Search results for: timing offset
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 497

Search results for: timing offset

197 Crafting a Livelihood: A Story of the Kotpad Dyers and Weavers

Authors: Anahita Suri

Abstract:

Craft -an integral part of the conduit to create something beautiful- is a visual representation of the human imagination given life through the hand. The Mirgan tribe in the Naxalite infested forests of Koraput, Odisha are not exempt from this craving for beauty. These skilled craftsmen dye and weave the simple yet sophisticated Kotpad textiles. The women undertake the time-consuming task of dyeing the cotton and silk yarns with the root of the aul tree. The men then weave these yarns into beautiful sarees and dupattas. The root of the aul tree lends the textile its maroon to brown color, which is offset against the unbleached cotton to create a minimalist and distinctive look. The motifs, incorporated through the extra weft technique, reflect the rich tribal heritage of the community. This is an eco-friendly, non-toxic textile. Kotpad fabrics were on the verge of extinction due to various factors like poor infrastructure, no innovation in traditional designs/products, customer ignorance leading to low demand. With livelihood opportunities through craft slowly dwindling, artisans were moving to alternative sources of income generation, like agriculture and daily wage labor. There was an urgent need for intervention to revive the craft, spread awareness about them in urban spaces, and strengthen the artisan’s ability to innovate and create. Recent efforts by government bodies and local designers have given Kotpad handloom a contemporary look without diluting its essence. This research explores the possibilities to leverage Kotpad handloom to find a place in the dynamic culture of the world by its promotion among different target groups and incorporating self-sustaining practices for the artisans. This could further encourage a space for handmade and handcrafted art, rich with stories about India, with a contemporary visual sensibility. This will strengthen environmental and ethical sustainability.

Keywords: craft, contemporary, handloom, natural dye, tribal

Procedia PDF Downloads 145
196 Navigating the Nexus of HIV/AIDS Care: Leveraging Statistical Insight to Transform Clinical Practice and Patient Outcomes

Authors: Nahashon Mwirigi

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The management of HIV/AIDS is a global challenge, demanding precise tools to predict disease progression and guide tailored treatment. CD4 cell count dynamics, a crucial immune function indicator, play an essential role in understanding HIV/AIDS progression and enhancing patient care through effective modeling. While several models assess disease progression, existing methods often fall short in capturing the complex, non-linear nature of HIV/AIDS, especially across diverse demographics. A need exists for models that balance predictive accuracy with clinical applicability, enabling individualized care strategies based on patient-specific progression rates. This study utilizes patient data from Kenyatta National Hospital (2003–2014) to model HIV/AIDS progression across six CD4-defined states. The Exponential, 2-Parameter Weibull, and 3-Parameter Weibull models are employed to analyze failure rates and explore progression patterns by age and gender. Model selection is based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to identify models best representing disease progression variability across demographic groups. The 3-Parameter Weibull model emerges as the most effective, accurately capturing HIV/AIDS progression dynamics, particularly by incorporating delayed progression effects. This model reflects age and gender-specific variations, offering refined insights into patient trajectories and facilitating targeted interventions. One key finding is that older patients progress more slowly through CD4-defined stages, with a delayed onset of advanced stages. This suggests that older patients may benefit from extended monitoring intervals, allowing providers to optimize resources while maintaining consistent care. Recognizing slower progression in this demographic helps clinicians reduce unnecessary interventions, prioritizing care for faster-progressing groups. Gender-based analysis reveals that female patients exhibit more consistent progression, while male patients show greater variability. This highlights the need for gender-specific treatment approaches, as men may require more frequent assessments and adaptive treatment plans to address their variable progression. Tailoring treatment by gender can improve outcomes by addressing distinct risk patterns in each group. The model’s ability to account for both accelerated and delayed progression equips clinicians with a robust tool for estimating the duration of each disease stage. This supports individualized treatment planning, allowing clinicians to optimize antiretroviral therapy (ART) regimens based on demographic factors and expected disease trajectories. Aligning ART timing with specific progression patterns can enhance treatment efficacy and adherence. The model also has significant implications for healthcare systems, as its predictive accuracy enables proactive patient management, reducing the frequency of advanced-stage complications. For resource limited providers, this capability facilitates strategic intervention timing, ensuring that high-risk patients receive timely care while resources are allocated efficiently. Anticipating progression stages enhances both patient care and resource management, reinforcing the model’s value in supporting sustainable HIV/AIDS healthcare strategies. This study underscores the importance of models that capture the complexities of HIV/AIDS progression, offering insights to guide personalized, data-informed care. The 3-Parameter Weibull model’s ability to accurately reflect delayed progression and demographic risk variations presents a valuable tool for clinicians, supporting the development of targeted interventions and resource optimization in HIV/AIDS management.

Keywords: HIV/AIDS progression, 3-parameter Weibull model, CD4 cell count stages, antiretroviral therapy, demographic-specific modeling

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195 Ecosystem Engineering Strengthens Bottom-Up and Weakens Top-Down Effects via Trait-Mediated Indirect Interactions

Authors: Zhiwei Zhong, Xiaofei Li, Deli Wang

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Ecosystem engineering is a powerful force shaping community structure and ecosystem function. Yet, very little is known about the mechanisms by which engineers affect vital ecosystem processes like trophic interactions. Here, we examine the potential for a herbivore ecosystem engineer, domestic sheep, to affect trophic interactions between the web-building spider Argiope bruennichi, its grasshopper prey Euchorthippus spp., and the grasshoppers’ host plant Leymus chinensis. By integrating small- and large-scale field experiments, we demonstrate that: 1) moderate sheep grazing changed the structure of plant communities by suppressing strongly interacting forbs within a grassland matrix; 2) this change in plant community structure drove interaction modifications between the grasshoppers and their grass host plants and between grasshoppers and their spider predators, and 3) these interaction modifications were entirely mediated by plasticity in grasshopper behavior. Overall, ecosystem engineering by sheep grazing strengthened bottom-up effects and weakened top-down effects via trait-mediated interactions, resulting in a nearly two-fold increase in grasshopper densities. Interestingly, the grasshopper behavioral shifts which reduced spider per capita predation rates in the microcosms did not translate to reduced spider predation rates at the larger system scale because increased grasshopper densities offset behavioral effects at larger scales. Our findings demonstrate that 1) ecosystem engineering can strongly alter trophic interactions, 2) such effects can be driven by cryptic trait-mediated interactions, and 3) the relative importance of trait- versus density effects as measured by microcosm experiments may not reflect the importance of these processes at realistic ecological scales due to scale-dependent interactions.

