Search results for: annual report
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3327

Search results for: annual report

2967 Analysis of Epileptic Electroencephalogram Using Detrended Fluctuation and Recurrence Plots

Authors: Mrinalini Ranjan, Sudheesh Chethil

Abstract:

Epilepsy is a common neurological disorder characterised by the recurrence of seizures. Electroencephalogram (EEG) signals are complex biomedical signals which exhibit nonlinear and nonstationary behavior. We use two methods 1) Detrended Fluctuation Analysis (DFA) and 2) Recurrence Plots (RP) to capture this complex behavior of EEG signals. DFA considers fluctuation from local linear trends. Scale invariance of these signals is well captured in the multifractal characterisation using detrended fluctuation analysis (DFA). Analysis of long-range correlations is vital for understanding the dynamics of EEG signals. Correlation properties in the EEG signal are quantified by the calculation of a scaling exponent. We report the existence of two scaling behaviours in the epileptic EEG signals which quantify short and long-range correlations. To illustrate this, we perform DFA on extant ictal (seizure) and interictal (seizure free) datasets of different patients in different channels. We compute the short term and long scaling exponents and report a decrease in short range scaling exponent during seizure as compared to pre-seizure and a subsequent increase during post-seizure period, while the long-term scaling exponent shows an increase during seizure activity. Our calculation of long-term scaling exponent yields a value between 0.5 and 1, thus pointing to power law behaviour of long-range temporal correlations (LRTC). We perform this analysis for multiple channels and report similar behaviour. We find an increase in the long-term scaling exponent during seizure in all channels, which we attribute to an increase in persistent LRTC during seizure. The magnitude of the scaling exponent and its distribution in different channels can help in better identification of areas in brain most affected during seizure activity. The nature of epileptic seizures varies from patient-to-patient. To illustrate this, we report an increase in long-term scaling exponent for some patients which is also complemented by the recurrence plots (RP). RP is a graph that shows the time index of recurrence of a dynamical state. We perform Recurrence Quantitative analysis (RQA) and calculate RQA parameters like diagonal length, entropy, recurrence, determinism, etc. for ictal and interictal datasets. We find that the RQA parameters increase during seizure activity, indicating a transition. We observe that RQA parameters are higher during seizure period as compared to post seizure values, whereas for some patients post seizure values exceeded those during seizure. We attribute this to varying nature of seizure in different patients indicating a different route or mechanism during the transition. Our results can help in better understanding of the characterisation of epileptic EEG signals from a nonlinear analysis.

Keywords: detrended fluctuation, epilepsy, long range correlations, recurrence plots

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2966 Heading for Modern Construction Management: Recommendation for Employers

Authors: Robin Becker, Maike Eilers, Nane Roetmann, Manfred Helmus

Abstract:

The shortage of junior staff in the construction industry is a problem that will be further exacerbated in the coming years by the retirement of the baby-boom generations (1955-1969) from employment. In addition, the current working conditions in the field of construction management are not attractive for young professionals. A survey of students revealed a desire for an increase in flexibility and an improved work-life balance in everyday working life. Students of civil engineering and architecture are basically interested in a career in construction management but have reservations due to the image of the profession and the current working conditions. A survey among experts from the construction industry shows that the profession can become more attractive. This report provides recommendations for action in the form of working modules to improve the working conditions of employees. If these are taken into account, graduates can be attracted to the profession of construction management, and existing staff can be retained more effectively. The aim of this report is to show incentives for employers to respond to the wishes and needs of their current and future employees to the extent that can be implemented.

