mark on the Serenissima and influenced the Venetian Renaissance. This will be achieved in the backdrop of Venice’s interaction and dichotomy with the Ottoman Empire during the Venetian rule over the island (1474-1571). The research is carried out within the interdisciplinary domains of architecture, visual arts, and literature. Such studies have already been carried out extensively for other ex-Byzantine centers and consecutively Venetian possessions, like, for example Crete. Cyprus, however, has largely been left on the periphery of scholarly interest, and the author will strive to fill this gap as much as possible. The nature of much of the Venetian Renaissance Architecture on Cyprus was dictated by the Ottoman threat to the island. On the other hand, the vast majority of the Cypriot Renaissance literary production was done in Italy, a little before and after the Ottoman conquest of Cyprus in 1571. This conquest was an enormous crisis for both Venetians and Cypriots, and it led to migrations, mutual Venetian-Cypriot interaction in arts and literature, the formation of cultural landscapes, the shaping of Cypriot identity/ies, dialect and diasporas in Italy, etc., which makes the current research very important.

Keywords: architecture, arts, Cyprus, gender, identity, linguistics, Ottoman Empire, Venice

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1809 Effects of Variation of Centers in the Torsional Analysis of Asymmetrical Buildings by Performing Non Linear Static Analysis

Authors: Md Masihuddin Siddiqui, Abdul Haakim Mohammed

Abstract:

Earthquakes are the most unpredictable and devastating of all natural disasters. The behaviour of a building during an earthquake depends on several factors such as stiffness, adequate lateral strength, ductility, and configurations. The experience from the performance of buildings during past earthquakes has shown that the buildings with regular geometry, uniformly distributed mass and stiffness in plan as well as in elevation suffer much less damage compared to irregular configurations. The three centers namely- centre of mass, centre of strength, centre of stiffness are the torsional parameters which contribute to the strength of the building in case of an earthquake. Inertial forces and resistive forces in a structural system act through the center of mass and center of rigidity respectively which together oppose the forces that are produced during seismic excitation. So these centers of a structural system should be positioned where the structural system is the strongest so that the effects produced due to the earthquake may have a minimal effect on the structure. In this paper, the effects of variation of strength eccentricity and stiffness eccentricity in reducing the torsional responses of the asymmetrical buildings by using pushover analysis are studied. The maximum reduction of base torsion was observed in the case of minimum strength eccentricity, and the least reduction was observed in the case of minimum stiffness eccentricity.

Keywords: strength eccentricity, stiffness eccentricity, asymmetric structure, base torsion, push over analysis

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1808 Walkability and Urban Centers: The Valuation of Public Open Spaces from a Sustainable Alternative

Authors: Ursula D'Almeida, Danielly Aliprandi

Abstract:

A car-based development is observed in our cities, what leads to social and environmental impacts, such as air pollution, excessive noises and the substitution of public open spaces for roads and parking lots. Concerning the efforts to promote a sustainable development, a key issue is the reduction of fossil fuels consumption. An alternative to the pollutant gases emission, especially from urban transportation, is the incentive for active transport. The promoting of non-motorized travels and locomotion ways that only depend on human propulsion meets the sustainable mobility notion. Walking is one of the healthiest, cleanest, most natural and economical means to move around. Also, it integrates part of public transportation travels. Since walking demands physical effort, it is sensitive to environmental conditions. In urban space, not always we come across pedestrian friendly road structures. Based on the theory of walkability, the present paper aims to discuss the walking conditions in city centers by analyzing the distribution of urban services and uses, and this also regarding sidewalks quality. The case study presented is the urban center in the medium-sized Brazilian city Campos dos Goytacazes, in Rio de Janeiro State. The study also brings contributions to the recovering of underused public open spaces, especially by encouraging their use and appropriation through valuing non-motorized travels conditions.

Keywords: active transport, historical center, sustainable mobility, walking

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1807 Comparison of Early Post-operative Outcomes of Cardiac Surgery Patients Who Have Had Blood Transfusion Based on Fixed Cut-off Point versus of Change in Percentage of Basic Hematocrit Levels

Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

Abstract:

Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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1806 Dietary Patterns and Adherence to the Mediterranean Diet among Breast Cancer Female Patients in Lebanon: A Cross-Sectional Study

Authors: Yasmine Aridi, Lara Nasreddine, Maya Khalil, Arafat Tfayli, Anas Mugharbel, Farah Naja

Abstract:

Breast cancer is the most commonly diagnosed cancer site among women worldwide and the second most common cause of cancer mortality. Breast cancer rates differ vastly between geographical areas, countries, and within the same country. In Lebanon, the proportion of breast cancer to all other sites of tumor is 38.2%; these rates are still lower than those observed worldwide, but remain the highest among Arab countries. Studies and evidence based reviews show a strong association between breast cancer development and prognosis and dietary habits, specifically the Mediterranean diet (MD). As such, the aim of this study is to examine dietary patterns and adherence to the MD among a sample of 182 breast cancer female patients in Beirut, Lebanon. Subjects were recruited from two major hospitals; a private medical center and a public hospital. All subjects were administered two questionnaires: socio- demographics and Mediterranean diet adherence. Five Mediterranean scores were calculated: MS, MSDPS, PMDI, PREDIMED and DDS. The mean age of the participants was 53.78 years. The overall adherence to the Mediterranean diet (MD) was low since the sample means of 3 out of the 5 calculated scores were less than the scores’ medians. Given that 4 out of the 5 Mediterranean scores significantly varied between the recruitment sites, women in the private medical center were found to adhere more to the MD. Our results also show that the majority of the sample population’s intakes are exceeding the recommendations for total and saturated fat, while meeting the requirements for fiber, EPA, DHA and Linolenic Acid. Participants in the private medical center were consuming significantly more calories, carbohydrates, fiber, sugar, Lycopene, Calcium, Iron and Folate and less fat. After conducting multivariate linear regression analyses, the following significant results were observed: positive associations between MD (CPMDI, PREDIMED) and monthly income & current state of health, while negative associations between MD (MSDPS, PREDIMED) and age & employment status. Our findings indicated a low overall adherence to the MD and identified factors associated with it; which suggests a need to address dietary habits among BC patients in Lebanon, specifically encouraging them to adhere to their traditional Mediterranean diet.

Keywords: Adherence, Breast cancer, Dietary patterns, Mediterranean diet, Nutrition

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1805 Characteristics and Key Exploration Directions of Gold Deposits in China

Authors: Bin Wang, Yong Xu, Honggang Qu, Rongmei Liu, Zhenji Gao

Abstract:

Based on the geodynamic environment, basic geological characteristics of minerals and so on, gold deposits in China are divided into 11 categories, of which tectonic fracture altered rock, mid-intrudes and contact zone, micro-fine disseminated and continental volcanic types are the main prospecting kinds. The metallogenic age of gold deposits in China is dominated by the Mesozoic and Cenozoic. According to the geotectonic units, geological evolution, geological conditions, spatial distribution, gold deposits types, metallogenic factors etc., 42 gold concentration areas are initially determined and have a concentrated distribution feature. On the basis of the gold exploration density, gold concentration areas are divided into high, medium and low level areas. High ones are mainly distributed in the central and eastern regions. 93.04% of the gold exploration drillings are within 500 meters, but there are some problems, such as less and shallower of drilling verification etc.. The paper discusses the resource potentials of gold deposits and proposes the future prospecting directions and suggestions. The deep and periphery of old mines in the central and eastern regions and western area, especially in Xinjiang and Qinghai, will be the future key prospecting one and have huge potential gold reserves. If the exploration depth is extended to 2,000 meters shallow, the gold resources will double.

Keywords: gold deposits, gold deposits types, gold concentration areas, prospecting, resource potentiality

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1804 Urban Heat Island Effects on Human Health in Birmingham and Its Mitigation

Authors: N. A. Parvin, E. B. Ferranti, L. A. Chapman, C. A. Pfrang

Abstract:

This study intends to investigate the effects of the Urban Heat Island on public health in Birmingham. Birmingham is located at the center of the West Midlands and its weather is Highly variable due to geographical factors. Residential developments, road networks and infrastructure often replace open spaces and vegetation. This transformation causes the temperature of urban areas to increase and creates an "island" of higher temperatures in the urban landscape. Extreme heat in the urban area is influencing public health in the UK as well as in the world. Birmingham is a densely built-up area with skyscrapers and congested buildings in the city center, which is a barrier to air circulation. We will investigate the city regarding heat and cold-related human mortality and other impacts. We are using primary and secondary datasets to examine the effect of population shift and land-use change on the UHI in Birmingham. We will also use freely available weather data from the Birmingham Urban Observatory and will incorporate satellite data to determine urban spatial expansion and its effect on the UHI. We have produced a temperature map based on summer datasets of 2020, which has covered 25 weather stations in Birmingham to show the differences between diurnal and nocturnal summer and annual temperature trends. Some impacts of the UHI may be beneficial, such as the lengthening of the plant growing season, but most of them are highly negative. We are looking for various effects of urban heat which is impacting human health and investigating mitigation options.