Keywords: bottom-up effects, ecosystem engineering, trait-mediated indirect effects, top-down effects

Procedia PDF Downloads 355
194 Multi-Objective Optimization of Intersections

Authors: Xiang Li, Jian-Qiao Sun

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As the crucial component of city traffic network, intersections have significant impacts on urban traffic performance. Despite of the rapid development in transportation systems, increasing traffic volumes result in severe congestions especially at intersections in urban areas. Effective regulation of vehicle flows at intersections has always been an important issue in the traffic control system. This study presents a multi-objective optimization method at intersections with cellular automata to achieve better traffic performance. Vehicle conflicts and pedestrian interference are considered. Three categories of the traffic performance are studied including transportation efficiency, energy consumption and road safety. The left-turn signal type, signal timing and lane assignment are optimized for different traffic flows. The multi-objective optimization problem is solved with the cell mapping method. The optimization results show the conflicting nature of different traffic performance. The influence of different traffic variables on the intersection performance is investigated. It is observed that the proposed optimization method is effective in regulating the traffic at the intersection to meet multiple objectives. Transportation efficiency can be usually improved by the permissive left-turn signal, which sacrifices safety. Right-turn traffic suffers significantly when the right-turn lanes are shared with the through vehicles. The effect of vehicle flow on the intersection performance is significant. The display pattern of the optimization results can be changed remarkably by the traffic volume variation. Pedestrians have strong interference with the traffic system.

Keywords: cellular automata, intersection, multi-objective optimization, traffic system

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193 Timetabling for Interconnected LRT Lines: A Package Solution Based on a Real-world Case

Authors: Huazhen Lin, Ruihua Xu, Zhibin Jiang

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In this real-world case, timetabling the LRT network as a whole is rather challenging for the operator: they are supposed to create a timetable to avoid various route conflicts manually while satisfying a given interval and the number of rolling stocks, but the outcome is not satisfying. Therefore, the operator adopts a computerised timetabling tool, the Train Plan Maker (TPM), to cope with this problem. However, with various constraints in the dual-line network, it is still difficult to find an adequate pairing of turnback time, interval and rolling stocks’ number, which requires extra manual intervention. Aiming at current problems, a one-off model for timetabling is presented in this paper to simplify the procedure of timetabling. Before the timetabling procedure starts, this paper presents how the dual-line system with a ring and several branches is turned into a simpler structure. Then, a non-linear programming model is presented in two stages. In the first stage, the model sets a series of constraints aiming to calculate a proper timing for coordinating two lines by adjusting the turnback time at termini. Then, based on the result of the first stage, the model introduces a series of inequality constraints to avoid various route conflicts. With this model, an analysis is conducted to reveal the relation between the ratio of trains in different directions and the possible minimum interval, observing that the more imbalance the ratio is, the less possible to provide frequent service under such strict constraints.

Keywords: light rail transit (LRT), non-linear programming, railway timetabling, timetable coordination

Procedia PDF Downloads 87
192 Time to CT in Major Trauma in Coffs Harbour Health Campus - The Australian Rural Centre Experience

Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

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Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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191 Aerobic Exercise Increases Circulating Hematopoietic Stem Cells and Endothelial Progenitor Cells

Authors: Khaled A. shady, Fagr B. Bazeed, Nashwa K. Abousamra, Ihab H. Elberawe, Ashraf E. shaalan, Mohamed A. Sobh

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Physical activity activates a variety of adult stem cells which might be released into the circulation or might be activated in their organ-resident state. A variety of stimuli such as metabolic, mechanical, and hormonal stimuli might by responsible for the mobilization. This study was done to know the changes in hematopoietic stem cells and endothelial progenitor in athletes in the 24 hours following 30 min of aerobic exercise. Methods: Ten healthy male's athlete's (age 20.7± 0.61 y) performed moderate running with 30 min at 80% of velocity of The IAT. Blood samples taken pre-, and immediately, 30 min, 2h, 6h and 24h post-exercise were analyzed for hematopoietic stem cells (HSCs ), endothelial progenitor cells (EPCs(, vascular endothelial growth factor (VEGF), nitric oxide (NO), lactic acid (LA), and white blood cells . HSCs and EPCs were quantified by flow cytometry. Results: After 30min of aerobic exercise significant increases in HSCs, EPC, VEGF, NO, LA and WBCs (p ˂ 0.05). This increase will be at different rates according to the timing of taking blood sample and was in the maximum rate of increase after 30 min of aerobic exercise. HSCs, EPC, NO and WBCs were in the maximum rate of increase 2h post exercise. In addition, VEGF was in the maximum rate of increase immediately post exercise and LA concentration not affected after exercise. Conclusion: These data suggest that HSCs and EPCs increased after aerobic exercise due to increase of VEGF which play an important role in mobilization of stem cells and promotes NO increase which contributes to increase EPCs.