Keywords: modern construction management, construction industry, work modules, shortage of junior staff, sustainable personnel management, making construction management more attractive, working time model

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2965 Training AI to Be Empathetic and Determining the Psychotype of a Person During a Conversation with a Chatbot

Authors: Aliya Grig, Konstantin Sokolov, Igor Shatalin

Abstract:

The report describes the methodology for collecting data and building an ML model for determining the personality psychotype using profiling and personality traits methods based on several short messages of a user communicating on an arbitrary topic with a chitchat bot. In the course of the experiments, the minimum amount of text was revealed to confidently determine aspects of personality. Model accuracy - 85%. Users' language of communication is English. AI for a personalized communication with a user based on his mood, personality, and current emotional state. Features investigated during the research: personalized communication; providing empathy; adaptation to a user; predictive analytics. In the report, we describe the processes that captures both structured and unstructured data pertaining to a user in large quantities and diverse forms. This data is then effectively processed through ML tools to construct a knowledge graph and draw inferences regarding users of text messages in a comprehensive manner. Specifically, the system analyzes users' behavioral patterns and predicts future scenarios based on this analysis. As a result of the experiments, we provide for further research on training AI models to be empathetic, creating personalized communication for a user

Keywords: AI, empathetic, chatbot, AI models

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2964 Implementing the WHO Air Quality Guideline for PM2.5 Worldwide can Prevent Millions of Premature Deaths Per Year

Authors: Despina Giannadaki, Jos Lelieveld, Andrea Pozzer, John Evans

Abstract:

Outdoor air pollution by fine particles ranks among the top ten global health risk factors that can lead to premature mortality. Epidemiological cohort studies, mainly conducted in United States and Europe, have shown that the long-term exposure to PM2.5 (particles with an aerodynamic diameter less than 2.5μm) is associated with increased mortality from cardiovascular, respiratory diseases and lung cancer. Fine particulates can cause health impacts even at very low concentrations. Previously, no concentration level has been defined below which health damage can be fully prevented. The World Health Organization ambient air quality guidelines suggest an annual mean PM2.5 concentration limit of 10μg/m3. Populations in large parts of the world, especially in East and Southeast Asia, and in the Middle East, are exposed to high levels of fine particulate pollution that by far exceeds the World Health Organization guidelines. The aim of this work is to evaluate the implementation of recent air quality standards for PM2.5 in the EU, the US and other countries worldwide and estimate what measures will be needed to substantially reduce premature mortality. We investigated premature mortality attributed to fine particulate matter (PM2.5) under adults ≥ 30yrs and children < 5yrs, applying a high-resolution global atmospheric chemistry model combined with epidemiological concentration-response functions. The latter are based on the methodology of the Global Burden of Disease for 2010, assuming a ‘safe’ annual mean PM2.5 threshold of 7.3μg/m3. We estimate the global premature mortality by PM2.5 at 3.15 million/year in 2010. China is the leading country with about 1.33 million, followed by India with 575 thousand and Pakistan with 105 thousand. For the European Union (EU) we estimate 173 thousand and the United States (US) 52 thousand in 2010. Based on sensitivity calculations we tested the gains from PM2.5 control by applying the air quality guidelines (AQG) and standards of the World Health Organization (WHO), the EU, the US and other countries. To estimate potential reductions in mortality rates we take into consideration the deaths that cannot be avoided after the implementation of PM2.5 upper limits, due to the contribution of natural sources to total PM2.5 and therefore to mortality (mainly airborne desert dust). The annual mean EU limit of 25μg/m3 would reduce global premature mortality by 18%, while within the EU the effect is negligible, indicating that the standard is largely met and that stricter limits are needed. The new US standard of 12μg/m3 would reduce premature mortality by 46% worldwide, 4% in the US and 20% in the EU. Implementing the AQG by the WHO of 10μg/m3 would reduce global premature mortality by 54%, 76% in China and 59% in India. In the EU and US, the mortality would be reduced by 36% and 14%, respectively. Hence, following the WHO guideline will prevent 1.7 million premature deaths per year. Sensitivity calculations indicate that even small changes at the lower PM2.5 standards can have major impacts on global mortality rates.

