Search results for: full face
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4944

Search results for: full face

1494 Sociolinguistic and Classroom Functions of Using Code-Switching in CLIL Context

Authors: Khatuna Buskivadze

Abstract:

The aim of the present study is to investigate the sociolinguistic and classroom functions and frequency of Teacher’s Code Switching (CS) in the Content and Language Integrated (CLIL) Lesson. Nowadays, Georgian society struggles to become the part of the European world, the English language itself plays a role in forming new generations with European values. Based on our research conducted in 2019, out of all 114 private schools in Tbilisi, full- programs of CLIL are taught in 7 schools, while only some subjects using CLIL are conducted in 3 schools. The goal of the former research was to define the features of Content and Language Integrated learning (CLIL) methodology within the process of teaching English on the Example of Georgian private high schools. Taking the Georgian reality and cultural features into account, the modified version of the questionnaire, based on the classification of using CS in ESL Classroom proposed By Ferguson (2009) was used. The qualitative research revealed students’ and teacher’s attitudes towards teacher’s code-switching in CLIL lesson. Both qualitative and quantitative research were conducted: the observations of the teacher’s lessons (Recording of T’s online lessons), interview and the questionnaire among Math’s T’s 20 high school students. We came to the several conclusions, some of them are given here: Math’s teacher’s CS behavior mostly serves (1) the conversational function of interjection; (2) the classroom functions of introducing unfamiliar materials and topics, explaining difficult concepts, maintaining classroom discipline and the structure of the lesson; The teacher and 13 students have negative attitudes towards using only Georgian in teaching Math. The higher level of English is the more negative is attitude towards using Georgian in the classroom. Although all the students were Georgian, their competence in English is higher than in Georgian, therefore they consider English as an inseparable part of their identities. The overall results of the case study of teaching Math (Educational discourse) in one of the private schools in Tbilisi will be presented at the conference.

Keywords: attitudes, bilingualism, code-switching, CLIL, conversation analysis, interactional sociolinguistics.

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1493 Surface Tension and Bulk Density of Ammonium Nitrate Solutions: A Molecular Dynamics Study

Authors: Sara Mosallanejad, Bogdan Z. Dlugogorski, Jeff Gore, Mohammednoor Altarawneh

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Ammonium nitrate (NH­₄NO₃, AN) is commonly used as the main component of AN emulsion and fuel oil (ANFO) explosives, that use extensively in civilian and mining operations for underground development and tunneling applications. The emulsion formulation and wettability of AN prills, which affect the physical stability and detonation of ANFO, highly depend on the surface tension, density, viscosity of the used liquid. Therefore, for engineering applications of this material, the determination of density and surface tension of concentrated aqueous solutions of AN is essential. The molecular dynamics (MD) simulation method have been used to investigate the density and the surface tension of high concentrated ammonium nitrate solutions; up to its solubility limit in water. Non-polarisable models for water and ions have carried out the simulations, and the electronic continuum correction model (ECC) uses a scaling of the charges of the ions to apply the polarisation implicitly into the non-polarisable model. The results of calculated density and the surface tension of the solutions have been compared to available experimental values. Our MD simulations show that the non-polarisable model with full-charge ions overestimates the experimental results while the reduce-charge model for the ions fits very well with the experimental data. Ions in the solutions show repulsion from the interface using the non-polarisable force fields. However, when charges of the ions in the original model are scaled in line with the scaling factor of the ECC model, the ions create a double ionic layer near the interface by the migration of anions toward the interface while cations stay in the bulk of the solutions. Similar ions orientations near the interface were observed when polarisable models were used in simulations. In conclusion, applying the ECC model to the non-polarisable force field yields the density and surface tension of the AN solutions with high accuracy in comparison to the experimental measurements.

Keywords: ammonium nitrate, electronic continuum correction, non-polarisable force field, surface tension

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1492 The Community Structure of Fish and its Correlation with Mangrove Forest Litter Production in Panjang Island, Banten Bay, Indonesia

Authors: Meilisha Putri Pertiwi, Mufti Petala Patria

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Mangrove forest often categorized as a productive ecosystem in trophic water and the highest carbon storage among all the forest types. Mangrove-derived organic matter determines the food web of fish and invertebrates. In Indonesia trophic water ecosystem, 80% commersial fish caught in coastal area are high related to food web in mangrove forest ecosystem. Based on the previous research in Panjang Island, Bojonegara, Banten, Indonesia, removed mangrove litterfall to the sea water were 9,023 g/m³/s for two stations (west station–5,169 g/m³/s and north station-3,854 g/m³/s). The vegetation were dominated from Rhizophora apiculata and Rhizopora stylosa. C element is the highest content (27,303% and 30,373%) than N element (0,427% and 0,35%) and P element (0,19% and 0,143%). The aim of research also to know the diversity of fish inhabit in mangrove forest. Fish sampling is by push net. Fish caught are collected into plastics, total length measured, weigh measured, and individual and total counted. Meanwhile, the 3 modified pipes (1 m long, 5 inches diameter, and a closed one hole part facing the river by using a nylon cloth) set in the water channel connecting mangrove forest and sea water for each stasiun. They placed for 1 hour at low tide. Then calculate the speed of water flow and volume of modified pipes. The fish and mangrove litter will be weigh for wet weight, dry weight, and analyze the C, N, and P element content. The sampling data will be conduct 3 times of month in full moon. The salinity, temperature, turbidity, pH, DO, and the sediment of mangrove forest will be measure too. This research will give information about the fish diversity in mangrove forest, the removed mangrove litterfall to the sea water, the composition of sediment, the total element content (C, N, P) of fish and mangrove litter, and the correlation of element content absorption between fish and mangrove litter. The data will be use for the fish and mangrove ecosystem conservation.

