Search results for: continuous peripheral nerve blocks
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3454

Search results for: continuous peripheral nerve blocks

334 Congenital Diaphragmatic Hernia Outcomes in a Low-Volume Center

Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

Procedia PDF Downloads 96
333 Obesity and Cancer: Current Scientific Evidence and Policy Implications

Authors: Martin Wiseman, Rachel Thompson, Panagiota Mitrou, Kate Allen

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Since 1997 World Cancer Research Fund (WCRF) International and the American Institute for Cancer Research (AICR) have been at the forefront of synthesising and interpreting the accumulated scientific literature on the link between diet, nutrition, physical activity and cancer, and deriving evidence-based Cancer Prevention Recommendations. The 2007 WCRF/AICR 2nd Expert Report was a landmark in the analysis of evidence linking diet, body weight and physical activity to cancer and led to the establishment of the Continuous Update Project (CUP). In 2018, as part of the CUP, WCRF/AICR will publish a new synthesis of the current evidence and update the Cancer Prevention Recommendations. This will ensure that everyone - from policymakers and health professionals to members of the public - has access to the most up-to-date information on how to reduce the risk of developing cancer. Overweight and obesity play a significant role in cancer risk, and rates of both are increasing in many parts of the world. This session will give an overview of new evidence relating obesity to cancer since the 2007 report. For example, since the 2007 Report, the number of cancers for which obesity is judged to be a contributory cause has increased from seven to eleven. The session will also shed light on the well-established mechanisms underpinning obesity and cancer links. Additionally, the session will provide an overview of diet and physical activity related factors that promote positive energy imbalance, leading to overweight and obesity. Finally, the session will highlight how policy can be used to address overweight and obesity at a population level, using WCRF International’s NOURISHING Framework. NOURISHING formalises a comprehensive package of policies to promote healthy diets and reduce obesity and non-communicable diseases; it is a tool for policymakers to identify where action is needed and assess if an approach is sufficiently comprehensive. The framework brings together ten policy areas across three domains: food environment, food system, and behaviour change communication. The framework is accompanied by a regularly updated database providing an extensive overview of implemented government policy actions from around the world. In conclusion, the session will provide an overview of obesity and cancer, highlighting the links seen in the epidemiology and exploring the mechanisms underpinning these, as well as the influences that help determine overweight and obesity. Finally, the session will illustrate policy approaches that can be taken to reduce overweight and obesity worldwide.

Keywords: overweight, obesity, nutrition, cancer, mechanisms, policy

Procedia PDF Downloads 157
332 Comprehensive Approach to Control Virus Infection and Energy Consumption in An Occupant Classroom

Authors: SeyedKeivan Nateghi, Jan Kaczmarczyk

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People nowadays spend most of their time in buildings. Accordingly, maintaining a good quality of indoor air is very important. New universal matters related to the prevalence of Covid-19 also highlight the importance of indoor air conditioning in reducing the risk of virus infection. Cooling and Heating of a house will provide a suitable zone of air temperature for residents. One of the significant factors in energy demand is energy consumption in the building. In general, building divisions compose more than 30% of the world's fundamental energy requirement. As energy demand increased, greenhouse effects emerged that caused global warming. Regardless of the environmental damage to the ecosystem, it can spread infectious diseases such as malaria, cholera, or dengue to many other parts of the world. With the advent of the Covid-19 phenomenon, the previous instructions to reduce energy consumption are no longer responsive because they increase the risk of virus infection among people in the room. Two problems of high energy consumption and coronavirus infection are opposite. A classroom with 30 students and one teacher in Katowice, Poland, considered controlling two objectives simultaneal. The probability of transmission of the disease is calculated from the carbon dioxide concentration of people. Also, in a certain period, the amount of energy consumption is estimated by EnergyPlus. The effect of three parameters of number, angle, and time or schedule of opening windows on the probability of infection transmission and energy consumption of the class were investigated. Parameters were examined widely to determine the best possible condition for simultaneous control of infection spread and energy consumption. The number of opening windows is discrete (0,3), and two other parameters are continuous (0,180) and (8 AM, 2 PM). Preliminary results show that changes in the number, angle, and timing of window openings significantly impact the likelihood of virus transmission and class energy consumption. The greater the number, tilt, and timing of window openings, the less likely the student will transmit the virus. But energy consumption is increasing. When all the windows were closed at all hours of the class, the energy consumption for the first day of January was only 0.2 megajoules. In comparison, the probability of transmitting the virus per person in the classroom is more than 45%. But when all windows were open at maximum angles during class, the chance of transmitting the infection was reduced to 0.35%. But the energy consumption will be 36 megajoules. Therefore, school classrooms need an optimal schedule to control both functions. In this article, we will present a suitable plan for the classroom with natural ventilation through windows to control energy consumption and the possibility of infection transmission at the same time.

Keywords: Covid-19, energy consumption, building, carbon dioxide, energyplus

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331 Photovoltaic-Driven Thermochemical Storage for Cooling Applications to Be Integrated in Polynesian Microgrids: Concept and Efficiency Study

Authors: Franco Ferrucci, Driss Stitou, Pascal Ortega, Franck Lucas

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The energy situation in tropical insular regions, as found in the French Polynesian islands, presents a number of challenges, such as high dependence on imported fuel, high transport costs from the mainland and weak electricity grids. Alternatively, these regions have a variety of renewable energy resources, which favor the exploitation of smart microgrids and energy storage technologies. With regards to the electrical energy demand, the high temperatures in these regions during the entire year implies that a large proportion of consumption is used for cooling buildings, even during the evening hours. In this context, this paper presents an air conditioning system driven by photovoltaic (PV) electricity that combines a refrigeration system and a thermochemical storage process. Thermochemical processes are able to store energy in the form of chemical potential with virtually no losses, and this energy can be used to produce cooling during the evening hours without the need to run a compressor (thus no electricity is required). Such storage processes implement thermochemical reactors in which a reversible chemical reaction between a solid compound and a gas takes place. The solid/gas pair used in this study is BaCl2 reacting with ammonia (NH3), which is also the coolant fluid in the refrigeration circuit. In the proposed system, the PV-driven electric compressor is used during the daytime either to run the refrigeration circuit when a cooling demand occurs or to decompose the ammonia-charged salt and remove the gas from thermochemical reactor when no cooling is needed. During the evening, when there is no electricity from solar source, the system changes its configuration and the reactor reabsorbs the ammonia gas from the evaporator and produces the cooling effect. In comparison to classical PV-driven air conditioning units equipped with electrochemical batteries (e.g. Pb, Li-ion), the proposed system has the advantage of having a novel storage technology with a much longer charge/discharge life cycle, and no self-discharge. It also allows a continuous operation of the electric compressor during the daytime, thus avoiding the problems associated with the on-off cycling. This work focuses on the system concept and on the efficiency study of its main components. It also compares the thermochemical with electrochemical storage as well as with other forms of thermal storage, such as latent (ice) and sensible heat (chilled water). The preliminary results show that the system seems to be a promising alternative to simultaneously fulfill cooling and energy storage needs in tropical insular regions.