Keywords: air quality guidelines, outdoor air pollution, particulate matter, premature mortality

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2963 Recreation and Environmental Quality of Tropical Wetlands: A Social Media Based Spatial Analysis

Authors: Michael Sinclair, Andrea Ghermandi, Sheela A. Moses, Joseph Sabu

Abstract:

Passively crowdsourced data, such as geotagged photographs from social media, represent an opportunistic source of location-based and time-specific behavioral data for ecosystem services analysis. Such data have innovative applications for environmental management and protection, which are replicable at wide spatial scales and in the context of both developed and developing countries. Here we test one such innovation, based on the analysis of the metadata of online geotagged photographs, to investigate the provision of recreational services by the entire network of wetland ecosystems in the state of Kerala, India. We estimate visitation to individual wetlands state-wide and extend, for the first time to a developing region, the emerging application of cultural ecosystem services modelling using data from social media. The impacts of restoration of wetland areal extension and water quality improvement are explored as a means to inform more sustainable management strategies. Findings show that improving water quality to a level suitable for the preservation of wildlife and fisheries could increase annual visits by 350,000, an increase of 13% in wetland visits state-wide, while restoring previously encroached wetland area could result in a 7% increase in annual visits, corresponding to 49,000 visitors, in the Ashtamudi and Vembanad lakes alone, two large coastal Ramsar wetlands in Kerala. We discuss how passive crowdsourcing of social media data has the potential to improve current ecosystem service analyses and environmental management practices also in the context of developing countries.

Keywords: coastal wetlands, cultural ecosystem services, India, passive crowdsourcing, social media, wetland restoration

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2962 Advanced Eales’ Disease with Neovascular Glaucoma at First Presentation: Case Report

Authors: Mohammed A. Alfayyadh, Halla A. AlAbdulhadi, Mahdi H. Almubarak

Abstract:

Purpose: Eales’ disease is an idiopathic vasculitis that affects the peripheral retina. It is characterized by recurrent vitreous hemorrhage as a complication of retinal neovascularization. It is more prevalent in India and affects young males. Here we present a patient with neovascular glaucoma as a rare first presentation of Eales’ disease. Observations: This is a 24-year-old Indian gentleman, who complained of a sudden decrease in vision in the left eye over less than 24 hours, along with frontal headache and eye pain for the last three weeks. Ocular examination revealed peripheral retinal ischemia in the right eye, very high intraocular pressure, rubeosis iridis, vitreous hemorrhage and extensive retinal ischemia in the left eye, vascular sheathing and neovascularization in both eyes. Purified protein derivative skin test was positive. The patient was managed with anti-glaucoma, intravitreal anti-vascular endothelial growth factor and laser photocoagulation. Systemic steroids and anti-tuberculous therapy were also initiated. Conclusions: Neovascular glaucoma is an infrequent complication of Eales’ disease. However, the lack of early detection of the disease in the early stages might lead to such serious complication.

Keywords: case report, Eales’ disease, mycobacterium tuberculosis, neovascular glaucoma

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2961 Pulmonary Hydatid Cyst in a 13-Year-Old Child: A Case Report

Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel

Abstract:

Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.

Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst

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2960 CVOIP-FRU: Comprehensive VoIP Forensics Report Utility

Authors: Alejandro Villegas, Cihan Varol

Abstract:

Voice over Internet Protocol (VoIP) products is an emerging technology that can contain forensically important information for a criminal activity. Without having the user name and passwords, this forensically important information can still be gathered by the investigators. Although there are a few VoIP forensic investigative applications available in the literature, most of them are particularly designed to collect evidence from the Skype product. Therefore, in order to assist law enforcement with collecting forensically important information from variety of Betamax VoIP tools, CVOIP-FRU framework is developed. CVOIP-FRU provides a data gathering solution that retrieves usernames, contact lists, as well as call and SMS logs from Betamax VoIP products. It is a scripting utility that searches for data within the registry, logs and the user roaming profiles in Windows and Mac OSX operating systems. Subsequently, it parses the output into readable text and html formats. One superior way of CVOIP-FRU compared to the other applications that due to intelligent data filtering capabilities and cross platform scripting back end of CVOIP-FRU, it is expandable to include other VoIP solutions as well. Overall, this paper reveals the exploratory analysis performed in order to find the key data paths and locations, the development stages of the framework, and the empirical testing and quality assurance of CVOIP-FRU.