Keywords: fish diversity, mangrove forest, mangrove litter, carbon element, nitrogen element, P element, conservation

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1491 Jail Reentry in Rural America: A Quasi-Experimental Examination of a Rural Behavioral Health Reentry Program

Authors: Debra L. Stanley, Gabriela Wasileski

Abstract:

Offenders face many challenges as they transition from being incarcerated to the community, ranging from housing and employment needs to long standing problems with addictions and mental health issues. A lack of appropriate behavioral health services in the more remote parts of the United States has led to a significant illegal substance abuse problem, housing instability, and unaddressed mental health and trauma issues. High rates of poverty and unemployment exacerbate the growing behavioral health issues, drug overdoses, co-occurring disorders, and crime that are so prevalent across rural communities. This study examines the challenges of rural jail reentry faced by offenders in a treatment capacity. The client-centered evidence-based program is uniquely designed to provide continuity of care that focuses on issues which affect rural communities. Prior to release from jail, individuals go through comprehensive assessment screenings to measure mental health and substance use disorder as well as trauma and prior crime victimization histories; the assessments help to target client-specific services. The quasi-experimental research design tracks clients throughout their recovery and reintegration into the community. Individuals in a rural program often do not have the benefit of easy access or peer mentoring that is so often found in urban recovery programs. Therefore, much of the support is provided through telehealth and e-services. The goal of this study is to explore the nature of rural reentry programs and measures of recidivism, drug overdoses, and other behavioral health needs and successful reentry to include stable housing and employment.

Keywords: jail reentry, rehabilitation, behavioral health, drug abuse, recidivism

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1490 Impacts of Climate Elements on the Annual Periodic Behavior of the Shallow Groundwater Level: Case Study from Central-Eastern Europe

Authors: Tamas Garamhegyi, Jozsef Kovacs, Rita Pongracz, Peter Tanos, Balazs Trasy, Norbert Magyar, Istvan G. Hatvani

Abstract:

Like most environmental processes, shallow groundwater fluctuation under natural circumstances also behaves periodically. With the statistical tools at hand, it can easily be determined if a period exists in the data or not. Thus, the question may be raised: Does the estimated average period time characterize the whole time period, or not? This is especially important in the case of such complex phenomena as shallow groundwater fluctuation, driven by numerous factors. Because of the continuous changes in the oscillating components of shallow groundwater time series, the most appropriate method should be used to investigate its periodicity, this is wavelet spectrum analysis. The aims of the research were to investigate the periodic behavior of the shallow groundwater time series of an agriculturally important and drought sensitive region in Central-Eastern Europe and its relationship to the European pressure action centers. During the research ~216 shallow groundwater observation wells located in the eastern part of the Great Hungarian Plain with a temporal coverage of 50 years were scanned for periodicity. By taking the full-time interval as 100%, the presence of any period could be determined in percentages. With the complex hydrogeological/meteorological model developed in this study, non-periodic time intervals were found in the shallow groundwater levels. On the local scale, this phenomenon linked to drought conditions, and on a regional scale linked to the maxima of the regional air pressures in the Gulf of Genoa. The study documented an important link between shallow groundwater levels and climate variables/indices facilitating the necessary adaptation strategies on national and/or regional scales, which have to take into account the predictions of drought-related climatic conditions.

Keywords: climate change, drought, groundwater periodicity, wavelet spectrum and coherence analyses

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1489 Diagnostics and Explanation of the Current Status of the 40- Year Railway Viaduct

Authors: Jakub Zembrzuski, Bartosz Sobczyk, Mikołaj MIśkiewicz

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Besides designing new constructions, engineers all over the world must face another problem – maintenance, repairs, and assessment of the technical condition of existing bridges. To solve more complex issues, it is necessary to be familiar with the theory of finite element method and to have access to the software that provides sufficient tools which to enable create of sometimes significantly advanced numerical models. The paper includes a brief assessment of the technical condition, a description of the in situ non-destructive testing carried out and the FEM models created for global and local analysis. In situ testing was performed using strain gauges and displacement sensors. Numerical models were created using various software and numerical modeling techniques. Particularly noteworthy is the method of modeling riveted joints of the crossbeam of the viaduct. It is a simplified method that consists of the use of only basic numerical tools such as beam and shell finite elements, constraints, and simplified boundary conditions (fixed support and symmetry). The results of the numerical analyses were presented and discussed. It is clearly explained why the structure did not fail, despite the fact that the weld of the deck plate completely failed. A further research problem that was solved was to determine the cause of the rapid increase in values on the stress diagram in the cross-section of the transverse section. The problems were solved using the solely mentioned, simplified method of modeling riveted joints, which demonstrates that it is possible to solve such problems without access to sophisticated software that enables to performance of the advanced nonlinear analysis. Moreover, the obtained results are of great importance in the field of assessing the operation of bridge structures with an orthotropic plate.

Keywords: bridge, diagnostics, FEM simulations, failure, NDT, in situ testing

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1488 The Publication Impact of London’s Air Ambulance on the Field of Pre-Hospital Medicine and Its Application to Air Ambulances Internationally: A Bibliometric Analysis

Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

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Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

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1487 Study on Shifting Properties of CVT Rubber V-belt

Authors: Natsuki Tsuda, Kiyotaka Obunai, Kazuya Okubo, Hideyuki Tashiro, Yoshinori Yamaji, Hideyuki Kato

Abstract:

The objective of this study is to investigate the effect of belt stiffness on the performance of the CVT unit, such as the required pulley thrust force and the ratio coverage. The CVT unit consists of the V-grooved pulleys and the rubber CVT belt. The width of the driving pulley groove was controlled by the stepper motor, while that of the driven pulley was controlled by the hydraulic pressure. The generated mechanical power on the motor was transmitted from the driving axis to the driven axis through the CVT unit. The rotational speed and the transmitting torque of both axes were measured by the tachometers and the torque meters attached with these axes, respectively. The transmitted, mechanical power was absorbed by the magnetic powder brake. The thrust force acting on both pulleys and the force between both shafts were measured by the load cell. The back face profile of the rubber CVT belt along with width direction was measured by the 2-dimensional laser displacement meter. This paper found that when the stiffness of the rubber CVT belt in the belt width direction was reduced, the thrust force required for shifting was reduced. Moreover, when the stiffness of the rubber CVT belt in the belt width direction was reduced, the ratio coverage of the CVT unit was reduced. Due to the decrement of stiffness in belt width direction, the excessive concave deformation of belt in pulley groove was confirmed. Because of this excessive concave deformation, apparent wrapping radius of belt would have been reduced. Proposed model could be effectively estimated the difference of ratio coverage due to concave deformation. The proposed model could also be utilized for designing the rubber CVT belt with optimal bending stiffness in width direction.