Keywords: microgrid, solar air-conditioning, solid/gas sorption, thermochemical storage, tropical and insular regions

Procedia PDF Downloads 241
330 Baseline Study of Water Quality in Indonesia Using Dynamic Methods and Technologies

Authors: R. L. P. de Lima, F. C. B. Boogaard, D. Setyo Rini, P. Arisandi, R. E. de Graaf-Van Dinther

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Water quality in many Asian countries is very poor due to inefficient solid waste management, high population growth and the lack of sewage and purification systems for households and industry. A consortium of Indonesian and Dutch organizations has begun a large-scale international research project to evaluate and propose solutions to face the surface water pollution challenges in Brantas Basin, Indonesia (East Java: Malang / Surabaya). The first phase of the project consisted in a baseline study to assess the current status of surface water bodies and to determine the ambitions and strategies among local stakeholders. This study was conducted with high participatory / collaborative and knowledge sharing objectives. Several methods such as using mobile sensors (attached to boats or underwater drones), test strips and mobile apps, bio-monitoring (sediments), ecology scans using underwater cameras, or continuous / static measurements, were applied in different locations in the regions of the basin, at multiple locations within the water systems (e.g. spring, upstream / downstream of industry and urban areas, mouth of the Surabaya River, groundwater). Results gave an indication of (reference) values of basic water quality parameters such as turbidity, electrical conductivity, dissolved oxygen or nutrients (ammonium / nitrate). An important outcome was that collecting random samples may not be representative of a body of water, given that water quality parameters can vary widely in space (x, y, and depth) and time (day / night and seasonal). Innovative / dynamic monitoring methods (e.g. underwater drones, sensors on boats) can contribute to better understand the quality of the living environment (water, ecology, sediment) and factors that affect it. The field work activities, in particular, underwater drones, revealed potential as awareness actions as they attracted interest from locals and local press. This baseline study involved the cooperation with local managing organizations with Dutch partners, and their willingness to work together is important to ensure participatory actions and social awareness regarding the process of adaptation and strengthening of regulations, or for the construction of facilities such as sewage.

Keywords: water quality monitoring, pollution, underwater drones, social awareness

Procedia PDF Downloads 192
329 Changes in Heavy Metals Bioavailability in Manure-Derived Digestates and Subsequent Hydrochars to Be Used as Soil Amendments

Authors: Hellen L. De Castro e Silva, Ana A. Robles Aguilar, Erik Meers

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Digestates are residual by-products, rich in nutrients and trace elements, which can be used as organic fertilisers on soils. However, due to the non-digestibility of these elements and reduced dry matter during the anaerobic digestion process, metal concentrations are higher in digestates than in feedstocks, which might hamper their use as fertilisers according to the threshold values of some country policies. Furthermore, there is uncertainty regarding the required assimilated amount of these elements by some crops, which might result in their bioaccumulation. Therefore, further processing of the digestate to obtain safe fertilizing products has been recommended. This research aims to analyze the effect of applying the hydrothermal carbonization process to manure-derived digestates as a thermal treatment to reduce the bioavailability of heavy metals in mono and co-digestates derived from pig manure and maize from contaminated land in France. This study examined pig manure collected from a novel stable system (VeDoWs, province of East Flanders, Belgium) that separates the collection of pig urine and feces, resulting in a solid fraction of manure with high up-concentration of heavy metals and nutrients. Mono-digestion and co-digestion processes were conducted in semi-continuous reactors for 45 days at mesophilic conditions, in which the digestates were dried at 105 °C for 24 hours. Then, hydrothermal carbonization was applied to a 1:10 solid/water ratio to guarantee controlled experimental conditions in different temperatures (180, 200, and 220 °C) and residence times (2 h and 4 h). During the process, the pressure was generated autogenously, and the reactor was cooled down after completing the treatments. The solid and liquid phases were separated through vacuum filtration, in which the solid phase of each treatment -hydrochar- was dried and ground for chemical characterization. Different fractions (exchangeable / adsorbed fraction - F1, carbonates-bound fraction - F2, organic matter-bound fraction - F3, and residual fraction – F4) of some heavy metals (Cd, Cr, Ni, and Cr) have been determined in digestates and derived hydrochars using the modified Community Bureau of Reference (BCR) sequential extraction procedure. The main results indicated a difference in the heavy metals fractionation between digestates and their derived hydrochars; however, the hydrothermal carbonization operating conditions didn’t have remarkable effects on heavy metals partitioning between the hydrochars of the proposed treatments. Based on the estimated potential ecological risk assessment, there was one level decrease (considerate to moderate) when comparing the HMs partitioning in digestates and derived hydrochars.

Keywords: heavy metals, bioavailability, hydrothermal treatment, bio-based fertilisers, agriculture

Procedia PDF Downloads 100
328 Demographic and Socio-Economic Study of the Elderly Population in Kolkata, India

Authors: Ambika Roy Bardhan

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Kolkata, the City of Joy, is a greying metropolis not only in respect of its concrete jungle but also because of the largest population of 60-plus residents that it shelters among all other cities in India. Declining birth and death rates and a negative growth of population indicate that the city has reached the last stage of demographic transition. Thus, the obvious consequence has been the ageing of its population. With this background, the present paper attempts to study the demographic and socio-economic status of the elderly population in Kolkata. Analysis and findings have been based on secondary data obtained from Census of India of various years, Sample Registration System Reports and reports by HelpAge India. Findings show that the elderly population is increasing continuously. With respect to gender, the male elderly outnumbers the female elderly population. The percentage of households having one elderly member is more in the city due to the emergence of the nuclear families and erosion of joint family system. With respect to socio-economic status, those elderly who are the heads of the family are lower in percentages than those in the other age groups. Also, male elderly as head of the family are greater in percentage than female elderly. Elderly in the category of currently married records the highest percentage followed by widowed, never married and lastly, separated or divorced. Male elderly outnumber the female elderly as currently married, while female elderly outnumbers the male elderly in the category of widowed. In terms of living status, the percentage of elderly who are living alone is highest in Kolkata and the reason for staying alone as no support from children also happens to be highest in this city. The literacy rate and higher level of education is higher among the male than female elderly. Higher percentages of female elderly have been found to be with disability. Disability in movement and multiple disabilities have been found to be more common among the elderly population in Kolkata. Percentages of male literate pensioners are highest than other categories. Also, in terms of levels of education male elderly who are graduate and above other than technical degree are the highest receivers of pension. Also, in terms of working status, elderly as non-workers are higher in percentages with the population of elderly females outnumbering the males. The old age dependency ratio in the city is increasing continuously and the ratio is higher among females than male. Thus, it can be stated that Kolkata is witnessing continuous and rapid ageing of its population. Increasing dependency ratio is likely to create pressure on the working population, available civic, social and health amenities. This requires intervention in the form of planning, formulation and implementation of laws, policies, programs and measures to safeguard and improve the conditions of the elderly in Kolkata.

Keywords: demographic, elderly, population, socio-economic

Procedia PDF Downloads 138
327 Modern Information Security Management and Digital Technologies: A Comprehensive Approach to Data Protection

Authors: Mahshid Arabi

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With the rapid expansion of digital technologies and the internet, information security has become a critical priority for organizations and individuals. The widespread use of digital tools such as smartphones and internet networks facilitates the storage of vast amounts of data, but simultaneously, vulnerabilities and security threats have significantly increased. The aim of this study is to examine and analyze modern methods of information security management and to develop a comprehensive model to counteract threats and information misuse. This study employs a mixed-methods approach, including both qualitative and quantitative analyses. Initially, a systematic review of previous articles and research in the field of information security was conducted. Then, using the Delphi method, interviews with 30 information security experts were conducted to gather their insights on security challenges and solutions. Based on the results of these interviews, a comprehensive model for information security management was developed. The proposed model includes advanced encryption techniques, machine learning-based intrusion detection systems, and network security protocols. AES and RSA encryption algorithms were used for data protection, and machine learning models such as Random Forest and Neural Networks were utilized for intrusion detection. Statistical analyses were performed using SPSS software. To evaluate the effectiveness of the proposed model, T-Test and ANOVA statistical tests were employed, and results were measured using accuracy, sensitivity, and specificity indicators of the models. Additionally, multiple regression analysis was conducted to examine the impact of various variables on information security. The findings of this study indicate that the comprehensive proposed model reduced cyber-attacks by an average of 85%. Statistical analysis showed that the combined use of encryption techniques and intrusion detection systems significantly improves information security. Based on the obtained results, it is recommended that organizations continuously update their information security systems and use a combination of multiple security methods to protect their data. Additionally, educating employees and raising public awareness about information security can serve as an effective tool in reducing security risks. This research demonstrates that effective and up-to-date information security management requires a comprehensive and coordinated approach, including the development and implementation of advanced techniques and continuous training of human resources.