Keywords: betamax, digital forensics, report utility, VoIP, VoIPBuster, VoIPWise

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2959 Comprehensive Care and the Right to Autonomy of Children and Adolescents with Cancer

Authors: Sandra Soca Lozano, Teresa Isabel Lozano Pérez, Germain Weber

Abstract:

Cancer is a chronic disease of high prevalence in children and adolescents. Medical care in Cuba is carried out by a multidisciplinary team and family is the mediator between this team and the patient. Around this disease, there are interwoven many stereotypes and taboos by its relation to death. In this research report, we describe the work paradigm of psychological care to patients suffering from these diseases in the University Pediatric Hospital Juan Manuel Márquez of Havana, Cuba. We present the psychosocial factors that must be taken into account to provide comprehensive care and ensuring the quality of life of patients and their families. We also present the factors related to the health team and the management of information done with the patient. This is a descriptive proposal from the working experience accumulated in the named institution and in the review of the literature. As a result of this report we make a proposal of teamwork and the aspects in which psychological intervention should be continue performing in terms of increasing the quality of the care made by the health team. We conclude that it is necessary to continue improving the information management of children and adolescents with theses health problems and took into account their right to autonomy.

Keywords: comprehensive care, management of information, psychosocial factors, right to autonomy

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2958 Assessing the Macroeconomic Effects of Fiscal Policy Changes in Egypt: A Bayesian Structural Vector Autoregression Approach

Authors: Walaa Diab, Baher Atlam, Nadia El Nimer

Abstract:

Egypt faces many obvious economic challenges, and it is so clear that a real economic transformation is needed to address those problems, especially after the recent decisions of floating the Egyptian pound and the gradual subsidy cuts that are trying to meet the needed conditions to get the IMF support of (a £12bn loan) for its economic reform program. Following the post-2008 revival of the interest in the fiscal policy and its vital role in speeding up or slowing down the economic growth. Here comes the value of this paper as it seeks to analyze the macroeconomic effects of fiscal policy in Egypt by applying A Bayesian SVAR Approach. The study uses the Bayesian method because it includes the prior information and no relevant information is omitted and so it is well suited for rational, evidence-based decision-making. Since the study aims to define the effects of fiscal policy shocks in Egypt to help the decision-makers in determining the proper means to correct the structural problems in the Egyptian economy, it has to study the period of 1990s economic reform, but unfortunately; the available data is on an annual frequency. Thus, it uses annual time series to study the period 1991: 2005 And quarterly data over the period 2006–2016. It uses a set of six main variables includes government expenditure and net tax revenues as fiscal policy arms affecting real GDP, unemployment, inflation and the interest rate. The study also tries to assess the 'crowding out' effects by considering the effects of government spending and government revenue shocks on the composition of GDP, namely, on private consumption and private investment. Last but not least the study provides its policy implications regarding the needed role of fiscal policy in Egypt in the upcoming economic reform building on the results it concludes from the previous reform program.

Keywords: fiscal policy, government spending, structural vector autoregression, taxation

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2957 It Is Time to Perform Total Laparoscopic Hysterectomy (TLH) without the Use of Uterine Manipulator: Kamran's TLH

Authors: Ahmed Gendia, Waseem Kamran

Abstract:

Objective: Total Laparoscopic hysterectomy (TLH) remains a common approach among laparoscopic surgeons. However, this approach depends on the use of uterine manipulator to facilitate the surgery. Although many studies reported the effectiveness of TLH with uterine manipulator, only few reported TLH without the use of any uterine or vaginal manipulation. the aim of this report is to demonstrate our Technique (kamran's TLH) in performing TLH without the use of any uterine or vaginal manipulation in benign conditions and report our intra- and post-operative outcomes. Methodology : surgical technique will be demonstrated through a short video highlighting the easy and safe to learn surgical steps. Additionally, the data of 86 patients who underwent KTLH for benign condition were retrospectively analyzed. the data included intra- and postoperative finding and complications. Results : A total of 86 hysterectomies were performed utilizing the Kamran's TLH ( KTHL). Mean age was 52.2 (±11) years old and BMI was 28.2(±7). Mean operative time was 64.7(±27.9) minutes and estimated bloods loss was 46.2(±54.6) ml. No intraoperative complications were recorded and there was no conversion to open surgery. Only one patient required readmission and surgery for vaginal vault dehiscence. Conclusion & Significance: Uterine manipulator is a key component in performing laparoscopic hysterectomy. However, our approach demonstrated that TLH can be safely performed without the use of any uterine or vaginal manipulation.