Keywords: physical activity, hematopoietic stem cells, mobilization, athletes

Procedia PDF Downloads 117
190 The Effect of a 12 Week Rhythmic Movement Intervention on Selected Biomotor Abilities on Academy Rugby Players

Authors: Jocelyn Solomons, Kraak

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Rhythmic movement, also referred to as “dance”, involves the execution of different motor skills as well as the integration and sequencing of actions between limbs, timing and spatial precision. The aim of this study was therefore to investigate and compare the effect of a 16-week rhythmic movement intervention on flexibility, dynamic balance, agility, power and local muscular endurance of academy rugby players in the Western Cape, according to positional groups. Players (N ¼ 54) (age 18.66 0.81 years; height 1.76 0.69 cm; weight 76.77 10.69 kg), were randomly divided into a treatment-control [TCA] (n ¼ 28) and a control-treatment [CTB] (n ¼ 26) group. In this crossover experimental design, the interaction effect of the treatment order and the treatment time between the TCA and CTB group, was determined. Results indicated a statistically significant improvement (p < 0.05) in agility2 (p ¼ 0.06), power2 (p ¼ 0.05), local muscular endurance1 (p ¼ 0.01) & 3 (p ¼ 0.01) and dynamic balance (p < 0.01). Likewise, forwards and backs also showed statistically significant improvements (p < 0.05) per positional groups. Therefore, a rhythmic movement intervention has the potential to improve rugby-specific bio-motor skills and furthermore, improve positional specific skills should it be designed with positional groups in mind. Future studies should investigate, not only the effect of rhythmic movement on improving specific rugby bio-motor skills, but the potential of its application as an alternative training method during off- season (or detraining phases) or as a recovery method.

Keywords: agility, dance, dynamic balance, flexibility, local muscular endurance, power, training

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189 Forecasting Equity Premium Out-of-Sample with Sophisticated Regression Training Techniques

Authors: Jonathan Iworiso

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Forecasting the equity premium out-of-sample is a major concern to researchers in finance and emerging markets. The quest for a superior model that can forecast the equity premium with significant economic gains has resulted in several controversies on the choice of variables and suitable techniques among scholars. This research focuses mainly on the application of Regression Training (RT) techniques to forecast monthly equity premium out-of-sample recursively with an expanding window method. A broad category of sophisticated regression models involving model complexity was employed. The RT models include Ridge, Forward-Backward (FOBA) Ridge, Least Absolute Shrinkage and Selection Operator (LASSO), Relaxed LASSO, Elastic Net, and Least Angle Regression were trained and used to forecast the equity premium out-of-sample. In this study, the empirical investigation of the RT models demonstrates significant evidence of equity premium predictability both statistically and economically relative to the benchmark historical average, delivering significant utility gains. They seek to provide meaningful economic information on mean-variance portfolio investment for investors who are timing the market to earn future gains at minimal risk. Thus, the forecasting models appeared to guarantee an investor in a market setting who optimally reallocates a monthly portfolio between equities and risk-free treasury bills using equity premium forecasts at minimal risk.

Keywords: regression training, out-of-sample forecasts, expanding window, statistical predictability, economic significance, utility gains

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188 Did Chilling Injury of Rice Decrease under Climate Warming? A Case Study in Northeast China

Authors: Fengmei Yao, Pengcheng Qin, Jiahua Zhang, Min Liu

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Global warming is expected to reduce the risk of low temperature stress in rice grown in temperate regions, but this impact has not been well verified by empirical studies directly on chilling injury in rice. In this study, a case study in Northeast China was presented to investigate whether the frequencies of chilling injury declined as a result of climate change, in comprehensive consideration of the potential effects from autonomous adaptation of rice production in response to climate change, such as shifts in cultivation timing and rice cultivars. It was found that frequency of total chilling injury (either delayed-growth type or sterile-type in a year) decreased but only to a limit extent in the context of climate change, mainly owing to a pronounced decrease in frequency of the delayed-growth chilling injury, while there was no overwhelming decreasing tendency for frequency of the sterile-type chilling injury, rather, it even increased considerably for some regions. If changes in cultivars had not occurred, risks of chilling injury of both types would have been much lower, specifically for the sterile-type chilling injury for avoiding deterioration in chilling sensitivity of rice cultivars. In addition, earlier planting helped lower the risk of chilling injury but still can not overweight the effects of introduction of new cultivars. It was concluded that risks of chilling injury in rice would not necessarily decrease as a result of climate change, considering the accompanying adaptation process may increase the chilling sensitivity of rice production system in a warmer climate conditions, and thus precautions should still be taken.

Keywords: chilling injury, rice, CERES-rice model, climate warming, North east China

Procedia PDF Downloads 334
187 Inducing Flow Experience in Mobile Learning: An Experiment Using a Spanish Learning Mobile Application

Authors: S. Jonsson, D. Millard, C. Bokhove

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Smartphones are ubiquitous and frequently used as learning tools, which makes the design of educational apps an important area of research. A key issue is designing apps to encourage engagement while maintaining a focus on the educational aspects of the app. Flow experience is a promising method for addressing this issue, which refers to a mental state of cognitive absorption and positive emotion. Flow experience has been shown to be associated with positive emotion and increased learning performance. Studies have shown that immediate feedback is an antecedent to Flow. This experiment investigates the effect of immediate feedback on Flow experience. An app teaching Spanish phrases was developed, and 30 participants completed both a 10min session with immediate feedback and a 10min session with delayed feedback. The app contained a task where the user assembles Spanish phrases by pressing bricks with Spanish words. Immediate feedback was implemented by incorrect bricks recoiling, while correct brick moved to form part of the finished phrase. In the delayed feedback condition, the user did not know if the bricks they pressed were correct until the phrase was complete. The level of Flow experienced by the participants was measured after each session using the Flow Short Scale. The results showed that higher levels of Flow were experienced in the immediate feedback session. It was also found that 14 of the participants indicated that the demands of the task were ‘just right’ in the immediate feedback session, while only one did in the delayed feedback session. These results have implications for how to design educational technology and opens up questions for how Flow experience can be used to increase performance and engagement.