Keywords: data protection, digital technologies, information security, modern management

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326 Euthanasia Reconsidered: Voting and Multicriteria Decision-Making in Medical Ethics

Authors: J. Hakula

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Discussion on euthanasia is a continuous process. Euthanasia is defined as 'deliberately ending a patient's life by administering life-ending drugs at the patient's explicit request'. With few exceptions, worldwide in most countries human societies have not been able to agree on some fundamental issues concerning ultimate decisions of life and death. Outranking methods in voting oriented social choice theory and multicriteria decision-making (MCDM) can be applied to issues in medical ethics. There is a wide range of voting methods, and using different methods the same group of voters can end up with different outcomes. In the MCDM context, decision alternatives can be substituted for candidates, and criteria for voters. The view chosen here is that of a single decision-maker. Initially, three alternatives and three criteria are chosen. Pairwise and basic positional voting rules - plurality, anti-plurality and the Borda count - are applied. In the MCDM solution, criteria are put weights by giving them the more 'votes'; the more important the decision-maker ranks them. A hypothetical example on evaluating properties of euthanasia consists of three alternatives A, B, and C, which are ranked according to three criteria - the patient’s willingness to cooperate, general action orientation (active/passive), and cost-effectiveness - the criteria having weights 7, 5, and 4, respectively. Using the plurality rule and the weights given to criteria, A is the best alternative, B and C thereafter. In pairwise comparisons, both B and C defeat A with weight scores 7 to 9. On the other hand, B is defeated by C with weights 11 to 5. Thus, C (i.e. the so-called Condorcet winner) defeats both A and B. The best alternative using the plurality principle is not necessarily the best in the pairwise sense, the conflict remaining unsolved with or without additional weights. Positional rules are sensitive to variations in alternative sets. In the example above, the plurality rule gives the rank ABC. If we leave out C, the plurality ranking between A and B results in BA. Withdrawing B or A the ranking is CA and CB, respectively. In pairwise comparisons an analogous problem emerges when the number of criteria is varied. Cyclic preferences may lead to a total tie, and no (rational) choice between the alternatives can be made. In conclusion, the choice of the best commitment to re-evaluate euthanasia, with criteria left unchanged, depends entirely on the evaluation method used. The right strategies matter, too. Future studies might concern the problem of an abstention - a situation where voters do not vote - and still their best candidate may win. Or vice versa, actively giving the ballot to their first rank choice might lead to a total loss. In MCDM terms, a decision might occur where some central criteria are not actively involved in the best choice made.

Keywords: medical ethics, euthanasia, voting methods, multicriteria decision-making

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325 Response Analysis of a Steel Reinforced Concrete High-Rise Building during the 2011 Tohoku Earthquake

Authors: Naohiro Nakamura, Takuya Kinoshita, Hiroshi Fukuyama

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The 2011 off The Pacific Coast of Tohoku Earthquake caused considerable damage to wide areas of eastern Japan. A large number of earthquake observation records were obtained at various places. To design more earthquake-resistant buildings and improve earthquake disaster prevention, it is necessary to utilize these data to analyze and evaluate the behavior of a building during an earthquake. This paper presents an earthquake response simulation analysis (hereafter a seismic response analysis) that was conducted using data recorded during the main earthquake (hereafter the main shock) as well as the earthquakes before and after it. The data were obtained at a high-rise steel-reinforced concrete (SRC) building in the bay area of Tokyo. We first give an overview of the building, along with the characteristics of the earthquake motion and the building during the main shock. The data indicate that there was a change in the natural period before and after the earthquake. Next, we present the results of our seismic response analysis. First, the analysis model and conditions are shown, and then, the analysis result is compared with the observational records. Using the analysis result, we then study the effect of soil-structure interaction on the response of the building. By identifying the characteristics of the building during the earthquake (i.e., the 1st natural period and the 1st damping ratio) by the Auto-Regressive eXogenous (ARX) model, we compare the analysis result with the observational records so as to evaluate the accuracy of the response analysis. In this study, a lumped-mass system SR model was used to conduct a seismic response analysis using observational data as input waves. The main results of this study are as follows: 1) The observational records of the 3/11 main shock put it between a level 1 and level 2 earthquake. The result of the ground response analysis showed that the maximum shear strain in the ground was about 0.1% and that the possibility of liquefaction occurring was low. 2) During the 3/11 main shock, the observed wave showed that the eigenperiod of the building became longer; this behavior could be generally reproduced in the response analysis. This prolonged eigenperiod was due to the nonlinearity of the superstructure, and the effect of the nonlinearity of the ground seems to have been small. 3) As for the 4/11 aftershock, a continuous analysis in which the subject seismic wave was input after the 3/11 main shock was input was conducted. The analyzed values generally corresponded well with the observed values. This means that the effect of the nonlinearity of the main shock was retained by the building. It is important to consider this when conducting the response evaluation. 4) The first period and the damping ratio during a vibration were evaluated by an ARX model. Our results show that the response analysis model in this study is generally good at estimating a change in the response of the building during a vibration.

Keywords: ARX model, response analysis, SRC building, the 2011 off the Pacific Coast of Tohoku Earthquake

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324 A Quality Improvement Approach for Reducing Stigma and Discrimination against Young Key Populations in the Delivery of Sexual Reproductive Health and Rights Services

Authors: Atucungwiire Rwebiita

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Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

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323 Effects of the Quality Construction of Public Construction in Taiwan to Implementation Three Levels Quality Management Institution

Authors: Hsin-Hung Lai, Wei Lo

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Whether it is in virtue or vice for a construction quality of public construction project, it is one of the important indicators for national economic development and overall construction, the impact on the quality of national life is very deep. In recent years, a number of scandal of public construction project occurred, the requirements of the government agencies and the public require the quality of construction of public construction project are getting stricter than ever, the three-level public construction project construction quality of quality control system implemented by the government has a profound impact. This study mainly aggregated the evolution of ISO 9000 quality control system, the difference between the practice of implementing management of construction quality by many countries and three-level quality control of our country, so we explored and found that almost all projects of enhancing construction quality are dominated by civil organizations in foreign countries, whereas, it is induced by the national power in our country and develop our three-level quality control system and audit mechanism based on IOS system and implement the works by legislation, we also explored its enhancement and relevance with construction quality of public construction project that are intervened by such system and national power, and it really presents the effectiveness of construction quality been enhanced by the audited result. The three-level quality control system of our country to promote the policy of public construction project is almost same with the quality control system of many developed countries; however our country mainly implements such system on public construction project only, we promote the three-level quality control system is for enhancing the quality of public construction project, for establishing effective quality management system, so as to urge, correct and prevent the defects of quality management by manufacturers, whereas, those developed countries is comprehensively promoting (both public construction project and civil construction) such system. Therefore, this study is to explore the scope for public construction project only; the most important is the quality recognition by the executor, either good quality or deterioration is not a single event, there is a certain procedure extends from the demand and feasibility analysis, design, tendering, contracting, construction performance, inspection, continuous improvement, completion and acceptance, transferring and meeting the needs of the users, all of mentioned above have a causal relationship and it is a systemic problems. So the best construction quality would be manufactured and managed by reasonable cost if it is by extensive thinking and be preventive. We aggregated the implemented results in the past 10 years (2005 to 2015), the audited results of both in central units and local ones were slightly increased in A-grade while those listed in B-grade were decreased, although the levels were not evidently upgraded, yet, such result presents that the construction quality of concept of manufacturers are improving, and the construction quality has been established in the design stage, thus it is relatively beneficial to the enhancement of construction quality of overall public construction project.