Keywords: laparoscopic hystrectomy, TLH, uterine manipulator, surgery

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2956 Case Report: Clinical Improvement of Forbrain Neurologic Signs in 3- Month- Old Persian Mastiff Dog with Calvarial Hyperostosis Syndrome after Corticosteroid, Antiepileptic and Antibiotic Therapy

Authors: Hamidreza Jahani, Zahra Salehzadeh, Ehsan Amini, Mohsen Tohidifar

Abstract:

Calvarial Hyperostosis Syndrome (CHS) is a benign bone disease of the skull. It is a non-neoplastic and proliferative bone disease, and the main feature of the disease is progressive and asymmetrical bone involvement. CHS is mostly reported in young male and female bullmastiff dogs and less frequently in other breeds. The etiology of CHS is unknown. This is the first case report of CHS in Iran. A 3-month-old male Persian Mastiff was presented with chief complaints of multiple episodes of seizure, pacing, bizarre behavior, delayed growth, head pressing, and difficulty in opening the mouth. Central blindness and open fontanelles were observed in clinical examination. No abnormality was found in the complete blood count and routine blood biochemical tests. CT scan findings include cortical thickening of frontal and parietal bones and enlargement of the left retropharyngeal lymph node. For treatment, oral clindamycin for two weeks, prednisolone and phenobarbital for one month, respectively, were administrated, and the case showed improvement after a week and recovered after one month.

Keywords: calvarial hyperostosis, Persian Mastiff, frontal bone, seizure

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2955 Remedying the Scourge of Poverty as a Social Problem: The Islamic Perspective

Authors: Maryam Umar Ladan, Arshad Munir

Abstract:

Poverty has always been a constant feature of society throughout history. It has existed in the lives of people and it is a fact that although the majority of people lives in poverty, the remaining minority lives in luxury. While some countries called the first World countries lives in luxury, the third World countries lives in poverty. It remains an undesirable phenomenon affecting a vast number of people across the globe despite governmental, institutional and private organizations’ interventions with measures aimed at cushioning its adverse effects. Unequal distribution of societal resources, accumulated wealth in the hands of few, lack of access to education and employment, individual responsibility among others, were highlighted as factors associated with poverty. Poverty predisposes the poor individual to malnutrition and starvation, exposure to disease, thereby resulting to violence, crimes, and experiencing lifelong problems. Evidence show that about 50 percent of the world population lives on less than 2.50 dollar a day, 90 percent of whom are from Sub-Saharan Africa and South Asia including countries where Islam is the major if not one adherent religion. As a solution to poverty, Islam prescribes a system of annual Zakat (charity). The Islamic law prescribes that every person who has a saving that reaches a certain limit should give out 2.5 percent of the total annual earning (as in income, money, farm produce) to deserving and prescribed citizens. This is to, among others; reduce the level of inequality through distribution of wealth among the Muslim Ummah (community). Furthermore, Islam encourages the rich in several places in the Qur’an to spend their wealth on poor people other than the compulsory 2.5%. Therefore, it is inarguable that the Islamic system of distribution of resources (as zakat) is the best strategy to poverty eradication. Thus, strongly recommended for desired results in poverty eradication efforts. If every rich person gives Zakat sincerely, poverty will be eradicated in the world, and not a single person will die of want of food or material things.