Keywords: feedback timing, flow experience, L2 language learning, mobile learning

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186 A Carrier Phase High Precision Ranging Theory Based on Frequency Hopping

Authors: Jie Xu, Zengshan Tian, Ze Li

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Previous indoor ranging or localization systems achieving high accuracy time of flight (ToF) estimation relied on two key points. One is to do strict time and frequency synchronization between the transmitter and receiver to eliminate equipment asynchronous errors such as carrier frequency offset (CFO), but this is difficult to achieve in a practical communication system. The other one is to extend the total bandwidth of the communication because the accuracy of ToF estimation is proportional to the bandwidth, and the larger the total bandwidth, the higher the accuracy of ToF estimation obtained. For example, ultra-wideband (UWB) technology is implemented based on this theory, but high precision ToF estimation is difficult to achieve in common WiFi or Bluetooth systems with lower bandwidth compared to UWB. Therefore, it is meaningful to study how to achieve high-precision ranging with lower bandwidth when the transmitter and receiver are asynchronous. To tackle the above problems, we propose a two-way channel error elimination theory and a frequency hopping-based carrier phase ranging algorithm to achieve high accuracy ranging under asynchronous conditions. The two-way channel error elimination theory uses the symmetry property of the two-way channel to solve the asynchronous phase error caused by the asynchronous transmitter and receiver, and we also study the effect of the two-way channel generation time difference on the phase according to the characteristics of different hardware devices. The frequency hopping-based carrier phase ranging algorithm uses frequency hopping to extend the equivalent bandwidth and incorporates a carrier phase ranging algorithm with multipath resolution to achieve a ranging accuracy comparable to that of UWB at 400 MHz bandwidth in the typical 80 MHz bandwidth of commercial WiFi. Finally, to verify the validity of the algorithm, we implement this theory using a software radio platform, and the actual experimental results show that the method proposed in this paper has a median ranging error of 5.4 cm in the 5 m range, 7 cm in the 10 m range, and 10.8 cm in the 20 m range for a total bandwidth of 80 MHz.

Keywords: frequency hopping, phase error elimination, carrier phase, ranging

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185 The Impact of Covid-19 Pandemic on Acute Urology Admissions in a Busy District General Hospital in the UK

Authors: D. Bheenick, M. Young, M.Elmussareh, A.Ali

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Objective: Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. Patient and methods: Retrospective data of patients presenting acutely to the urology department was collected between 13th January to 22nd March 2020 (pre-lockdown period) and 23rd March to 31st May 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Results: 1092 patients were included in the study. An overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. Conclusion: The admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

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184 Optical Analysis of the Plasmon Resonances of Gold Nano-Ring

Authors: Mehrnaz Mostafavi

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The current research aims to explore a method for creating nano-ring structures through chemical reduction. By employing a direct reduction process at a controlled, slow pace, and concurrently introducing specific reduction agents, the goal is to fabricate these unique nano-ring formations. The deliberate slow reduction of nanoparticles within this process helps prevent spatial hindrances caused by the reduction agents. The timing of the reduction of metal atoms, facilitated by these agents, emerges as a crucial factor influencing the creation of nano-ring structures. In investigation involves a chemical approach utilizing bovine serum albumin and human serum albumin as organic reducing agents to produce gold nano-rings. The controlled reduction of metal atoms at a slow pace and under specific pH conditions plays a pivotal role in the successful fabrication of these nanostructures. Optical spectroscopic analyses revealed distinctive plasmonic behavior in both visible and infrared spectra, owing to the collective movement of electrons along the inner and outer walls of the gold nano-rings. Importantly, these ring-shaped nanoparticles exhibit customizable plasmon resonances in the near-infrared spectrum, a characteristic absent in solid particles of similar sizes. This unique attribute makes the generated samples valuable for applications in Nanomedicine and Nanobiotechnology, leveraging the distinct optical properties of these nanostructures.

Keywords: nano-ring structure, nano-particles, reductant agents, plasmon resonace

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183 Effects of Virtual Reality on Relieving Postoperative Pain in Surgical Patients: A Systematic Review and Meta-Analysis

Authors: Lingyu Ding, Hongxia Hua, Hanfei Zhu, Jinling Lu, Qin Xu

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Background: Postoperative pain is a prevalent problem leading to many adverse outcomes in surgical patients. Virtual reality (VR) is an emerging non-pharmacological method of postoperative pain relief, but the effects of it are not clear. This review aimed to explore the effects of VR on relieving postoperative pain. Methods: We searched PubMed, Embase, Web of Science, and other databases from inception to November 2019 to get the eligible studies. Meta-analyses were conducted to compare VR and usual care for relieving postoperative pain. Subgroup analyses and sensitivity analyses were performed to explain the heterogeneity. Results: Overall, 8 randomized control trials (RCTs) enrolling 723 participants were included. Our results demonstrated that the patients receiving the VR intervention had lower postoperative pain scores than those receiving the usual care. One subgroup analysis revealed that VR could relieve postoperative pain both in minor surgery and major surgery. Another subgroup analysis demonstrated a significant reduction in postoperative pain among patients receiving VR during the intraoperative and the postoperative periods. However, there was no significant postoperative pain relief when receiving VR during the preoperative period. Additionally, significant improvements in postoperative satisfaction were reported in two studies. However, another two studies included found that VR could not affect physiological parameters related to pain. Conclusion: Applying VR can relieve postoperative pain effectively. The type of surgery and timing of using VR are the main sources of heterogeneity. More rigorous studies about the relationship between VR and postoperative pain relief will be needed.

Keywords: meta-analysis, postoperative pain, systematic review, virtual reality

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182 Numerical Investigation of Fluid Outflow through a Retinal Hole after Scleral Buckling