Keywords: urban heat, public health, climate change

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1803 Computational Modeling of Thermal Comfort and CO2 Distribution in Common Room-Lecture Room by Using Hybrid Air Ventilation System, Thermoelectric-PV-Silica Gel under IAQ Standard

Authors: Jirod Chaisan, Somchai Maneewan, Chantana Punlek, Ninnart Rachapradit, Surapong Chirarattananon, Pattana Rakkwamsuk

Abstract:

In this paper, simulation modeling of heat transfer, air flow and distribution emitted from CO2 was performed in a regenerated air. The study room was divided in 3 types: common room, small lecture room and large lecture room under evaluated condition in two case: released and unreleased CO2 including of used hybrid air ventilation system for regenerated air under Thailand climate conditions. The carbon dioxide was located on the center of the room and released rate approximately 900-1200 ppm corresponded with indoor air quality standard (IAQs). The indoor air in the thermal comfort zone was calculated and simulated with the numerical method that using real data from the handbook guideline. The results of the study showed that in the case of hybrid air ventilation system explained thermal and CO2 distribution due to the system was adapted significantly in the comfort zone. The results showed that when CO2 released on the center of the other room, the CO2 high concentration in comfort zone so used hybrid air ventilation that decreased CO2 with regeneration air including of reduced temperature indoor. However, the study is simulation modeling and guideline only so the future should be the experiment of hybrid air ventilation system for evaluated comparison of the systems.

Keywords: air ventilation, indoor air quality, thermal comfort, thermoelectric, photovoltaic, dehumidify

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1802 Relationship between Personality Traits and Postural Stability among Czech Military Combat Troops

Authors: K. Rusnakova, D. Gerych, M. Stehlik

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Postural stability is a complex process involving actions of biomechanical, motor, sensory and central nervous system components. Numerous joint systems, muscles involved, the complexity of sporting movements and situations require perfect coordination of the body's movement patterns. To adapt to a constantly changing situation in such a dynamic environment as physical performance, optimal input of information from visual, vestibular and somatosensory sensors are needed. Combat soldiers are required to perform physically and mentally demanding tasks in adverse conditions, and poor postural stability has been identified as a risk factor for lower extremity musculoskeletal injury. The aim of this study is to investigate whether some personality traits are related to the performance of static postural stability among soldiers of combat troops. NEO personality inventory (NEO-PI-R) was used to identify personality traits and the Nintendo Wii Balance Board was used to assess static postural stability of soldiers. Postural stability performance was assessed by changes in center of pressure (CoP) and center of gravity (CoG). A posturographic test was performed for 60 s with eyes opened during quiet upright standing. The results showed that facets of neuroticism and conscientiousness personality traits were significantly correlated with measured parameters of CoP and CoG. This study can help for better understanding the relationship between personality traits and static postural stability. The results can be used to optimize the training process at the individual level.

Keywords: neuroticism, conscientiousness, postural stability, combat troops

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1801 Enabling UDP Multicast in Cloud IaaS: An Enterprise Use Case

Authors: Patrick J. Kerpan, Ryan C. Koop, Margaret M. Walker, Chris P. Swan

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The User Datagram Protocol (UDP) multicast is a vital part of data center networking that is being left out of major cloud computing providers' network infrastructure. Enterprise users rely on multicast, and particularly UDP multicast to create and connect vital business operations. For example, UPD makes a variety of business functions possible from simultaneous content media updates, High-Performance Computing (HPC) grids, and video call routing for massive open online courses (MOOCs). Essentially, UDP multicast's technological slight is causing a huge effect on whether companies choose to use (or not to use) public cloud infrastructure as a service (IaaS). Allowing the ‘chatty’ UDP multicast protocol inside a cloud network could have a serious impact on the performance of the cloud as a whole. Cloud IaaS providers solve the issue by disallowing all UDP multicast. But what about enterprise use cases for multicast applications in organizations that want to move to the cloud? To re-allow multicast traffic, enterprises can build a layer 3 - 7 network over the top of a data center, private cloud, or public cloud. An overlay network simply creates a private, sealed network on top of the existing network. Overlays give complete control of the network back to enterprise cloud users the freedom to manage their network beyond the control of the cloud provider’s firewall conditions. The same logic applies if for users who wish to use IPsec or BGP network protocols inside or connected into an overlay network in cloud IaaS.

Keywords: cloud computing, protocols, UDP multicast, virtualization

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