Keywords: CVT, countinuously variable transmission, rubber, belt stiffness, transmission

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1486 Development of a Computer Aided Diagnosis Tool for Brain Tumor Extraction and Classification

Authors: Fathi Kallel, Abdulelah Alabd Uljabbar, Abdulrahman Aldukhail, Abdulaziz Alomran

Abstract:

The brain is an important organ in our body since it is responsible about the majority actions such as vision, memory, etc. However, different diseases such as Alzheimer and tumors could affect the brain and conduct to a partial or full disorder. Regular diagnosis are necessary as a preventive measure and could help doctors to early detect a possible trouble and therefore taking the appropriate treatment, especially in the case of brain tumors. Different imaging modalities are proposed for diagnosis of brain tumor. The powerful and most used modality is the Magnetic Resonance Imaging (MRI). MRI images are analyzed by doctor in order to locate eventual tumor in the brain and describe the appropriate and needed treatment. Diverse image processing methods are also proposed for helping doctors in identifying and analyzing the tumor. In fact, a large Computer Aided Diagnostic (CAD) tools including developed image processing algorithms are proposed and exploited by doctors as a second opinion to analyze and identify the brain tumors. In this paper, we proposed a new advanced CAD for brain tumor identification, classification and feature extraction. Our proposed CAD includes three main parts. Firstly, we load the brain MRI. Secondly, a robust technique for brain tumor extraction is proposed. This technique is based on both Discrete Wavelet Transform (DWT) and Principal Component Analysis (PCA). DWT is characterized by its multiresolution analytic property, that’s why it was applied on MRI images with different decomposition levels for feature extraction. Nevertheless, this technique suffers from a main drawback since it necessitates a huge storage and is computationally expensive. To decrease the dimensions of the feature vector and the computing time, PCA technique is considered. In the last stage, according to different extracted features, the brain tumor is classified into either benign or malignant tumor using Support Vector Machine (SVM) algorithm. A CAD tool for brain tumor detection and classification, including all above-mentioned stages, is designed and developed using MATLAB guide user interface.

Keywords: MRI, brain tumor, CAD, feature extraction, DWT, PCA, classification, SVM

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1485 Research on the Feasibility of Evaluating Low-Temperature Cracking Performance of Asphalt Mixture Using Fracture Energy

Authors: Tao Yang, Yongli Zhao

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Low-temperature cracking is one of the major challenges for asphalt pavement in the cold region. Fracture energy could determine from various test methods, which is a commonly used parameter to evaluate the low-temperature cracking resistance of asphalt mixture. However, the feasibility of evaluating the low-temperature cracking performance of asphalt mixture using fracture energy is not investigated comprehensively. This paper aims to verify whether fracture energy is an appropriate parameter to evaluate the low-temperature cracking performance. To achieve this goal, this paper compared the test results of thermal stress restrained specimen test (TSRST) and semi-circular bending test (SCB) of asphalt mixture with different types of aggregate, TSRST and indirect tensile test (IDT) of asphalt mixture with different additives, and single-edge notched beam test (SENB) and TSRST of asphalt mixture with different asphalt. Finally, the correlation between in-suit cracking performance and fracture energy was surveyed. The experimental results showed the evaluation result of critical cracking temperature and fracture energy are not always consistent; the in-suit cracking performance is also not correlated well with fracture energy. These results indicated that it is not feasible to evaluate low-temperature performance by fracture energy. Then, the composition of fracture energy of TSRST, SCB, disk-shaped compact tension test (DCT), three-point bending test (3PB) and IDT was analyzed. The result showed: the area of thermal stress versus temperature curve is the multiple of fracture energy and could be used to represent fracture energy of TSRST, as the multiple is nearly equal among different asphalt mixtures for a specific specimen; the fracture energy, determined from TSRST, SCB, DCT, 3PB, SENB and IDT, is mainly the surface energy that forms the fracture face; fracture energy is inappropriate to evaluate the low-temperature cracking performance of asphalt mixture, as the relaxation/viscous performance is not considered; if the fracture energy was used, it is recommended to combine this parameter with an index characterizing the relaxation or creep performance of asphalt mixture.

Keywords: asphalt pavement, cold region, critical cracking temperature, fracture energy, low-temperature cracking

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1484 Using Problem-Based Learning on Teaching Early Intervention for College Students

Authors: Chen-Ya Juan

Abstract:

In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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1483 Reconstruction of Wujiaochang Plaza: A Potential Avenue Towards Sustainability

Authors: Caiwei Chen, Jianhao Li, Jiasong Zhu

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The reform and opening-up stimulated economic and technological take-off in China while resulting in massive urbanization and motorization. Wujiaochang area was set as a secondary business district in Shanghai to meet the growing demand, with the reconstruction of Wujiaochang Plaza in 2005 being a milestone of this intended urban renewal. Wujiaochang is now an economically dynamic area providing much larger traffic and transit capacity transportation-wise. However, this rebuilding has completely changed the face of the district. It is, therefore, appropriate to evaluate its impact on neighborhoods and communities while assessing the overall sustainability of such an operation. In this study, via an online questionnaire survey among local residents and daily visitors, we assess the perceptions and the estimated impact of Wujiaochang Plaza's reconstruction. We then confront these results to the 62 answers from local residents to a questionnaire collected on paper. The analysis of our data, along with observation and other forms of information -such as maps analysis or online applications (Dianping)- demonstrate major improvement in economic sustainability but also significant losses in environmental sustainability, especially in terms of active transportation. As for the social viewpoint, local residents' opinions tend to be rather positive, especially regarding traffic safety and access to consumption, despite the lack of connectivity and radical changes induced by Wujiaochang massive transformations. In general, our investigation exposes the overall positive outcomes of Wujiaochang Plaza reconstruction but also unveils major drawbacks, especially in terms of soft mobility and traffic fluidity. We gather that our approach could be of tremendous help for future major urban interventions, as such approaches in municipal regeneration are widely implemented in Chinese cities and yet still need to be thoroughly assessed in terms of sustainability.