Keywords: ISO 9000, three-level quality control system, audit and review mechanism for construction implementation, quality of construction implementation

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322 An Effective Approach to Knowledge Capture in Whole Life Costing in Constructions Project

Authors: Ndibarafinia Young Tobin, Simon Burnett

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In spite of the benefits of implementing whole life costing technique as a valuable approach for comparing alternative building designs allowing operational cost benefits to be evaluated against any initial cost increases and also as part of procurement in the construction industry, its adoption has been relatively slow due to the lack of tangible evidence, ‘know-how’ skills and knowledge of the practice, i.e. the lack of professionals in many establishments with knowledge and training on the use of whole life costing technique, this situation is compounded by the absence of available data on whole life costing from relevant projects, lack of data collection mechanisms and so on. This has proved to be very challenging to those who showed some willingness to employ the technique in a construction project. The knowledge generated from a project can be considered as best practices learned on how to carry out tasks in a more efficient way, or some negative lessons learned which have led to losses and slowed down the progress of the project and performance. Knowledge management in whole life costing practice can enhance whole life costing analysis execution in a construction project, as lessons learned from one project can be carried on to future projects, resulting in continuous improvement, providing knowledge that can be used in the operation and maintenance phases of an assets life span. Purpose: The purpose of this paper is to report an effective approach which can be utilised in capturing knowledge in whole life costing practice in a construction project. Design/methodology/approach: An extensive literature review was first conducted on the concept of knowledge management and whole life costing. This was followed by a semi-structured interview to explore the existing and good practice knowledge management in whole life costing practice in a construction project. The data gathered from the semi-structured interview was analyzed using content analysis and used to structure an effective knowledge capturing approach. Findings: From the results obtained in the study, it shows that the practice of project review is the common method used in the capturing of knowledge and should be undertaken in an organized and accurate manner, and results should be presented in the form of instructions or in a checklist format, forming short and precise insights. The approach developed advised that irrespective of how effective the approach to knowledge capture, the absence of an environment for sharing knowledge, would render the approach ineffective. Open culture and resources are critical for providing a knowledge sharing setting, and leadership has to sustain whole life costing knowledge capture, giving full support for its implementation. The knowledge capturing approach has been evaluated by practitioners who are experts in the area of whole life costing practice. The results have indicated that the approach to knowledge capture is suitable and efficient.

Keywords: whole life costing, knowledge capture, project review, construction industry, knowledge management

Procedia PDF Downloads 260
321 Early Buddhist History in Architecture before Sui Dynasty

Authors: Yin Ruoxi

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During the Eastern Han to Three Kingdoms period, Buddhism had not yet received comprehensive support from the ruling class, and its dissemination remained relatively limited. Based on existing evidence, Buddhist architecture was primarily concentrated in regions central to scripture translation and cultural exchange with the Western Regions, such as Luoyang, Pengcheng, and Guangling. The earliest Buddhist structures largely adhered to the traditional forms of ancient Indian architecture. The frequent wars of the late Western Jin and Sixteen Kingdoms periods compelled the Central Plains culture to interact with other civilizations. As a result, Buddhist architecture gradually integrated characteristics of Central Asian, ancient Indian, and native Chinese styles. In the Northern and Southern Dynasties, Buddhism gained formal support from rulers, leading to the establishment of numerous temples across the Central Plains. The prevalence of warfare, combined with the emergence of Wei-Jin reclusive thought and Buddhism’s own ascetic philosophy, gave rise to mountain temples. Additionally, the eastward spread of rock-cut cave architecture along the Silk Road accelerated the development of such mountain temples. Temple layouts also became increasingly complex with the deeper translation of Buddhist scriptures and the influence of traditional Chinese architectural concepts. From the earliest temples, where the only Buddhist structure was the temple itself, to layouts centered on the stupa with a "front stupa, rear hall" arrangement, and finally to Mahavira Halls becoming the sacred focal point, temple design evolved significantly. The grand halls eventually matched the scale of the central halls in imperial palaces, reflecting the growing deification of the Buddha in the public imagination. The multi-storied wooden pagoda exemplifies Buddhism’s remarkable adaptability during its early introduction to the Central Plains, while the dense- eaved pagoda represents a synthesis of Gandharan stupas, Central Asian temple shrines, ancient Indian devalaya, and Chinese multi-storied pavilions. This form demonstrates Buddhism’s ability to absorb features from diverse cultures during its dissemination. Through its continuous interaction with various cultures, Buddhist architecture achieved sustained development in both form and meaning, laying a solid foundation for the establishment and growth of Buddhism across different regions.

Keywords: Buddhism, buddhist architecture, pagoda, temple, South Asian Buddhism, Chinese Buddhism

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320 A Case Study of Psycho-Social Status of Rohingya Women Refugees Settled in Delhi

Authors: Fizza Saghir

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Rohingyas are an ethnic minority of predominantly Buddhist-Myanmar. Living in ghettos in Rakhine, one of the poorest states of Myanmar, for decades, they have been marginalized, discriminated, deprived of the basic amenities and have faced ghastly violations of their rights- politically, socially, economically and culturally. In 2012, in violence that, erupted between ethnic Rakhine Buddhists and Rohingya Muslims, hundreds of Rohingyas were slayed and many more displaced. The state does not recognize them as ‘citizens’ and the military and police have constantly persecuted and pushed them to either migrate to other countries like India, Bangladesh or else die of deprivation. Amidst the deadly violence, Rohingya women are the most vulnerable. Many of them have faced sexual abuse and gender-based violence. Minimalistic to insignificant studies have been done on the plight of Rohingya women refugees in context of India. Thus, this paper focuses on psycho-social status of Rohingya women refugees settled in Delhi, India. The research study used both quantitative and qualitative methods. It was explorative in nature and used non-probability sampling, purposive sampling, in particular. A sample size of 30 Rohingya women refugees was interviewed out of the universe of 45 Rohingya refugee families living in Kalindi Kunj Refugee Camp of Delhi. Case studies were developed. The paper explores the psychological and social status of the respondents along with a deep understanding of their issues and concerns. Moreover, it assesses the impact of violence and migration on respondents. It was found that Rohingya women refugees are deeply and severely affected by a violent past, an insecure present and an uncertain future. Major problems they face in Delhi, India are finding employment, lack of identity cards to avail government services, language barrier, lack of health and education facilities. All they desire is peace and shelter in India. Besides, recommendations and suggestions have been given to various stakeholders of the forced mass migration of Rohingya refugees which includes, Government of Myanmar, Government of India, other bordering nations of Myanmar, international NGOs and media and the Rohingya community, itself. Only an immediate, peaceful and continuous dialogue process can help resolve the issue of exodus of Rohingyas. Countries, including India, must come together to help the Rohingyas who are in need of urgent humanitarian aid and assistance.