Keywords: Islam, charity, poverty, zakat

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2954 Landsat Data from Pre Crop Season to Estimate the Area to Be Planted with Summer Crops

Authors: Valdir Moura, Raniele dos Anjos de Souza, Fernando Gomes de Souza, Jose Vagner da Silva, Jerry Adriani Johann

Abstract:

The estimate of the Area of Land to be planted with annual crops and its stratification by the municipality are important variables in crop forecast. Nowadays in Brazil, these information’s are obtained by the Brazilian Institute of Geography and Statistics (IBGE) and published under the report Assessment of the Agricultural Production. Due to the high cloud cover in the main crop growing season (October to March) it is difficult to acquire good orbital images. Thus, one alternative is to work with remote sensing data from dates before the crop growing season. This work presents the use of multitemporal Landsat data gathered on July and September (before the summer growing season) in order to estimate the area of land to be planted with summer crops in an area of São Paulo State, Brazil. Geographic Information Systems (GIS) and digital image processing techniques were applied for the treatment of the available data. Supervised and non-supervised classifications were used for data in digital number and reflectance formats and the multitemporal Normalized Difference Vegetation Index (NDVI) images. The objective was to discriminate the tracts with higher probability to become planted with summer crops. Classification accuracies were evaluated using a sampling system developed basically for this study region. The estimated areas were corrected using the error matrix derived from these evaluations. The classification techniques presented an excellent level according to the kappa index. The proportion of crops stratified by municipalities was derived by a field work during the crop growing season. These proportion coefficients were applied onto the area of land to be planted with summer crops (derived from Landsat data). Thus, it was possible to derive the area of each summer crop by the municipality. The discrepancies between official statistics and our results were attributed to the sampling and the stratification procedures. Nevertheless, this methodology can be improved in order to provide good crop area estimates using remote sensing data, despite the cloud cover during the growing season.

Keywords: area intended for summer culture, estimated area planted, agriculture, Landsat, planting schedule

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2953 Case Report: Cap Polyposis with Advanced Pelvic Floor Dysfunction: Stronger Evidence of Mechanical Prolapse-related Pathology

Authors: Adrian Sebastian, Chris Gillespie

Abstract:

We describe a case of diffuse rectal involvement with cap polyposis, manifesting with a protein-losing colopathy and occurring in the setting of advanced mechanical pelvic floor dysfunction. A 59-year-old male with a 5-year history of persistent excessive flatulence, defecatory difficulties, and diarrhea. He had extensive cap polyposis of the entire rectum endoscopically. His symptoms progressed to severe fecal incontinence with mucus leakage, pelvic pain, weight loss, and hypoalbuminemia. Clinical examination exhibited severe perineal descent, a large rectocele, poor anal squeeze, and a poor defecatory technique. After a trial of nonoperative therapies addressing his defecatory dysfunction, and Helicobacter pylori eradication, surgical resection was offered due to severe symptoms with ongoing incontinence and protein loss with no other reasonable options. A robotic abdominoperineal resection with a permanent colostomy was performed, followed by an uncomplicated recovery. Our observation of coexisting mechanical pelvic floor changes in this patient lends weight to the concept of a prolapse-related phenomenon in the pathophysiology of this rare condition.

Keywords: cap polyposis, pelvic dysfunction, fecal incontinence, case report

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2952 Climate Change Results in Increased Accessibility of Offshore Wind Farms for Installation and Maintenance

Authors: Victoria Bessonova, Robert Dorrell, Nina Dethlefs, Evdokia Tapoglou, Katharine York

Abstract:

As the global pursuit of renewable energy intensifies, offshore wind farms have emerged as a promising solution to combat climate change. The global offshore wind installed capacity is projected to increase 56-fold by 2055. However, the impacts of climate change, particularly changes in wave climate, are not widely understood. Offshore wind installation and maintenance activities often require specific weather windows, characterized by calm seas and low wave heights, to ensure safe and efficient operations. However, climate change-induced alterations in wave characteristics can reduce the availability of suitable weather windows, leading to delays and disruptions in project timelines. it applied the operational limits of installation and maintenance vessels to past and future climate wave projections. This revealed changes in the annual and monthly accessibility of offshore wind farms at key global development locations. When accessibility is only defined by significant wave height, spatial patterns in the annual accessibility roughly follow changes in significant wave height, with increased availability where significant wave height is decreasing. This resulted in a 1-6% increase in Europe and North America and a similar decrease in South America, Australia and Asia. Monthly changes suggest unchanged or slightly decreased (1-2%) accessibility in summer months and increased (2-6%) in winter. Further assessment includes assessing the sensitivity of accessibility to operational limits defined by wave height combined with wave period and wave height combined with wind speed. Results of this assessment will be included in the presentation. These findings will help stakeholders inform climate change adaptations in installation and maintenance planning practices.