Keywords: China's reform and opening-up, economical revitalization, neighborhood identity, sustainability assessment, urban renewal

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1482 Constrains to Financial Engineering for Liquidity Management: A Multiple Case Study of Islamic Banks

Authors: Sadia Bibi, Karim Ullah

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Islamic banks have excess liquidity, which needs proper management to earn a high rate of return on them to remain competitive. However, they lack assets-backed avenues and rely on a few sukuks, which led them to liquidity management issues. Financial engineering comes forward to innovate and develop instruments for the requisite financial problem. Still, they face many challenges, explored in the context of liquidity management in Islamic banks. The rigorous literature review shows that Shariah compliance, competition from the conventional banks, lack of sufficient instruments, derivatives are still not accepted as legitimate products, the inter-bank market being less developed, and no possibility of lender of last resort is the six significant constraints to financial engineering for liquidity management of Islamic banks. To further explore the problem, a multiple case study strategy is used to extend and develop the theory with the philosophical stance of social constructivism. Narrative in-depth interviews over the telephone are conducted with key personnel at treasury departments of selected banks. Data is segregated and displayed using NVivo 11 software, and the thematic analysis approach identifies themes related to the constraints. The exploration of further constraints to financial engineering for liquidity management of Islamic banks achieves the research aim. The theory is further developed by the addition of three more constraints to the theoretical framework, which are i) lack of skilled human resources, ii) lack of unified vision, and iii) lack of government support to the Islamic banks. These study findings are fruitful for the use of the government, regulatory authorities of the banking sector, the State Bank of Pakistan (Central Bank), and the product design & development division of Islamic banks to make the financial engineering process feasible and resolve liquidity management issues of Islamic banks.

Keywords: financial engineering, liquidity management, Islamic banks, shariah compliance

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1481 Planning for Enviromental and Social Sustainability in Coastal Areas: A Case of Alappad

Authors: K. Vrinda

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Coastal ecosystems across the world are facing a lot of challenges due to natural phenomena as well as from uncontrolled human interventions. Here, Alappad, a coastal island situated in Kerala, India is undergoing significant damage and is gradually losing its environmental and social sustainability. The area is blessed with very rare and precious black mineral sand deposits. Sand mining for these minerals started in 1911 and is still continuing. But, unfortunately all the problems that Alappad faces now, have its root on mining of this mineral sand. The land area is continuously diminishing due to sea erosion. The mining has also caused displacement of people and environmental degradation. Marine life also is getting affected by mining on beach and pollution. The inhabitants are fishermen who are largely dependent on the eco-system for a living. So loss of environmental sustainability subsequently affects social sustainability too. Now the damage has reached a point beyond which our actions may not be able to make any impact. This was one of the most affected areas of the 2004 tsunami and the environmental degradation has further increased the vulnerability. So this study focuses on understanding the concerns related to the resource utilization, environment and the indigenous community staying there, and on formulating suitable strategies to restore the sustainability of the area. An extensive study was conducted on site, to find out the physical, social, and economical characteristics of the area. A focus group discussion with the inhabitants shed light on different issues they face in their day-to-day life. The analysis of all these data, led to the formation of a new development vision for the area which focuses on environmental restoration and socio-economic development while allowing controlled exploitation of resources. A participatory approach is formulated which enables these three aspects through community based programs.

Keywords: Community development, Disaster resilience, Ecological restoration, Environmental sustainability, Social-environmental planning, Social Sustainability

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1480 A Comparative Study of the Proposed Models for the Components of the National Health Information System

Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

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National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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1479 Case Report and Literature Review of Opalski Syndrome: A Rare Brainstem Stroke

Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing

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Background: In lateral medullary strokes, hemiparesis doesn't typically manifest due to the distinct vascular supply to the corticospinal tract located within the medulla's tegmentum. Hemiparesis resulting from a medullary infarct would likely be attributable to a medial medullary stroke characterized by contralateral hemiparesis since the corticospinal tract fibers at this level have yet to cross over. This paper reports a unique case of a lateral medullary stroke variant that presented with ipsilateral hemiparesis. Objective: There have only been 23 other cases of reported Opalski syndrome, making this only the 24th and 25th case reported worldwide. Case Presentation: A 53-year-old male was admitted with slurring of speech with gait instability, numbness on the right face, Horner’s syndrome, and 4/5 motor strength on the right extremities. Hyperreflexia was noted on the right, together with a Babinski’s sign. Cranial magnetic resonance imaging (MRI) showed an infarct on the right dorsolateral medulla. A 48-year-old male was admitted complaining of dizziness, ataxic gait, veering to the left during ambulation, left facial numbness, left hemiplegia, crossed sensory disturbance, and right limb ataxia. MRI revealed an acute left lateral medullary infarction. Conclusion: A rare type of lateral medullary infarction, the Opalski Syndrome, is a weakness ipsilateral to the lesion of the infarct. The lesion involves the ipsilateral corticospinal tract below the pyramidal decussation. The considerable diversity in the posterior brain circulation serves as a contributing factor to the clinical observation of incomplete textbook syndromes, underscoring the significance of the neurological clinical approach and a solid foundation in neuroanatomy.

Keywords: Opalski syndrome, rare stroke, stroke, Wallenberg's syndrome

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1478 Public Perception and Willingness to Undergo Cosmetic Procedures during COVID-19 Pandemic: A Questionnaire-Based Study Applied to Asymptomatic Individuals

Authors: Ibrahim Alreshidi, Aseel Albrekeit, Ruaa Alharthi

Abstract:

Background: As a result of the spread of COVID-19 at the beginning of 2020, many governments, including Saudi Arabia, have suspended operations in many agencies. Most dermatologists have restricted their practice, including cosmetic procedures, to ensure social distancing. On the 7th of May 2020, Saudi authorities reduced the restriction of COVID-19 virus preventative measures, allowing clinics to start accepting patients following the ministry of health protocols. Objectives: Evaluation of the public's perception and willingness to undergo cosmetic procedures during COVID-19 outbreaks in Saudi Arabia. Materials and methods: A descriptive, cross-sectional, questionnaire-based study was carried out among the individuals who lack typical symptoms of COVID-19 infection in Saudi Arabia. A self-designed web-based questionnaire was developed; content face validity and a pilot study were done. The questionnaire was distributed electronically from the 8th of May until the 31st of May 2020. Results: A total of 656 individuals who lack typical symptoms of COVID-19 infection were included in this analysis. Only 10.5% of participants expressed their will to do cosmetic procedures during the COVID-19 pandemic. More than 90% of the participants believed that the COVID-19 pandemic was either somewhat serious (52.9%) or very serious (38.7%). The willingness to do cosmetic procedures during the COVID-19 pandemic remained unaltered when the price was discounted (p<0.001) and when infection control measures were ensured (p<0.001). Conclusion: The COVID-19 pandemic had a negative impact on the practice of cosmetic dermatology. Fear of transferring the infection to a beloved home member is the main reason to avoid these procedures. Generating well-structured safety guidelines to decrease the risk of this unusual virus transmission in dermatology practice and creating financial incentives may help increase the public willingness to do these cosmetic procedures during this pandemic.