Keywords: dialogue process, ethnic minority, forced mass migration, impact of violence and migration, psycho-social status, Rohingya women refugees, sexual abuse

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319 Quality Assessment of the Given First Aid on the Spot Events in the Opinion of Members of the Teams of the Medical Rescue in Warsaw in Poland

Authors: Aneta Binkowska, Artur Kamecki

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The ability to provide first aid should be one of the basic skills of each of us. First aid by the Law on National Medical Emergency dated 8 September 2006 as amended, is a set of actions undertaken to save a person at the scene of an accident. In Poland, on the basis of Article 162 of the Criminal Code, we are obliged to provide first aid to the victim. In addition, according to a large part of society, unselfishness towards others in need of help is our moral obligation. The aim of the study was to learn the opinion of the members of Medical Rescue Teams (MRT) of the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service (PA and STS ‘Meditrans’) in Warsaw on how people react in real situations threatening life or health of the injured person. The study was conducted in the third quarter of 2015 on 335 members of medical rescue teams, including 77 W and 258 M, who provided medical services in the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service MRT in Warsaw. The research tool was an anonymous questionnaire survey of own design, which consisted of 12 questions: closed, half open and one open question. Respondents were divided into 3 age groups and by individual medical professions (doctor, paramedic, nurse). The straight majority of respondents encountered granting the first aid the event on the spot. However, the frequency of appearing in such proceedings isn’t too high. The first aid has most often been given in the street and in houses. The final audited fairly important element is the reason not to provide first aid by bystanders in the opinion of members of the medical teams. Respondents to this question, which was an open question were asked to name the reason for not taking any action while waiting for an ambulance. Over 50% of respondents could not answer. The most common answers were: fear, lack of knowledge and skills, reluctance, indifference, lack of training, lack of experience and fear that harm. Conclusion: The majority of respondents have encountered instances of first aid provision, but respondents assessed the frequency of such situations as low. Placing the victim in the recovery position is the simplest and most common form of first aid. Therefore, training should be introduced not only on CPR but also in the scope of helping persons in sudden health emergency, who do not have a sudden cardiac arrest. A statement can be formulated, as a main conclusion of the analysis, that only continuous education and in particular practical training will help people to overcome the barrier of their limitations in order to help others. Among the largest group of witnesses providing first aid are the elderly and youth, who are subjected to various forms of education related to first aid provision.

Keywords: BLS, first aid, medical rescue, resuscitation

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318 Effects of Gender on Kinematics Kicking in Soccer

Authors: Abdolrasoul Daneshjoo

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Soccer is a game which draws more attention in different countries especially in Brazil. Kicking among different skills in soccer and soccer players is an excellent role for the success and preference of a team. The way of point gaining in this game is passing the ball over the goal lines which are gained by shoot skill in attack time and or during the penalty kicks.Regarding the above assumption, identifying the effective factors in instep kicking in different distances shoot with maximum force and high accuracy or pass and penalty kick, may assist the coaches and players in raising qualitative level of performing the skill.The aim of the present study was to study of a few kinematical parameters in instep kicking from 5 and 7 meter distance among the male and female elite soccer players.24 right dominant lower limb subjects (12 males and 12 females) among Tehran elite soccer players with average and the standard deviation (22.5 ± 1.5) & (22.08± 1.31) years, height of (179.5 ± 5.81) & (164.3 ± 4.09) cm, weight of (69.66 ± 4.09) & (53.16 ± 3.51) kg, %BMI (21.06 ± .731) & (19.67 ± .709), having playing history of (4 ± .73) & (3.08 ± .66) years respectively participated in this study. They had at least two years of continuous playing experience in Tehran soccer league.For sampling player's kick; Kinemetrix Motion analysis with three cameras with 1000 Hz was used. Five reflective markers were placed laterally on the kicking leg over anatomical points (the iliac crest, major trochanter, lateral epicondyle of femur, lateral malleolus, and lateral aspect of distal head of the fifth metatarsus). Instep kick was filmed, with one step approach and 30 to 45 degrees angle from stationary ball. Three kicks were filmed, one kick selected for further analyses. Using Kinemetrix 3D motion analysis software, the position of the markers was analyzed. Descriptive statistics were used to describe the mean and standard deviation, while the analysis of variance, and independent t-test (P < 0.05) were used to compare the kinematic parameters between two genders.Among the evaluated parameters, the knee acceleration, the thigh angular velocity, the angle of knee proportionately showed significant relationship with consequence of kick. While company performance on 5m in 2 genders, significant differences were observed in internal – external displacement of toe, ankle, hip and the velocity of toe, ankle and the acceleration of toe and the angular velocity of pelvic, thigh and before time contact . Significant differences showed the internal – external displacement of toe, the ankle, the knee and the hip, the iliac crest and the velocity of toe, the ankle and acceleration of ankle and angular velocity of the pelvic and the knee.

Keywords: biomechanics, kinematics, instep kicking, soccer

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317 Redefining Success Beyond Borders: A Deep Dive into Effective Methods to Boost Morale Among Virtual Workers for Exponential Project Performance

Authors: Florence Ibeh, David Oyewmi Oyekunle, David Boohene

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The continuous advancement of information technology has completely transformed how businesses and organizations operate on a global scale. The widespread availability of virtual communication tools enables individuals to opt for remote work. While remote employment offers various benefits, such as facilitating corporate growth and enhancing customer support, it also presents distinct challenges. Therefore, investigating the intricacies of virtual team morale is crucial for ensuring the achievement of project objectives. For this study, content analysis of pre-existing secondary data was employed to examine the phenomenon. Essential elements vital for improving the success of projects within virtual teams were identified. These factors include technology adoption, creating a distraction-free work environment, effective leadership, trust-building, clear communication channels, well-defined task allocation, active team participation, and motivation. Furthermore, the study established a substantial correlation between morale levels and the participation and productivity of virtual team members. Higher levels of morale were associated with optimal performance among virtual teams. The study determined that the key factors for enhancing project performance in virtual teams are the adoption of technology, a focused environment, effective leadership, trust, communication, well-defined tasks, collaborative teamwork, and motivation. Additionally, the study discovered that modifying the optimal strategies employed by in-office teams can enhance the diminished morale prevalent in remote teams to sustain a high level of team morale for virtual teams. The findings of this study are highly significant in the dynamic field of project management. Currently, there is limited information regarding strategies that address challenges arising from external factors in virtual teams, such as ambient noise and disruptions caused by family members. The findings underscore the significance of selecting appropriate communication technologies, delineating distinct roles and responsibilities for virtual team members, and nurturing a culture of accountability and trust. Promoting seamless collaboration and instilling motivation among virtual team members are deemed highly effective in augmenting employee engagement and performance within virtual team setting.

Keywords: virtual teams, morale, project performance, distract-free environment, technology adaptation

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316 Long-Term Variabilities and Tendencies in the Zonally Averaged TIMED-SABER Ozone and Temperature in the Middle Atmosphere over 10°N-15°N

Authors: Oindrila Nath, S. Sridharan

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Long-term (2002-2012) temperature and ozone measurements by Sounding of Atmosphere by Broadband Emission Radiometry (SABER) instrument onboard Thermosphere, Ionosphere, Mesosphere Energetics and Dynamics (TIMED) satellite zonally averaged over 10°N-15°N are used to study their long-term changes and their responses to solar cycle, quasi-biennial oscillation and El Nino Southern Oscillation. The region is selected to provide more accurate long-term trends and variabilities, which were not possible earlier with lidar measurements over Gadanki (13.5°N, 79.2°E), which are limited to cloud-free nights, whereas continuous data sets of SABER temperature and ozone are available. Regression analysis of temperature shows a cooling trend of 0.5K/decade in the stratosphere and that of 3K/decade in the mesosphere. Ozone shows a statistically significant decreasing trend of 1.3 ppmv per decade in the mesosphere although there is a small positive trend in stratosphere at 25 km. Other than this no significant ozone trend is observed in stratosphere. Negative ozone-QBO response (0.02ppmv/QBO), positive ozone-solar cycle (0.91ppmv/100SFU) and negative response to ENSO (0.51ppmv/SOI) have been found more in mesosphere whereas positive ozone response to ENSO (0.23ppmv/SOI) is pronounced in stratosphere (20-30 km). The temperature response to solar cycle is more positive (3.74K/100SFU) in the upper mesosphere and its response to ENSO is negative around 80 km and positive around 90-100 km and its response to QBO is insignificant at most of the heights. Composite monthly mean of ozone volume mixing ratio shows maximum values during pre-monsoon and post-monsoon season in middle stratosphere (25-30 km) and in upper mesosphere (85-95 km) around 10 ppmv. Composite monthly mean of temperature shows semi-annual variation with large values (~250-260 K) in equinox months and less values in solstice months in upper stratosphere and lower mesosphere (40-55 km) whereas the SAO becomes weaker above 55 km. The semi-annual variation again appears at 80-90 km, with large values in spring equinox and winter months. In the upper mesosphere (90-100 km), less temperature (~170-190 K) prevails in all the months except during September, when the temperature is slightly more. The height profiles of amplitudes of semi-annual and annual oscillations in ozone show maximum values of 6 ppmv and 2.5 ppmv respectively in upper mesosphere (80-100 km), whereas SAO and AO in temperature show maximum values of 5.8 K and 4.6 K in lower and middle mesosphere around 60-85 km. The phase profiles of both SAO and AO show downward progressions. These results are being compared with long-term lidar temperature measurements over Gadanki (13.5°N, 79.2°E) and the results obtained will be presented during the meeting.