Authors: T. Walczak, J. K. Grabski, P. Fritzkowski, M. Stopa

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Objectives of the study are i) to perform numerical simulations that permit an analysis of the dynamics of subretinal fluid when an implant has induced scleral intussusception and ii) assess the impact of the physical parameters of the model on the flow rate. Computer simulations were created using finite element method (FEM) based on a model that takes into account the interaction of a viscous fluid (subretinal fluid) with a hyperelastic body (retina). The purpose of the calculation was to investigate the dependence of the flow rate of subretinal fluid through a hole in the retina on different factors such as viscosity of subretinal fluid, material parameters of the retina, and the offset of the implant from the retina’s hole. These simulations were performed for different speeds of eye movement that reflect the behavior of the eye when reading, REM, and saccadic movements. Similar to other works in the field of subretinal fluid flow, it was assumed stationary, single sided, forced fluid flow in the considered area simulating the subretinal space. Additionally, a hyperelastic material model of the retina and parameterized geometry of the considered model was adopted. The calculations also examined the influence the direction of the force of gravity due to the position of the patient’s head on the trend of outflow of fluid. The simulations revealed that fluid outflow from the retina becomes significant with eyeball movement speed of 100°/sec. This speed is greater than in the case of reading but is four times less than saccadic movement. The increase of viscosity of the fluid increased beneficial effect. Further, the simulation results suggest that moderate eye movement speed is optimal and that the conventional prescription of the avoidance of routine eye movement following retinal detachment surgery should be relaxed. Additionally, to verify numerical results, some calculations were repeated with use of meshless method (method of fundamental solutions), which is relatively fast and easy to implement. The paper has been supported by 02/21/DSPB/3477 grant.

Keywords: CFD simulations, FEM analysis, meshless method, retinal detachment

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181 Comparison of Donor Motivations in National Collegiate Athletic Association Division I vs Division II

Authors: Soojin Kim, Yongjae Kim

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Continuous economic downturn and ongoing budget cuts poses higher education with profound challenges which has a direct impact on the collegiate athletic programs. In response to the ever-changing landscape of the fiscal environment, universities seek to boost revenues, resorting to alternative sources of funding. In particular, athletic programs have become increasingly dependent on financial support from their alumni and boosters, which is how athletic departments attempt to offset budget shortfalls and make capital improvements. Although there currently exists three major divisions within National Collegiate Athletic Association (NCAA), the majority of the sport management studies on college sport tend to focus on Division I level. Particularly within the donor motivation literature, a plethora of donor motivation studies exist, but mainly on NCAA Division I athletic programs. Since each athletic department functions differently in a number of different dimensions, while institutional difference can also have a huge impact on athletic donor motivations, the current study attempts to fill this gap that exists in the literature. As such, the purpose of this study was to (I) reexamine the factor structure of the Athletic Donor motivation scale; and (II) identify the prominent athletic donor motives in a NCAA Division II athletic program. For the purpose of this study, a total of 232 actual donors were used for analysis. A confirmatory factor analysis (CFA) was employed to test construct validity, and the reliability of the scale was assessed using Composite Reliability. To identify the prominent motivational factors, the means and standard deviations were examined. Results of this study indicated that Vicarious Achievement, Philanthropy, and Commitment are the three primary motivational factors, while Tangible Benefits, was consistently found as an important motive in prior studies was found low. Such findings highlight the key difference and suggest different salient motivations exist that are specific to the context.

Keywords: college athletics, donor, motivation, NCAA

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180 A Comparative Analysis of Various Companding Techniques Used to Reduce PAPR in VLC Systems

Authors: Arushi Singh, Anjana Jain, Prakash Vyavahare

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Recently, Li-Fi(light-fiedelity) has been launched based on VLC(visible light communication) technique, 100 times faster than WiFi. Now 5G mobile communication system is proposed to use VLC-OFDM as the transmission technique. The VLC system focused on visible rays, is considered for efficient spectrum use and easy intensity modulation through LEDs. The reason of high speed in VLC is LED, as they flicker incredibly fast(order of MHz). Another advantage of employing LED is-it acts as low pass filter results no out-of-band emission. The VLC system falls under the category of ‘green technology’ for utilizing LEDs. In present scenario, OFDM is used for high data-rates, interference immunity and high spectral efficiency. Inspite of the advantages OFDM suffers from large PAPR, ICI among carriers and frequency offset errors. Since, the data transmission technique used in VLC system is OFDM, the system suffers the drawbacks of OFDM as well as VLC, the non-linearity dues to non-linear characteristics of LED and PAPR of OFDM due to which the high power amplifier enters in non-linear region. The proposed paper focuses on reduction of PAPR in VLC-OFDM systems. Many techniques are applied to reduce PAPR such as-clipping-introduces distortion in the carrier; selective mapping technique-suffers wastage of bandwidth; partial transmit sequence-very complex due to exponentially increased number of sub-blocks. The paper discusses three companding techniques namely- µ-law, A-law and advance A-law companding technique. The analysis shows that the advance A-law companding techniques reduces the PAPR of the signal by adjusting the companding parameter within the range. VLC-OFDM systems are the future of the wireless communication but non-linearity in VLC-OFDM is a severe issue. The proposed paper discusses the techniques to reduce PAPR, one of the non-linearities of the system. The companding techniques mentioned in this paper provides better results without increasing the complexity of the system.

Keywords: non-linear companding techniques, peak to average power ratio (PAPR), visible light communication (VLC), VLC-OFDM

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179 The Patterns of Cross-Sentence: An Event-Related Potential Study of Mathematical Word Problem

Authors: Tien-Ching Yao, Ching-Ching Lu

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Understanding human language processing is one of the main challenges of current cognitive neuroscience. The aims of the present study were to use a sentence decision task combined with event-related potentials to investigate the psychological reality of "cross-sentence patterns." Therefore, we take the math word problems the experimental materials and use the ERPs' P600 component to verify. In this study, the experimental material consisted of 200 math word problems with three different conditions were used ( multiplication word problems、division word problems type 1、division word problems type 2 ). Eighteen Mandarin native speakers participated in the ERPs study (14 of whom were female). The result of the grand average waveforms suggests a later posterior positivity at around 500ms - 900ms. These findings were tested statistically using repeated measures ANOVAs at the component caused by the stimulus type of different questions. Results suggest that three conditions present significant (P < 0.05) on the Mean Amplitude, Latency, and Peak Amplitude. The result showed the characteristic timing and posterior scalp distribution of a P600 effect. We interpreted these characteristic responses as the psychological reality of "cross-sentence patterns." These results provide insights into the sentence processing issues in linguistic theory and psycholinguistic models of language processing and advance our understanding of how people make sense of information during language comprehension.