Keywords: COVID-19 pandemic, cosmetic procedures, questionnaire, dermatology

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1477 The Revenue Management Implementation and Its Complexity in the Airline Industry: An Empirical Study on the Egyptian Airline Industry

Authors: Amr Sultan, Sara Elgazzar, Breksal Elmiligy

Abstract:

The airline industry nowadays is becoming a more growing industry facing a severe competition. It is an influential issue in this context to utilize revenue management (RM) concept and practice in order to develop the pricing strategy. There is an unfathomable necessity for RM to assist the airlines and their associates to disparage the cost and recuperate their revenue, which in turn will boost the airline industry performance. The complexity of RM imposes enormous challenges on the airline industry. Several studies have been proposed on the RM adaptation in airlines industry while there is a limited availability of implementing RM and its complexity in the developing countries such as Egypt. This research represents a research schema about the implementation of the RM to the Egyptian airline industry. The research aims at investigating and demonstrating the complexities face implementing RM in the airline industry, up on which the research provides a comprehensive understanding of how to overcome these complexities while adapting RM in the Egyptian airline industry. An empirical study was conducted on the Egyptian airline sector based on a sample of four airlines (Egyptair, Britishair, KLM, and Lufthansa). The empirical study was conducted using a mix of qualitative and quantitative approaches. First, in-depth interviews were carried out to analyze the Egyptian airline sector status and the main challenges faced by the airlines. Then, a structured survey on the three different parties of airline industry; airlines, airfreight forwarders, and passengers were conducted in order to investigate the main complexity factors from different parties' points of view. Finally, a focus group was conducted to develop a best practice framework to overcome the complexities faced the RM adaptation in the Egyptian airline industry. The research provides an original contribution to knowledge by creating a framework to overcome the complexities and challenges in adapting RM in the airline industry generally and the Egyptian airline industry particularly. The framework can be used as a RM tool to increase the effectiveness and efficiency of the Egyptian airline industry performance.

Keywords: revenue management, airline industry, revenue management complexity, Egyptian airline industry

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1476 The Feasibility of Glycerol Steam Reforming in an Industrial Sized Fixed Bed Reactor Using Computational Fluid Dynamic (CFD) Simulations

Authors: Mahendra Singh, Narasimhareddy Ravuru

Abstract:

For the past decade, the production of biodiesel has significantly increased along with its by-product, glycerol. Biodiesel-derived glycerol massive entry into the glycerol market has caused its value to plummet. Newer ways to utilize the glycerol by-product must be implemented or the biodiesel industry will face serious economic problems. The biodiesel industry should consider steam reforming glycerol to produce hydrogen gas. Steam reforming is the most efficient way of producing hydrogen and there is a lot of demand for it in the petroleum and chemical industries. This study investigates the feasibility of glycerol steam reforming in an industrial sized fixed bed reactor. In this paper, using computational fluid dynamic (CFD) simulations, the extent of the transport resistances that would occur in an industrial sized reactor can be visualized. An important parameter in reactor design is the size of the catalyst particle. The size of the catalyst cannot be too large where transport resistances are too high, but also not too small where an extraordinary amount of pressure drop occurs. The goal of this paper is to find the best catalyst size under various flow rates that will result in the highest conversion. Computational fluid dynamics simulated the transport resistances and a pseudo-homogenous reactor model was used to evaluate the pressure drop and conversion. CFD simulations showed that glycerol steam reforming has strong internal diffusion resistances resulting in extremely low effectiveness factors. In the pseudo-homogenous reactor model, the highest conversion obtained with a Reynolds number of 100 (29.5 kg/h) was 9.14% using a 1/6 inch catalyst diameter. Due to the low effectiveness factors and high carbon deposition rates, a fluidized bed is recommended as the appropriate reactor to carry out glycerol steam reforming.

Keywords: computational fluid dynamic, fixed bed reactor, glycerol, steam reforming, biodiesel

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1475 Verification and Validation of Simulated Process Models of KALBR-SIM Training Simulator

Authors: T. Jayanthi, K. Velusamy, H. Seetha, S. A. V. Satya Murty

Abstract:

Verification and Validation of Simulated Process Model is the most important phase of the simulator life cycle. Evaluation of simulated process models based on Verification and Validation techniques checks the closeness of each component model (in a simulated network) with the real system/process with respect to dynamic behaviour under steady state and transient conditions. The process of Verification and validation helps in qualifying the process simulator for the intended purpose whether it is for providing comprehensive training or design verification. In general, model verification is carried out by comparison of simulated component characteristics with the original requirement to ensure that each step in the model development process completely incorporates all the design requirements. Validation testing is performed by comparing the simulated process parameters to the actual plant process parameters either in standalone mode or integrated mode. A Full Scope Replica Operator Training Simulator for PFBR - Prototype Fast Breeder Reactor has been developed at IGCAR, Kalpakkam, INDIA named KALBR-SIM (Kalpakkam Breeder Reactor Simulator) wherein the main participants are engineers/experts belonging to Modeling Team, Process Design and Instrumentation and Control design team. This paper discusses the Verification and Validation process in general, the evaluation procedure adopted for PFBR operator training Simulator, the methodology followed for verifying the models, the reference documents and standards used etc. It details out the importance of internal validation by design experts, subsequent validation by external agency consisting of experts from various fields, model improvement by tuning based on expert’s comments, final qualification of the simulator for the intended purpose and the difficulties faced while co-coordinating various activities.