Keywords: trends, QBO, solar cycle, ENSO, ozone, temperature

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315 The Agency of Award Systems in Architecture: The Case of Cyprus

Authors: Christakis Chatzichristou, Elias Kranos

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Architectural awards, especially if they are given by the state, recognize excellence in the field and, at the same time, strongly contribute to the making of the architectural culture of a place. The present research looks at the houses that have been awarded through such a system in Cyprus in order to discuss the values promoted, directly or not, by such a setup which is quite similar to other prestigious award systems such as the Mies van de Rohe Prize in Europe. In fact, many of the projects signed out through the state award system end up being selected to represent the country for the European awards. The residential architecture encouraged by such systems is quite interesting in that the most public of institutions influence how the most private unit of society is architecturally accommodated. The methodology uses both qualitative as well as quantitative research tools in order to analyze: the official state call for entries to the competition; the final report of the evaluation committee; the spatial characteristics of the houses through the Space Syntax methodology; the statements of the architects regarding their intentions and the final outcome; the feelings of the owners and users of the houses regarding the design process as well as the degree of satisfaction regarding the final product. The above-mentioned analyses allow for a more thorough discussion regarding not only the values promoted explicitly by the system through the brief that describes what the evaluation committee is looking for but also the values that are actually being promoted indirectly through the results of the actual evaluation itself. The findings suggest that: the strong emphasis in brief on bioclimatic design and issues of sustainability weakens significantly, if at all present, in the actual selection process; continuous improvement seems to be fuzzily used as a concept; most of the houses tend to have a similar spatial genotype; most of the houses have similar aesthetic qualities; discrepancies between the proposed lifestyle through the design and the actual use of the spaces do not seem to be acknowledged in the evaluation as an issue; the temporal factor seems to be ignored as the projects are required to be ‘finished projects’ as though the users and their needs do not change through time. The research suggests that, rather than preserving a critical attitude regarding the role of the architect in society, the state award system tends, like any other non-reflective social organism, to simply promote its own unexamined values as well as prejudices. This is perhaps more evident in the shared aesthetic character of the awarded houses and less so in the hidden spatial genotype to which they belong. If the design of houses is indeed a great opportunity for architecture to contribute in a more deliberate manner to the evolution of society, then what the present study shows is that this opportunity seems to be largely missed. The findings may serve better less as a verdict and more as a chance for introspection and discussion.

Keywords: award systems, houses, spatial genotype, aesthetic qualities

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314 To Live on the Margins: A Closer Look at the Social and Economic Situation of Illegal Afghan Migrants in Iran

Authors: Abdullah Mohammadi

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Years of prolong war in Afghanistan has led to one of the largest refugee and migrant populations in the contemporary world. During this continuous unrest which began in 1970s (by military coup, Marxist revolution and the subsequent invasion of USSR), over one-third of the population migrated to neighboring countries, especially Pakistan and Iran. After the Soviet Army withdrawal in 1989, a new wave of conflicts emerged between rival Afghan groups and this led to new refugees. Taliban period, also, created its own refugees. During all these years, I.R. of Iran has been one of the main destinations of Afghan refugees and migrants. At first, due to the political situation after Islamic Revolution, Iran government didn’t restrict the entry of Afghan refugees. Those who came first in Iran received ID cards and had access to education and healthcare services. But in 1990s, due to economic and social concerns, Iran’s policy towards Afghan refugees and migrants changed. The government has tried to identify and register Afghans in Iran and limit their access to some services and jobs. Unfortunately, there are few studies on Afghan refugees and migrants’ situation in Iran and we have a dim and vague picture of them. Of the few studies done on this group, none of them focus on the illegal Afghan migrants’ situation in Iran. Here, we tried to study the social and economic aspects of illegal Afghan migrants’ living in Iran. In doing so, we interviewed 24 illegal Afghan migrants in Iran. The method applied for analyzing the data is thematic analysis. For the interviews, we chose family heads (17 men and 7 women). According to the findings, illegal Afghan migrants’ socio-economic situation in Iran is very undesirable. Its main cause is the marginalization of this group which is resulted from government policies towards Afghan migrants. Most of the illegal Afghan migrants work in unskilled and inferior jobs and live in rent houses on the margins of cities and villages. None of them could buy a house or vehicle due to law. Based on their income, they form one of the lowest, unprivileged groups in the society. Socially, they face many problems in their everyday life: social insecurity, harassment and violence, misuse of their situation by police and people, lack of education opportunity, etc. In general, we may conclude that illegal Afghan migrant have little adaptation with Iran’s society. They face severe limitations compared to legal migrants and refugees and have no opportunity for upward social mobility. However, they have managed some strategies to face these difficulties including: seeking financial and emotional helps from family and friendship networks, sending one of the family members to third country (mostly to European countries), establishing self-administered schools for children (schools which are illegal and run by Afghan educated youth).

Keywords: illegal Afghan migrants, marginalization, social insecurity, upward social mobility

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313 Predictors of Pericardial Effusion Requiring Drainage Following Coronary Artery Bypass Graft Surgery: A Retrospective Analysis

Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

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Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

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312 Foundation Phase Teachers' Experiences of School Based Support Teams: A Case of Selected Schools in Johannesburg

Authors: Ambeck Celyne Tebid, Harry S. Rampa

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The South African Education system recognises the need for all learners including those experiencing learning difficulties, to have access to a single unified system of education. For teachers to be pedagogically responsive to an increasingly diverse learner population without appropriate support has been proven to be unrealistic. As such, this has considerably hampered interest amongst teachers, especially those at the foundation phase to work within an Inclusive Education (IE) and training system. This qualitative study aimed at investigating foundation phase teachers’ experiences of school-based support teams (SBSTs) in two Full-Service (inclusive schools) and one Mainstream public primary school in the Gauteng province of South Africa; with particular emphasis on finding ways to supporting them, since teachers claimed they were not empowered in their initial training to teach learners experiencing learning difficulties. Hence, SBSTs were created at school levels to fill this gap thereby, supporting teaching and learning by identifying and addressing learners’, teachers’ and schools’ needs. With the notion that IE may be failing because of systemic reasons, this study uses Bronfenbrenner’s (1979) ecosystemic as well as Piaget’s (1980) maturational theory to examine the nature of support and experiences amongst teachers taking individual and systemic factors into consideration. Data was collected using in-depth, face-to-face interviews, document analysis and observation with 6 foundation phase teachers drawn from 3 different schools, 3 SBST coordinators, and 3 school principals. Data was analysed using the phenomenological data analysis method. Amongst the findings of the study is that South African full- service and mainstream schools have functional SBSTs which render formal and informal support to the teachers; this support varies in quality depending on the socio-economic status of the relevant community where the schools are situated. This paper, however, argues that what foundation phase teachers settled for as ‘support’ is flawed; as well as how they perceive the SBST and its role is problematic. The paper conclude by recommending that, the SBST should consider other approaches at foundation phase teacher support such as, empowering teachers with continuous practical experiences on how to deal with real classroom scenarios, as well as ensuring that all support, be it on academic or non-academic issues should be provided within a learning community framework where the teacher, family, SBST and where necessary, community organisations should harness their skills towards a common goal.