Keywords: language processing, sentence comprehension, event-related potentials, cross-sentence patterns

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178 Overview of Pre-Analytical Lab Errors in a Tertiary Care Hospital at Rawalpindi, Pakistan

Authors: S. Saeed, T. Butt, M. Rehan, S. Khaliq

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Objective: To determine the frequency of pre-analytical errors in samples taken from patients for various lab tests at Fauji Foundation Hospital, Rawalpindi. Material and Methods: All the lab specimens for diagnostic purposes received at the lab from Fauji Foundation hospital, Rawalpindi indoor and outdoor patients were included. Total number of samples received in the lab is recorded in the computerized program made for the hospital. All the errors observed for pre-analytical process including patient identification, sampling techniques, test collection procedures, specimen transport/processing and storage were recorded in the log book kept for the purpose. Results: A total of 476616 specimens were received in the lab during the period of study including 237931 and 238685 from outdoor and indoor patients respectively. Forty-one percent of the samples (n=197976) revealed pre-analytical discrepancies. The discrepancies included Hemolyzed samples (34.8%), Clotted blood (27.8%), Incorrect samples (17.4%), Unlabeled samples (8.9%), Insufficient specimens (3.9%), Request forms without authorized signature (2.9%), Empty containers (3.9%) and tube breakage during centrifugation (0.8%). Most of these pre-analytical discrepancies were observed in samples received from the wards revealing that inappropriate sample collection by the medical staff of the ward, as most of the outdoor samples are collected by the lab staff who are properly trained for sample collection. Conclusion: It is mandatory to educate phlebotomists and paramedical staff particularly performing duties in the wards regarding timing and techniques of sampling/appropriate container to use/early delivery of the samples to the lab to reduce pre-analytical errors.

Keywords: pre analytical lab errors, tertiary care hospital, hemolyzed, paramedical staff

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177 Ecosystem Services and Excess Water Management: Analysis of Ecosystem Services in Areas Exposed to Excess Water Inundation

Authors: Dalma Varga, Nora Hubayne H.

Abstract:

Nowadays, among the measures taken to offset the consequences of climate change, water resources management is one of the key tools, which can include excess water management. As a result of climate change’s effects and as a result of the frequent inappropriate landuse, more and more areas are affected by the excess water inundation. Hungary is located in the deepest part of the Pannonian Basin, which is exposed to water damage – especially lowland areas that are endangered by floods or excess waters. The periodical presence of excess water creates specific habitats in a given area, which have ecological, functional, and aesthetic values. Excess water inundation affects approximately 74% of Hungary’s lowland areas, of which about 46% is also under nature protection (such as national parks, protected landscape areas, nature conservation areas, Natura 2000 sites, etc.). These data prove that areas exposed to excess water inundation – which are predominantly characterized by agricultural land uses – have an important ecological role. Other research works have confirmed the presence of numerous rare and endangered plant species in drainage canals, on grasslands exposed to excess water, and on special agricultural fields with mud vegetation. The goal of this research is to define and analyze ecosystem services of areas exposed to excess water inundation. In addition to this, it is also important to determine the quantified indicators of these areas’ natural and landscape values besides the presence of protected species and the naturalness of habitats, so all in all, to analyze the various nature protections related to excess water. As a result, a practice-orientated assessment method has been developed that provides the ecological water demand, assimilates to ecological and habitat aspects, contributes to adaptive excess water management, and last but not least, increases or maintains the share of the green infrastructure network. In this way, it also contributes to reduce and mitigate the negative effects of climate change.

Keywords: ecosystem services, landscape architecture, excess water management, green infrastructure planning

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176 Thermal Regulation of Channel Flows Using Phase Change Material

Authors: Kira Toxopeus, Kamran Siddiqui

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Channel flows are common in a wide range of engineering applications. In some types of channel flows, particularly the ones involving chemical or biological processes, the control of the flow temperature is crucial to maintain the optimal conditions for the chemical reaction or to control the growth of biological species. This often becomes an issue when the flow experiences temperature fluctuations due to external conditions. While active heating and cooling could regulate the channel temperature, it may not be feasible logistically or economically and is also regarded as a non-sustainable option. Thermal energy storage utilizing phase change material (PCM) could provide the required thermal regulation sustainably by storing the excess heat from the channel and releasing it back as required, thus regulating the channel temperature within a range in the proximity of the PCM melting temperature. However, in designing such systems, the configuration of the PCM storage within the channel is critical as it could influence the channel flow dynamics, which would, in turn, affect the heat exchange between the channel fluid and the PCM. The present research is focused on the investigation of the flow dynamical behavior in the channel during heat transfer from the channel flow to the PCM thermal energy storage. Offset vertical columns in a narrow channel were used that contained the PCM. Two different column shapes, square and circular, were considered. Water was used as the channel fluid that entered the channel at a temperature higher than that of the PCM melting temperature. Hence, as the water was passing through the channel, the heat was being transferred from the water to the PCM, causing the PCM to store the heat through a phase transition from solid to liquid. Particle image velocimetry (PIV) was used to measure the two-dimensional velocity field of the channel flow as it flows between the PCM columns. Thermocouples were also attached to the PCM columns to measure the PCM temperature at three different heights. Three different water flow rates (0.5, 0.75 and 1.2 liters/min) were considered. At each flow rate, experiments were conducted at three different inlet water temperatures (28ᵒC, 33ᵒC and 38ᵒC). The results show that the flow rate and the inlet temperature influenced the flow behavior inside the channel.