Keywords: Verification and Validation (V&V), Prototype Fast Breeder Reactor (PFBR), Kalpakkam Breeder Reactor Simulator (KALBR-SIM), steady state, transient state

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1474 The Influence of Nyerere in Integrating Ubuntu Knowledge and Social Work in Tanzania – A Literature Review

Authors: Meinrad Haule Lembuka

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Ubuntu is an African philosophy and model with the meaning of 'humanity to others' or 'care for other’s needs because of the guiding principle of interdependence’ that embraces collective and holistic efforts in development through the human face. The study uses a literature review method reflecting Julius Nyerere’s contributions in realizing Ubuntu and social work practice. Nyerere strived to restore Africa development in the lens of humanism through the values of solidarity, communal participation, compassion, care, justice etc; He later founded developmental social work through Ujamaa model, educational for self reliance and African dignity. Nyerere was against post-colonial syndromes through African socialism that envisioned values and principles of social work to provide social justice, human dignity, social change and social development. Also, he managed to serve the primary mission of the social work profession to enhance human wellbeing and help meet basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty with African Ubuntu practice of equal distribution of resources. Nyerere further endorsed social work legal framework that embraced universal human rights: service, equality, social justice, and human dignity, Importance of human relationship, integrity and competence. Nyerere proved that Indigenous model can work with formal system like Social work profession. In 2014 the National Heritage Council of South Africa (NHC) honored him an Award of African Ubuntu champion. Nyerere strongly upheld to be an ambassador of social work through his remarkably contributions in developmental social work (Ujamaa model), social change, human dignity, equality, social unity and social justice in Africa and globe at large.

Keywords: ubuntu, Indiginious knowledge, Indiginious social work, ubuntu social work

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1473 Exploring the Barriers Regarding Safe Discussions about Menopausal Symptom Management, as Perceived or Experienced by Pre-menopausal and Menopausal Women.

Authors: Karish Thavabalan, Alistair Ovenell, Aman Sutaria, Annabelle Parkhouse, Numan Baydemir, Theodore Lally

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Background: Open discussions surrounding menopause are often associated with stigma, with many women feeling uncomfortable to engage in them with friends, colleagues, and healthcare professionals. Though the barriers regarding safe discussions of symptom management experienced by menopausal women are well documented, existing research offers little insight into whether these were shared by pre-menopausal women. This study aimed to explore the barriers regarding safe discussions about menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. Methods: This qualitative study was conducted over a 2-month period (March 2022 - April 2022) under the auspices of Imperial College Business School, London, UK. Snowball sampling was used to recruit both menopausal (age 45-70) and pre-menopausal participants (age <45), and sampling continued until data saturation was achieved. 16 semi-structured online interviews were conducted, and transcripts were thematically analyzed following Braun and Clarke’s six-step methodology. Results: A total of 7 higher themes regarding safe discussion of menopausal symptom management were identified by both pre-menopausal and menopausal women, including: “ineffective coping mechanisms”, “perceived onus to self-endure”, “lack of workplace support”, “poor knowledge of management approaches”, “poor healthcare infrastructure”, “poor support from friends and family”, “lack of knowledge and interest from a young age”. Conclusion: Identifying the barriers regarding safe discussion helped to highlight which areas require most significant intervention. Alongside tackling the barriers, menopausal women face, ultimately, there is a pertinent need to and address the lack of insight into menopause from a younger age and to encourage earlier discussions so as to not propagate the cycle of stigma.

Keywords: menopause, stigma, safe discussions, symptom management

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1472 A Novel Study Contrasting Traditional Autopsy with Post-Mortem Computed Tomography in Falls Leading to Death

Authors: Balaji Devanathan, Gokul G., Abilash S., Abhishek Yadav, Sudhir K. Gupta

Abstract:

Background: As an alternative to the traditional autopsy, a virtual autopsy is carried out using scanning and imaging technologies, mainly post-mortem computed tomography (PMCT). This facility aims to supplement traditional autopsy results and reduce or eliminate internal dissection in subsequent autopsies. For emotional and religious reasons, the deceased's relatives have historically disapproved such interior dissection. The non-invasive, objective, and preservative PMCT is what friends and family would rather have than a traditional autopsy. Additionally, it aids in the examination of the technologies and the benefits and drawbacks of each, demonstrating the significance of contemporary imaging in the field of forensic medicine. Results: One hundred falls resulting in fatalities was analysed by the writers. Before the autopsy, each case underwent a PMCT examination using a 16-slice Multi-Slice CT spiral scanner. By using specialised software, MPR and VR reconstructions were carried out following the capture of the raw images. The accurate detection of fractures in the skull, face bones, clavicle, scapula, and vertebra was better observed in comparison to a routine autopsy. The interpretation of pneumothorax, Pneumoperitoneum, pneumocephalus, and hemosiuns are much enhanced by PMCT than traditional autopsy. Conclusion. It is useful to visualise the skeletal damage in fall from height cases using a virtual autopsy based on PMCT. So, the ideal tool in traumatising patients is a virtual autopsy based on PMCT scans. When assessing trauma victims, PMCT should be viewed as an additional helpful tool to traditional autopsy. This is because it can identify additional bone fractures in body parts that are challenging to examine during autopsy, such as posterior regions, which helps the pathologist reconstruct the victim's life and determine the cause of death.