Keywords: foundation phase, full- service schools, inclusive education, learning difficulties, school-based support teams, teacher support

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311 Medial Temporal Tau Predicts Memory Decline in Cognitively Unimpaired Elderly

Authors: Angela T. H. Kwan, Saman Arfaie, Joseph Therriault, Zahra Azizi, Firoza Z. Lussier, Cecile Tissot, Mira Chamoun, Gleb Bezgin, Stijn Servaes, Jenna Stevenon, Nesrine Rahmouni, Vanessa Pallen, Serge Gauthier, Pedro Rosa-Neto

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Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [¹⁸F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the Translational Biomarkers in Aging and Dementia (TRIAD) study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau PET with [¹⁸F]-MK-6420 and Aβ PET with [¹⁸F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke, or other neurological disorders. There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEε4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive, and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [¹⁸F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12-month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = -0.52 (-0.82-0.21), p < 0.001, for dichotomized tau PET and -1.22 (-1.84-(-0.61)), p < 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T-, and A-T-, though it should be noted that the A-T+ group was small.Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [¹⁸F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [¹⁸F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of AD defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [¹⁸F]-MK-6420 PET provides us with the hope that living patients with AD may be diagnosed during the preclinical phase before it is too late.

Keywords: alzheimer’s disease, braak I-II, in vivo biomarkers, memory, PET, tau

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310 Servitization in Machine and Plant Engineering: Leveraging Generative AI for Effective Product Portfolio Management Amidst Disruptive Innovations

Authors: Till Gramberg

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In the dynamic world of machine and plant engineering, stagnation in the growth of new product sales compels companies to reconsider their business models. The increasing shift toward service orientation, known as "servitization," along with challenges posed by digitalization and sustainability, necessitates an adaptation of product portfolio management (PPM). Against this backdrop, this study investigates the current challenges and requirements of PPM in this industrial context and develops a framework for the application of generative artificial intelligence (AI) to enhance agility and efficiency in PPM processes. The research approach of this study is based on a mixed-method design. Initially, qualitative interviews with industry experts were conducted to gain a deep understanding of the specific challenges and requirements in PPM. These interviews were analyzed using the Gioia method, painting a detailed picture of the existing issues and needs within the sector. This was complemented by a quantitative online survey. The combination of qualitative and quantitative research enabled a comprehensive understanding of the current challenges in the practical application of machine and plant engineering PPM. Based on these insights, a specific framework for the application of generative AI in PPM was developed. This framework aims to assist companies in implementing faster and more agile processes, systematically integrating dynamic requirements from trends such as digitalization and sustainability into their PPM process. Utilizing generative AI technologies, companies can more quickly identify and respond to trends and market changes, allowing for a more efficient and targeted adaptation of the product portfolio. The study emphasizes the importance of an agile and reactive approach to PPM in a rapidly changing environment. It demonstrates how generative AI can serve as a powerful tool to manage the complexity of a diversified and continually evolving product portfolio. The developed framework offers practical guidelines and strategies for companies to improve their PPM processes by leveraging the latest technological advancements while maintaining ecological and social responsibility. This paper significantly contributes to deepening the understanding of the application of generative AI in PPM and provides a framework for companies to manage their product portfolios more effectively and adapt to changing market conditions. The findings underscore the relevance of continuous adaptation and innovation in PPM strategies and demonstrate the potential of generative AI for proactive and future-oriented business management.

Keywords: servitization, product portfolio management, generative AI, disruptive innovation, machine and plant engineering

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309 A Comparative Study of Environmental, Social and Economic Cross-Border Cooperation in Post-Conflict Environments: The Israel-Jordan Border

Authors: Tamar Arieli

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Cross-border cooperation has long been hailed as a means for stabilizing and normalizing relations between former enemies. Cooperation in problem-solving and realizing of local interests in post-conflict environments can indeed serve as a basis for developing dialogue and meaningful relations between neighbors across borders. Hence the potential for formerly sealed borders to serve as a basis for generating local and national perceptions of interdependence and as a buffer against the resume of conflict. Central questions which arise for policy-makers and third parties are how to facilitate cross-border cooperation and which areas of cooperation best serve to normalize post-conflict border regions. The Israel-Jordan border functions as a post-conflict border, in that it is a peaceful border since the 1994 Israel-Jordan peace treaty yet cross-border relations are defined but the highly securitized nature of the border region and the ongoing Arab-Israel regional conflict. This case study is based on long term qualitative research carried out in the border regions of both Israel and Jordan, which mapped and analyzed cross-border in a wide range of activities – social interactions sponsored by peace-facilitating NGOs, government sponsored agricultural cooperation, municipal initiated emergency planning in cross-border continuous urban settings, private cross-border business ventures and various environmental cooperative initiatives. These cooperative initiatives are evaluated through multiple interviews carried out with initiators and partners in cross-border cooperation as well as analysis of documentation, funding and media. These cooperative interactions are compared based on levels of cross-border local and official awareness and involvement as well as sustainability over time. This research identifies environmental cooperation as the most sustainable area of cross- border cooperation and as most conducive to generating perceptions of regional interdependence. This is a variation to the ‘New Middle East’ vision of business-based cooperation leading to conflict amelioration and regional stability. Environmental cooperation serving the public good rather than personal profit enjoys social legitimization even in the face of widespread anti-normalization sentiments common in the post-conflict environment. This insight is examined in light of philosophical and social aspects of the natural environment and its social perceptions. This research has theoretical implications for better understanding dynamics of cooperation and conflict, as well as practical ramifications for practitioners in border region policy and management.

Keywords: borders, cooperation, post-conflict, security

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308 The Development and Testing of a Small Scale Dry Electrostatic Precipitator for the Removal of Particulate Matter

Authors: Derek Wardle, Tarik Al-Shemmeri, Neil Packer

Abstract:

This paper presents a small tube/wire type electrostatic precipitator (ESP). In the ESPs present form, particle charging and collecting voltages and airflow rates were individually varied throughout 200 ambient temperature test runs ranging from 10 to 30 kV in increments on 5 kV and 0.5 m/s to 1.5 m/s, respectively. It was repeatedly observed that, at input air velocities of between 0.5 and 0.9 m/s and voltage settings of 20 kV to 30 kV, the collection efficiency remained above 95%. The outcomes of preliminary tests at combustion flue temperatures are, at present, inconclusive although indications are that there is little or no drop in comparable performance during ideal test conditions. A limited set of similar tests was carried out during which the collecting electrode was grounded, having been disconnected from the static generator. The collecting efficiency fell significantly, and for that reason, this approach was not pursued further. The collecting efficiencies during ambient temperature tests were determined by mass balance between incoming and outgoing dry PM. The efficiencies of combustion temperature runs are determined by analysing the difference in opacity of the flue gas at inlet and outlet compared to a reference light source. In addition, an array of Leit tabs (carbon coated, electrically conductive adhesive discs) was placed at inlet and outlet for a number of four-day continuous ambient temperature runs. Analysis of the discs’ contamination was carried out using scanning electron microscopy and ImageJ computer software that confirmed collection efficiencies of over 99% which gave unequivocal support to all the previous tests. The average efficiency for these runs was 99.409%. Emissions collected from a woody biomass combustion unit, classified to a diameter of 100 µm, were used in all ambient temperature trials test runs apart from two which collected airborne dust from within the laboratory. Sawdust and wood pellets were chosen for laboratory and field combustion trials. Video recordings were made of three ambient temperature test runs in which the smoke from a wood smoke generator was drawn through the precipitator. Although these runs were visual indicators only, with no objective other than to display, they provided a strong argument for the device’s claimed efficiency, as no emissions were visible at exit when energised.  The theoretical performance of ESPs, when applied to the geometry and configuration of the tested model, was compared to the actual performance and was shown to be in good agreement with it.