Keywords: channel flow, phase change material, thermal energy storage, thermal regulation

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175 The Benefits of a Totally Autologous Breast Reconstruction Technique Using Extended Latissimus Dorsi Flap with Lipo-Modelling: A Seven Years United Kingdom Tertiary Breast Unit Results

Authors: Wisam Ismail, Brendan Wooler, Penelope McManus

Abstract:

Introduction: The public perception of implants has been damaged in the wake of recent negative publicity and increasingly we are finding patients wanting to avoid them. Planned lipo-modelling to enhance the volume of a Latissimus dorsi flap is a viable alternative to silicone implants and maintains a Totally Autologous Technique (TAT). Here we demonstrate that when compared to an Implant Assisted Technique (IAT), a TAT offers patients many benefits that offset the requirement of more operations initially, with reduced short and long term complications, reduced symmetrisation surgery and reduced revision rates. Methods. Data was collected prospectively over 7 years. The minimum follows up was 3 years. The technique was generally standardized in the hand of one surgeon. All flaps were extended LD flaps (ELD). Lipo-modelling was performed using standard techniques. Outcome measures were unplanned secondary procedures, complication rates, and contralateral symmetrisation surgery rates. Key Results Were: Lower complication rates in the TAT group (18.5% vs. 33.3%), despite higher radiotherapy rates (TAT=49%, IAT=36.8%), TAT was associated with lower subsequent symmetrisation rates (30.6% vs. 50.9%), IAT had a relative risk of 3.1 for subsequent unplanned procedure, Autologous patients required an average of 1.76 sessions of lipo-modelling, Conclusions: Using lipo-modelling to enable totally autologous LD reconstruction offers significant advantages over an implant assisted technique. We have shown a lower subsequent unplanned procedure rate, lower revision surgery, and less contralateral symmetrisation surgery. We anticipate that a TAT will be supported by patient satisfaction surveys and long-term patient-reported cosmetic outcome data and intended to study this.

Keywords: breast, Latissimus dorsi, lipomodelling, reconstruction

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174 Medicinal Plants Supply Chain Innovations for Producer Surplus: Relationship Integration to Benefit the Rural Agrientrepreneurs in Bangladesh

Authors: Akm Shahidullah

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This paper assessed the medicinal plants production and related entrepreneurial and management aspects with a focus to understand the present medicinal plants-based supply chain of Bangladesh. It delineated the overall supply chain and the extent of benefit that the plant-producingagrientrepreneursderive out of the existing system of the chain. The key objective was to put forward innovative supply chain strategiesthatcan leverage the benefit of the rural farmer-entrepreneur of medicinal plants. A field-based investigation was carried out in the Natore district of northwest Bangladesh, where a total of 225 farmers and households from eight villages were engaged in the production of medicinal plant species. The research had a survey with the agrientrepreneurs of two of those villages and focus group discussions at a union level to gather information about the price, buyers, seasonality, and overall supply infrastructure and trading mechanisms of the plant products. The research also gathered explanations on the overall supply chain system of the plants and plant-based processed products through key informant interviews with the local and regional selling agents, stockists, wholesalers, and secondary processors. The findings revealed that, in the existing supply chain system, the primary and wholesale secondary markets were mostly dominated by middlemen who cause market distortions and inflated prices due to a lack of coordination between the primary producers and secondary processors. The discoordination and inefficiencies in the supply chain system could be offset by the producer-processor relationship integration that could result in a multitude of benefits to both the parties in terms of price, quality, lead time, and overall control of the supply chain. Therefore, to ensure the growth of medicinal plants production, the industry users, secondary processors, and policy stakeholders should ensure that the primary producers get the fair share of the benefit; the producer-processor relationship integration in the supply chain offers to ensure that fairness with maximum producer surplus.

Keywords: medicinal-plants, agrientrepreneur, supply chain, relationship integration, Bangladesh

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173 Computer-Aided Ship Design Approach for Non-Uniform Rational Basis Spline Based Ship Hull Surface Geometry

Authors: Anu S. Nair, V. Anantha Subramanian

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This paper presents a surface development and fairing technique combining the features of a modern computer-aided design tool namely the Non-Uniform Rational Basis Spline (NURBS) with an algorithm to obtain a rapidly faired hull form. Some of the older series based designs give sectional area distribution such as in the Wageningen-Lap Series. Others such as the FORMDATA give more comprehensive offset data points. Nevertheless, this basic data still requires fairing to obtain an acceptable faired hull form. This method uses the input of sectional area distribution as an example and arrives at the faired form. Characteristic section shapes define any general ship hull form in the entrance, parallel mid-body and run regions. The method defines a minimum of control points at each section and using the Golden search method or the bisection method; the section shape converges to the one with the prescribed sectional area with a minimized error in the area fit. The section shapes combine into evolving the faired surface by NURBS and typically takes 20 iterations. The advantage of the method is that it is fast, robust and evolves the faired hull form through minimal iterations. The curvature criterion check for the hull lines shows the evolution of the smooth faired surface. The method is applicable to hull form from any parent series and the evolved form can be evaluated for hydrodynamic performance as is done in more modern design practice. The method can handle complex shape such as that of the bulbous bow. Surface patches developed fit together at their common boundaries with curvature continuity and fairness check. The development is coded in MATLAB and the example illustrates the development of the method. The most important advantage is quick time, the rapid iterative fairing of the hull form.

Keywords: computer-aided design, methodical series, NURBS, ship design

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172 Early versus Late Percutaneous Tracheostomy in Critically Ill Adult Mechanically Ventilated Patients

Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

Procedia PDF Downloads 600
171 Performance and Damage Detection of Composite Structural Insulated Panels Subjected to Shock Wave Loading

Authors: Anupoju Rajeev, Joanne Mathew, Amit Shelke

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In the current study, a new type of Composite Structural Insulated Panels (CSIPs) is developed and investigated its performance against shock loading which can replace the conventional wooden structural materials. The CSIPs is made of Fibre Cement Board (FCB)/aluminum as the facesheet and the expanded polystyrene foam as the core material. As tornadoes are very often in the western countries, it is suggestable to monitor the health of the CSIPs during its lifetime. So, the composite structure is installed with three smart sensors located randomly at definite locations. Each smart sensor is fabricated with an embedded half stainless phononic crystal sensor attached to both ends of the nylon shaft that can resist the shock and impact on facesheet as well as polystyrene foam core and safeguards the system. In addition to the granular crystal sensors, the accelerometers are used in the horizontal spanning and vertical spanning with a definite offset distance. To estimate the health and damage of the CSIP panel using granular crystal sensor, shock wave loading experiments are conducted. During the experiments, the time of flight response from the granular sensors is measured. The main objective of conducting shock wave loading experiments on the CSIP panels is to study the effect and the sustaining capacity of the CSIP panels in the extreme hazardous situations like tornados and hurricanes which are very common in western countries. The effects have been replicated using a shock tube, an instrument that can be used to create the same wind and pressure intensity of tornado for the experimental study. Numerous experiments have been conducted to investigate the flexural strength of the CSIP. Furthermore, the study includes the damage detection using three smart sensors embedded in the CSIPs during the shock wave loading.