Keywords: PMCT, fall from height, autopsy, fracture

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1471 Associated Risks of Spontaneous Lung Collapse after Shoulder Surgery: A Literature Review

Authors: Fiona Bei Na Tan, Glen Wen Kiat Ho, Ee Leen Liow, Li Yin Tan, Sean Wei Loong Ho

Abstract:

Background: Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Objectives: Our aim is to highlight a case report of pneumothorax post shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors associated with developing a pneumothorax during or after shoulder arthroscopy. Case Report: We report the case of a 75-year-old male non-smoker who underwent left shoulder arthroscopy without regional anaesthesia and in the left lateral position. The general anaesthesia and surgery were uncomplicated. The patient was desaturated postoperatively and was found to have a pneumothorax on examination and chest X-ray. A chest tube drain was inserted promptly into the right chest. He had an uncomplicated postoperative course. Methods: PubMed Medline and Cochrane database search was carried out using the terms shoulder arthroplasty, pneumothorax, pneumomediastinum, and subcutaneous emphysema. We selected full-text articles written in English. Results: Thirty-two articles were identified and thoroughly reviewed. Based on our inclusion and exclusion criteria, 14 articles, which included 20 cases of pneumothorax during or after shoulder arthroscopy, were included. Eighty percent (16/20) of pneumothoraxes occurred postoperatively. In the articles that specify the side of pneumothorax, 91% (10/11) occur on the ipsilateral side of the arthroscopy. Eighty-eight percent (7/8) of pneumothoraxes occurred when subacromial decompression was performed. Fifty-six percent (9/16) occurred in patients placed in the lateral decubitus position. Only 30% (6/20) occurred in current or ex-smokers, and only 25% (5/20) had a pre-existing lung condition. Overall, of the articles that posit a mechanism, 75% (9/12) deem the pathogenesis to be multifactorial. Conclusion: The exact mechanism of pneumothorax is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should have a low threshold to obtain diagnostic plain radiographs in the event of clinical suspicion.

Keywords: rotator cuff repair, decompression, pressure, complication

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1470 Class Control Management Issues and Solutions in Interactive Learning Theories’ Efficiency and the Application Case Study: 3rd Year Primary School

Authors: Mohammed Belalia Douma

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Interactive learning is considered as the most effective strategy of learning, it is an educational philosophy based on the learner's contribution and involvement mainly in classroom and how he interacts toward his small society “classroom”, and the level of his collaboration into challenge, discovering, games, participation, all these can be provided through the interactive learning, which aims to activate the learner's role in the operation of learning, which focuses on research and experimentation, and the learner's self-reliance in obtaining information, acquiring skills, and forming values and attitudes. Whereas not based on memorization only, but rather on developing thinking and the ability to solve problems, on teamwork and collaborative learning. With the exchange or roles - teacher to student- , when the student will be more active and performing operations more than the student under the interactive learning method; we might face a several issues dealing with class controlling management, noise, and stability of learning… etc. This research paper is observing the application of the interactive learning on reality “classroom” and answers several assumptions and analyzes the issues coming up of these strategies mainly: noise, class control…etc The research sample was about 150 student of the 3rd year primary school in “Chlef” district, Algeria, level: beginners in the range of age 08 to 10 years old . We provided a questionnaire of confidential fifteen questions and also analyzing the attitudes of learners during three months. it have witnessed as teachers a variety of strategies dealing with applying the interactive learning but with a different issues; time management, noise, uncontrolled classes, overcrowded classes. Finally, it summed up that although the active education is an inevitably effective method of teaching, however, there are drawbacks to this, in addition to the fact that not all theoretical strategies can be applied and we conclude with solutions of this case study.

Keywords: interactive learning, student, learners, strategies.

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1469 Lived Experiences of Primary Caregiver of Schizophrenia Patients at Acute Crisis Intervention Service

Authors: Mykah W. Sumoldao, Maria Erissa C. Susa, Triny Cate M. Telan, Christian Arvin M. Torres, Jasmine I. Udasco, Franceis Jeramil M. Walis, Shellyn S. Wandagan, Janine May M. Warding, Queenie Diana Rose P. Zalun Hope Lulet A. Lomioan

Abstract:

This descriptive phenomenological study explored the lived experiences of the primary caregiver of schizophrenia patients at the Acute Crisis Intervention Service in Cagayan Valley Medical Center. The research aimed to understand the emotional, physical, and financial challenges these primary caregivers face. Data was gathered through interviews with nine (9) primary caregivers and analyzed using Colaizzi’s seven-step method. Two main themes emerged: Experience/ Challenges (Emotional, Physical, and Financial Challenges) and Managing Mechanisms (Support Systems and Resilience and Commitment). The study found that primary caregivers deal with a complex mix of difficulties, often with limited resources. They rely heavily on personal strength, faith, family, friends and community support to manage their roles. The findings highlighted the need for better support systems to ease primary caregivers' burdens. Financial aid, respite care, and mental health support are crucial for improving primary caregivers' quality of life and the care they provide. Additionally, raising awareness about primary caregivers' challenges can foster a supportive community, with more help from local organizations and government entities. Thus, this study provided insights into the caregiving experiences of those supporting schizophrenia patients. It emphasized the importance of practical support and emotional resilience. By addressing these needs, a more supportive environment can be created, benefiting both primary caregivers and their patients.

Keywords: primary caregiver burden, mental health, primary caregiver well-being, primary caregiver

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1468 Rheological Properties and Thermal Performance of Suspensions of Microcapsules Containing Phase Change Materials

Authors: Vinh Duy Cao, Carlos Salas-Bringas, Anna M. Szczotok, Marianne Hiorth, Anna-Lena Kjøniksen

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The increasing cost of energy supply for the purposes of heating and cooling creates a demand for more energy efficient buildings. Improved construction techniques and enhanced material technology can greatly reduce the energy consumption needed for the buildings. Microencapsulated phase change materials (MPCM) suspensions utilized as heat transfer fluids for energy storage and heat transfer applications provide promising potential solutions. A full understanding of the flow and thermal characteristics of microcapsule suspensions is needed to optimize the design of energy storage systems, in order to reduce the capital cost, system size, and energy consumption. The MPCM suspensions exhibited pseudoplastic and thixotropic behaviour, and significantly improved the thermal performance of the suspensions. Three different models were used to characterize the thixotropic behaviour of the MPCM suspensions: the second-order structural, kinetic model was found to give a better fit to the experimental data than the Weltman and Figoni-Shoemaker models. For all samples, the initial shear stress increased, and the breakdown rate accelerated significantly with increasing concentration. The thermal performance and rheological properties, especially the selection of rheological models, will be useful for developing the applications of microcapsules as heat transfer fluids in thermal energy storage system such as calculation of an optimum MPCM concentration, pumping power requirement, and specific power consumption. The effect of temperature on the shear thinning properties of the samples suggests that some of the phase change material is located outside the capsules, and contributes to agglomeration of the samples.