Keywords: electrostatic precipitators, air quality, particulates emissions, electron microscopy, image j

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307 Critical Analysis of International Protections for Children from Sexual Abuse and Examination of Indian Legal Approach

Authors: Ankita Singh

Abstract:

Sex trafficking and child pornography are those kinds of borderless crimes which can not be effectively prevented only through the laws and efforts of one country because it requires a proper and smooth collaboration among countries. Eradication of international human trafficking syndicates, criminalisation of international cyber offenders, and effective ban on child pornography is not possible without applying effective universal laws; hence, continuous collaboration of all countries is much needed to adopt and routinely update these universal laws. Congregation of countries on an international platform is very necessary from time to time, where they can simultaneously adopt international agendas and create powerful universal laws to prevent sex trafficking and child pornography in this modern digital era. In the past, some international steps have been taken through The Convention on the Rights of the Child (CRC) and through The Optional Protocol to the Convention on the Rights of the Child on the Sale of Children, Child Prostitution, and Child Pornography, but in reality, these measures are quite weak and are not capable in effectively protecting children from sexual abuse in this modern & highly advanced digital era. The uncontrolled growth of artificial intelligence (AI) and its misuse, lack of proper legal jurisdiction over foreign child abusers and difficulties in their extradition, improper control over international trade of digital child pornographic content, etc., are some prominent issues which can only be controlled through some new, effective and powerful universal laws. Due to a lack of effective international standards and a lack of improper collaboration among countries, Indian laws are also not capable of taking effective actions against child abusers. This research will be conducted through both doctrinal as well as empirical methods. Various literary sources will be examined, and a questionnaire survey will be conducted to analyse the effectiveness of international standards and Indian laws against child pornography. Participants in this survey will be Indian University students. In this work, the existing international norms made for protecting children from sexual abuse will be critically analysed. It will explore why effective and strong collaboration between countries is required in modern times. It will be analysed whether existing international steps are enough to protect children from getting trafficked or being subjected to pornography, and if these steps are not found to be sufficient enough, then suggestions will be given on how international standards and protections can be made more effective and powerful in this digital era. The approach of India towards the existing international standards, the Indian laws to protect children from being subjected to pornography, and the contributions & capabilities of India in strengthening the international standards will also be analysed.

Keywords: child pornography, prevention of children from sexual offences act, the optional protocol to the convention on the rights of the child on the sale of children, child prostitution and child pornography, the convention on the rights of the child

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306 A Quadratic Model to Early Predict the Blastocyst Stage with a Time Lapse Incubator

Authors: Cecile Edel, Sandrine Giscard D'Estaing, Elsa Labrune, Jacqueline Lornage, Mehdi Benchaib

Abstract:

Introduction: The use of incubator equipped with time-lapse technology in Artificial Reproductive Technology (ART) allows a continuous surveillance. With morphocinetic parameters, algorithms are available to predict the potential outcome of an embryo. However, the different proposed time-lapse algorithms do not take account the missing data, and then some embryos could not be classified. The aim of this work is to construct a predictive model even in the case of missing data. Materials and methods: Patients: A retrospective study was performed, in biology laboratory of reproduction at the hospital ‘Femme Mère Enfant’ (Lyon, France) between 1 May 2013 and 30 April 2015. Embryos (n= 557) obtained from couples (n=108) were cultured in a time-lapse incubator (Embryoscope®, Vitrolife, Goteborg, Sweden). Time-lapse incubator: The morphocinetic parameters obtained during the three first days of embryo life were used to build the predictive model. Predictive model: A quadratic regression was performed between the number of cells and time. N = a. T² + b. T + c. N: number of cells at T time (T in hours). The regression coefficients were calculated with Excel software (Microsoft, Redmond, WA, USA), a program with Visual Basic for Application (VBA) (Microsoft) was written for this purpose. The quadratic equation was used to find a value that allows to predict the blastocyst formation: the synthetize value. The area under the curve (AUC) obtained from the ROC curve was used to appreciate the performance of the regression coefficients and the synthetize value. A cut-off value has been calculated for each regression coefficient and for the synthetize value to obtain two groups where the difference of blastocyst formation rate according to the cut-off values was maximal. The data were analyzed with SPSS (IBM, Il, Chicago, USA). Results: Among the 557 embryos, 79.7% had reached the blastocyst stage. The synthetize value corresponds to the value calculated with time value equal to 99, the highest AUC was then obtained. The AUC for regression coefficient ‘a’ was 0.648 (p < 0.001), 0.363 (p < 0.001) for the regression coefficient ‘b’, 0.633 (p < 0.001) for the regression coefficient ‘c’, and 0.659 (p < 0.001) for the synthetize value. The results are presented as follow: blastocyst formation rate under cut-off value versus blastocyst rate formation above cut-off value. For the regression coefficient ‘a’ the optimum cut-off value was -1.14.10-3 (61.3% versus 84.3%, p < 0.001), 0.26 for the regression coefficient ‘b’ (83.9% versus 63.1%, p < 0.001), -4.4 for the regression coefficient ‘c’ (62.2% versus 83.1%, p < 0.001) and 8.89 for the synthetize value (58.6% versus 85.0%, p < 0.001). Conclusion: This quadratic regression allows to predict the outcome of an embryo even in case of missing data. Three regression coefficients and a synthetize value could represent the identity card of an embryo. ‘a’ regression coefficient represents the acceleration of cells division, ‘b’ regression coefficient represents the speed of cell division. We could hypothesize that ‘c’ regression coefficient could represent the intrinsic potential of an embryo. This intrinsic potential could be dependent from oocyte originating the embryo. These hypotheses should be confirmed by studies analyzing relationship between regression coefficients and ART parameters.

Keywords: ART procedure, blastocyst formation, time-lapse incubator, quadratic model

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305 Exploring the Correlation between Population Distribution and Urban Heat Island under Urban Data: Taking Shenzhen Urban Heat Island as an Example

Authors: Wang Yang

Abstract:

Shenzhen is a modern city of China's reform and opening-up policy, the development of urban morphology has been established on the administration of the Chinese government. This city`s planning paradigm is primarily affected by the spatial structure and human behavior. The subjective urban agglomeration center is divided into several groups and centers. In comparisons of this effect, the city development law has better to be neglected. With the continuous development of the internet, extensive data technology has been introduced in China. Data mining and data analysis has become important tools in municipal research. Data mining has been utilized to improve data cleaning such as receiving business data, traffic data and population data. Prior to data mining, government data were collected by traditional means, then were analyzed using city-relationship research, delaying the timeliness of urban development, especially for the contemporary city. Data update speed is very fast and based on the Internet. The city's point of interest (POI) in the excavation serves as data source affecting the city design, while satellite remote sensing is used as a reference object, city analysis is conducted in both directions, the administrative paradigm of government is broken and urban research is restored. Therefore, the use of data mining in urban analysis is very important. The satellite remote sensing data of the Shenzhen city in July 2018 were measured by the satellite Modis sensor and can be utilized to perform land surface temperature inversion, and analyze city heat island distribution of Shenzhen. This article acquired and classified the data from Shenzhen by using Data crawler technology. Data of Shenzhen heat island and interest points were simulated and analyzed in the GIS platform to discover the main features of functional equivalent distribution influence. Shenzhen is located in the east-west area of China. The city’s main streets are also determined according to the direction of city development. Therefore, it is determined that the functional area of the city is also distributed in the east-west direction. The urban heat island can express the heat map according to the functional urban area. Regional POI has correspondence. The research result clearly explains that the distribution of the urban heat island and the distribution of urban POIs are one-to-one correspondence. Urban heat island is primarily influenced by the properties of the underlying surface, avoiding the impact of urban climate. Using urban POIs as analysis object, the distribution of municipal POIs and population aggregation are closely connected, so that the distribution of the population corresponded with the distribution of the urban heat island.

Keywords: POI, satellite remote sensing, the population distribution, urban heat island thermal map

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