Keywords: composite structural insulated panels, damage detection, flexural strength, sandwich structures, shock wave loading

Procedia PDF Downloads 146
170 Software-Defined Architecture and Front-End Optimization for DO-178B Compliant Distance Measuring Equipment

Authors: Farzan Farhangian, Behnam Shakibafar, Bobda Cedric, Rene Jr. Landry

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Among the air navigation technologies, many of them are capable of increasing aviation sustainability as well as accuracy improvement in Alternative Positioning, Navigation, and Timing (APNT), especially avionics Distance Measuring Equipment (DME), Very high-frequency Omni-directional Range (VOR), etc. The integration of these air navigation solutions could make a robust and efficient accuracy in air mobility, air traffic management and autonomous operations. Designing a proper RF front-end, power amplifier and software-defined transponder could pave the way for reaching an optimized avionics navigation solution. In this article, the possibility of reaching an optimum front-end to be used with single low-cost Software-Defined Radio (SDR) has been investigated in order to reach a software-defined DME architecture. Our software-defined approach uses the firmware possibilities to design a real-time software architecture compatible with a Multi Input Multi Output (MIMO) BladeRF to estimate an accurate time delay between a Transmission (Tx) and the reception (Rx) channels using the synchronous scheduled communication. We could design a novel power amplifier for the transmission channel of the DME to pass the minimum transmission power. This article also investigates designing proper pair pulses based on the DO-178B avionics standard. Various guidelines have been tested, and the possibility of passing the certification process for each standard term has been analyzed. Finally, the performance of the DME was tested in the laboratory environment using an IFR6000, which showed that the proposed architecture reached an accuracy of less than 0.23 Nautical mile (Nmi) with 98% probability.

Keywords: avionics, DME, software defined radio, navigation

Procedia PDF Downloads 79
169 Utility of CT Perfusion Imaging for Diagnosis and Management of Delayed Cerebral Ischaemia Following Subarachnoid Haemorrhage

Authors: Abdalla Mansour, Dan Brown, Adel Helmy, Rikin Trivedi, Mathew Guilfoyle

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Introduction: Diagnosing delayed cerebral ischaemia (DCI) following aneurysmal subarachnoid haemorrhage (SAH) can be challenging, particularly in poor-grade patients. Objectives: This study sought to assess the value of routine CTP in identifying (or excluding) DCI and in guiding management. Methods: Eight-year retrospective neuroimaging study at a large UK neurosurgical centre. Subjects included a random sample of adult patients with confirmed aneurysmal SAH that had a CTP scan during their inpatient stay, over a 8-year period (May 2014 - May 2022). Data collected through electronic patient record and PACS. Variables included age, WFNS scale, aneurysm site, treatment, the timing of CTP, radiologist report, and DCI management. Results: Over eight years, 916 patients were treated for aneurysmal SAH; this study focused on 466 patients that were randomly selected. Of this sample, 181 (38.84%) had one or more CTP scans following brain aneurysm treatment (Total 318). The first CTP scan in each patient was performed at 1-20 days following ictus (median 4 days). There was radiological evidence of DCI in 83, and no reversible ischaemia was found in 80. Findings were equivocal in the remaining 18. Of the 103 patients treated with clipping, 49 had DCI radiological evidence, in comparison to 31 of 69 patients treated with endovascular embolization. The remaining 9 patients are either unsecured aneurysms or non-aneurysmal SAH. Of the patients with radiological evidence of DCI, 65 had a treatment change following the CTP directed at improving cerebral perfusion. In contrast, treatment was not changed for (61) patients without radiological evidence of DCI. Conclusion: CTP is a useful adjunct to clinical assessment in the diagnosis of DCI and is helpful in identifying patients that may benefit from intensive therapy and those in whom it is unlikely to be effective.

Keywords: SAH, vasospasm, aneurysm, delayed cerebral ischemia

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168 Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in an Urgent Care Center in Saudi Arabia

Authors: Abdullah Arafat, Ali Al-Farhan, Amir Omair

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Objectives: To review and assess the effectiveness of the implemented modified five-levels triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residential city, Riyadh, Saudi Arabia. Method: The applied study design was an observational cross sectional design. A data collection sheet was designed and distributed to triage nurses; the data collection was done during triage process and was directly observed by the co-investigator. Triage system was reviewed by measuring three time intervals as quality indicators: time before triage (TBT), time before being seen by physician (TBP) and total length of stay (TLS) taking in consideration timing of presentation and level of triage. Results: During the study period, a total of 187 patients were included in our study. 118 visits were at weekdays and 68 visits at weekends. Overall, 173 patients (92.5%) were seen by the physician in timely manner according to triage guidelines while 14 patients (7.5%) were not seen at appropriate time.Overall, The mean time before seen the triage nurse (TBT) was 5.36 minutes, the mean time to be seen by physician (TBP) was 22.6 minutes and the mean length of stay (TLS) was 59 minutes. The data didn’t showed significant increase in TBT, TBP, and number of patients not seen at the proper time, referral rate and admission rate during weekend. Conclusion: The CTAS is adaptable to countries beyond Canada and worked properly. The applied CTAS triage system in Al-Yarmook UCC is considered to be effective and well applied. Overall, urgent cases have been seen by physician in timely manner according to triage system and there was no delay in the management of urgent cases.

Keywords: CTAS, emergency, Saudi Arabia, triage, urgent care

Procedia PDF Downloads 321