Keywords: latent heat, microencapsulated phase change materials, pseudoplastic, suspension, thixotropic behaviour

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1467 Management of Autoimmune Diseases with Ayurveda

Authors: Simmi Chopra

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In the last few years, there has been a surge of Autoimmune diseases that have become more like an epidemic all over the world. The reasons vary from stress, insufficient sleep, smoking, genetics, environmental pollution, adulterated foods, and a diet full of “the deadly white,” which is white sugar and white flour. Most of the people diagnosed with these diseases are given steroids, opioids, supplements, or elimination diets to manage their lives, but most of them continue suffering to varying degrees. On the other hand, Ayurveda can help manage autoimmune problems effectively. Ayurveda is a 5000 years old holistic medical system from India that has an individualistic approach where health problems are looked at from the lens of balancing body and mind and by targeting the root cause of the problem. A combination of diet and lifestyle according to Ayurvedic principles, Ayurvedic herbal formulations and Ayurvedic therapies can help in the management of autoimmune and other chronic diseases. Panchkarma, which is an intense six weeks detox method, helps balance our body and mind, and has been very effective in managing autoimmune problems. The paper will introduce the basic concepts of Ayurveda and describe the terminologies- doshas, agni and ama. The paper will discuss the importance of diet and lifestyle according to the individual’s imbalance in the three functional parameters - doshas, which govern every aspect of our body and mind, our cells and tissues. The significance of agni, which can be correlated to digestive strength and ama, which can be correlated to toxins that are formed in our body leading to health problems, will be outlined. The Ayurvedic pathophysiology of autoimmune diseases will be discussed with emphasis on Rheumatoid arthritis, Multiple sclerosis and Psoriasis. Ayurvedic management will be discussed for these autoimmune conditions. As Ayurveda is an individualistic system, one protocol will not work for everyone. Therefore, case studies with Ayurvedic protocols for the above autoimmune disease will be presented. Conclusion: Ayurveda can help in managing as well as arresting the progression of autoimmune problems. Ayurveda is an ancient medical system, is much more needed today than ever. It is a tried and tested holistic system which has been practiced for the past many generations in India.

Keywords: ayurveda, autoimmune, diseases, nutrition

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1466 Glaucoma with Normal IOP, Is It True Normal Tension glaucoma or Something Else!

Authors: Sushma Tejwani, Shoruba Dinakaran, Kushal Kacha, K. Bhujang Shetty

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Introduction and aim: It is not unusual to find patients with glaucomatous damage and normal intraocular pressure, and to label a patient as Normal tension glaucoma (NTG) majority of clinicians depend on office Intraocular pressures (IOP) recordings; hence, the concern is that whether we are missing the late night or early morning spikes in this group of patients. Also, ischemia to the optic nerve is one of the presumed causes of damage in these patients, however demonstrating the same has been a challenge. The aim of this study was to evaluate IOP variations and patterns in a series of patients with open angles, glaucomatous discs or fields but normal office IOP, and in addition to identify ischemic factors for true NTG patients. Materials & Methods: This was an observational cross- sectional study from a tertiary care centre. The patients that underwent full day DVT from Jan 2012 to April 2014 were studied. All patients underwent IOP measurement on Goldmann applanation tonometry every 3 hours for 24 hours along with a recording of the blood pressure (BP). Further patients with normal IOP throughout the 24- hour period were evaluated with a cardiologist for echocardiography and carotid Doppler. Results: There were 47 patients and a maximum number of patients studied was in the age group of 50-70 years. A biphasic IOP peak was noted for almost all the patients. Out of the 47 patients, 2 were excluded from analysis as they were on treatment.20 patients (42%) were diagnosed on DVT to have an IOP spike and were then diagnosed as open angle glaucoma and another 25 (55%) were diagnosed to have normal tension glaucoma and were subsequently advised a carotid Doppler and a cardiologists consult. Another interesting finding was that 9 patients had a nocturnal dip in their BP and 3 were found to have carotid artery stenosis. Conclusion: A continuous 24-hour monitoring of the IOP and BP is a very useful albeit mildly cumbersome tool which provides a wealth of information in cases of glaucoma presenting with normal office pressures. It is of great value in differentiating between normal tension glaucoma patients & open angle glaucoma patients. It also helps in timely diagnosis & possible intervention due to referral to a cardiologist in cases of carotid artery stenosis.

Keywords: carotid artery disease in NTG, diurnal variation of IOP, ischemia in glaucoma, normal tension glaucoma

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1465 A Cross-Cultural Approach for Communication with Biological and Non-Biological Intelligences

Authors: Thomas Schalow

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This paper posits the need to take a cross-cultural approach to communication with non-human cultures and intelligences in order to meet the following three imminent contingencies: communicating with sentient biological intelligences, communicating with extraterrestrial intelligences, and communicating with artificial super-intelligences. The paper begins with a discussion of how intelligence emerges. It disputes some common assumptions we maintain about consciousness, intention, and language. The paper next explores cross-cultural communication among humans, including non-sapiens species. The next argument made is that we need to become much more serious about communicating with the non-human, intelligent life forms that already exist around us here on Earth. There is an urgent need to broaden our definition of communication and reach out to the other sentient life forms that inhabit our world. The paper next examines the science and philosophy behind CETI (communication with extraterrestrial intelligences) and how it has proven useful, even in the absence of contact with alien life. However, CETI’s assumptions and methodology need to be revised and based on the cross-cultural approach to communication proposed in this paper if we are truly serious about finding and communicating with life beyond Earth. The final theme explored in this paper is communication with non-biological super-intelligences using a cross-cultural communication approach. This will present a serious challenge for humanity, as we have never been truly compelled to converse with other species, and our failure to seriously consider such intercourse has left us largely unprepared to deal with communication in a future that will be mediated and controlled by computer algorithms. Fortunately, our experience dealing with other human cultures can provide us with a framework for this communication. The basic assumptions behind intercultural communication can be applied to the many types of communication envisioned in this paper if we are willing to recognize that we are in fact dealing with other cultures when we interact with other species, alien life, and artificial super-intelligence. The ideas considered in this paper will require a new mindset for humanity, but a new disposition will prepare us to face the challenges posed by a future dominated by artificial intelligence.

Keywords: artificial intelligence, CETI, communication, culture, language

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