Keywords: climate change, offshore wind, offshore wind installation, operations and maintenance, wave climate, wind farm accessibility

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2951 Vagal Nerve Stimulator as a Treatment Approach in CHARGE Syndrome: A Case Report

Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

Abstract:

Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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2950 Extra-Pulmonary Mycoplasma Pneumoniae Infection in a Healthy 25-Year-Old Female: A Case Report

Authors: Minna Chang

Abstract:

Introduction: M. pneumoniae is a respiratory pathogen, which commonly causes upper and lower respiratory infections. It primarily affects children and young adults. Respiratory symptoms are well recognized, but extrapulmonary involvement is also common. Other systems that have been implicated in the disease include: skin, mucus membranes, central, peripheral nervous systems, cardiovascular, haematological, renal, and musculoskeletal systems. Here, we report a case of an otherwise healthy, young female with M. pneumonia, who presented with right upper quadrant abdominal pain. Case presentation: a healthy 25-year-old female was referred to A&E by her general practitioner, after presenting with fever, malaise, and right upper quadrant pain. M. pneumoniae was confirmed retrospectively by serology. The patient made a full recovery after a six-day course of doxycycline 100mg. Conclusion: M. pneumonia is a well-established cause of respiratory infections in children and young adults. Febrile illness with multisystem involvement, even in the absence of respiratory symptoms, should raise suspicion of M. pneumoniae infection in healthy, young adults. Our case illustrates the multi-system involvement of M. pneumoniae, which was initially missed, due to paucity of respiratory symptoms at presentation.

Keywords: infectious diseases, mycoplasma pneumoniae, respiratory infections, extra-pulmonary manifestations

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2949 Early Vasopressor and De-resuscitation in Steven Johnson Syndrome with Septic Shock: A Case Report

Authors: Darma Putra Sitepu, Dewi Larasati, Yohanes Wolter Hendrik George

Abstract:

Sepsis is a life-threatening medical emergency frequently observed in intensive care unit (ICU). Surviving Sepsis Campaign in 2018 has recommended the administration of early vasopressor in the first hour of sepsis or septic shock but has not yet included de-resuscitation protocol. De-resuscitation in acute management of septic shock is where patient received active removal of accumulated fluid. It has been proposed by some studies and ongoing clinical trials. Here we present a case with early vasopressor and de-resuscitation. Male, 27 years old presenting to the emergency room with shortness of breath, altered mental status, and widespread blisters on his body and lips started a few hours prior, after receiving non-steroidal anti-inflammatory drug through intravenous injection. Patient was hypotensive, tachycardic, and tachypneic at admission, diagnosed with Steven Johnson Syndrome with Septic Shock. Patient received fluid resuscitation, early vasopressor, and diuresis agent aimed to actively remove fluid after the initial phase of resuscitation. Patient was admitted to ICU and progressively recovering. At day-10, patient was stabilized and was transferred to general ward. Early vasopressor and de-resuscitation are beneficial for the patient.

Keywords: sepsis, shock, de-resuscitation, vasopressor, fluid, case report

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2948 Discovery of Two-dimensional Hexagonal MBene HfBO

Authors: Nanxi Miao, Junjie Wang

Abstract:

The discovery of 2D materials with distinct compositions and properties has been a research aim since the report of graphene. One of the latest members of the 2D material family is MXene, which is produced from the topochemical deintercalation of the A layer from a laminate MAX phase. Recently, analogous 2D MBenes (transitional metal borides) have been predicted by theoretical calculations as excellent alternatives in applications such as metal-ion batteries, magnetic devices, and catalysts. However, the practical applications of two-dimensional (2D) transition-metal borides (MBenes) have been severely hindered by the lack of accessible MBenes because of the difficulties in the selective etching of traditional ternary MAB phases with orthorhombic symmetry (ort-MAB). Here, we discover a family of ternary hexagonal MAB (h-MAB) phases and 2D hexagonal MBenes (h-MBenes) by ab initio predictions and experiments. Calculations suggest that the ternary h-MAB phases are more suitable precursors for MBenes than the ort-MAB phases. Based on the prediction, we report the experimental synthesis of h-MBene HfBO by selective removal of in from h-MAB Hf2InB2. The synthesized 2D HfBO delivered a specific capacity of 420 mAh g-1 as an anode material in lithium-ion batteries, demonstrating the potential for energy-storage applications. The discovery of this h-MBene HfBO added a new member to the growing family of 2D materials and provided opportunities for a wide range of novel applications.

Keywords: 2D materials, DFT calculations, high-throughput screening, lithium-ion batteries

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2947 Simplifying Health Risk Assessment (HRA) and Its Operationalisation for Turnaround Activities

Authors: Thirumila Muthukamaru

Abstract:

The objective of a Health Risk Assessment (HRA) is to achieve a quality evaluation of risk assessments in a timely manner where adequate controls can be in place to protect workers health, especially during turnarounds where the exposure to health hazards is expected to rise during the performance of the many activities that take place, exposing workers to health risk. HRA development requires a competent team comprising experienced subject matter experts in the field, such as Industrial hygienists, Occupational Health Doctors, Turnaround Coordinators, Operation / Maintenance personnel, etc. The conventional way of conducting HRA is not only tedious and time-consuming but also less appreciated when it is not interpreted correctly, which may contribute to inadequate operationalization of it. Simplification can be the essence of timely intervention in managing health risks. This paper is intended as a sharing of the approach taken to simplify the methodology of developing the HRA report and operationalizing it. The approach includes developing a Generic HRA for turnaround activities to be used as a reference document and the empowerment of identified personnel through upskilling sessions to take up the role of facilitating HRA sessions. This empowerment is one of the key approaches towards the successful translation of the HRA into specific turnaround Job Hazard Analysis (JHA) that embed it in the Permit to Work (PTW) process. The approach used here increases awareness and compliance on HRA for turnaround activities through better interpretation and operationalization of the HRA report, adding value to the risk assessment for turnaround activities.

Keywords: industrial hygiene, health risk assessment, HRA, risk assessment

Procedia PDF Downloads 47
2946 Multivariate Ecoregion Analysis of Nutrient Runoff From Agricultural Land Uses in North America

Authors: Austin P. Hopkins, R. Daren Harmel, Jim A Ippolito, P. J. A. Kleinman, D. Sahoo

Abstract:

Field-scale runoff and water quality data are critical to understanding the fate and transport of nutrients applied to agricultural lands and minimizing their off-site transport because it is at that scale that agricultural management decisions are typically made based on hydrologic, soil, and land use factors. However, regional influences such as precipitation, temperature, and prevailing cropping systems and land use patterns also impact nutrient runoff. In the present study, the recently-updated MANAGE (Measured Annual Nutrient loads from Agricultural Environments) database was used to conduct an ecoregion-level analysis of nitrogen and phosphorus runoff from agricultural lands in the North America. Specifically, annual N and P runoff loads for cropland and grasslands in North American Level II EPA ecoregions were presented, and the impact of factors such as land use, tillage, and fertilizer timing and placement on N and P runoff were analyzed. Specifically we compiled annual N and P runoff load data (i.e., dissolved, particulate, and total N and P, kg/ha/yr) for each Level 2 EPA ecoregion and for various agricultural management practices (i.e., land use, tillage, fertilizer timing, fertilizer placement) within each ecoregion to showcase the analyses possible with the data in MANAGE. Potential differences in N and P runoff loads were evaluated between and within ecoregions with statistical and graphical approaches. Non-parametric analyses, mainly Mann-Whitney tests were conducted on median values weighted by the site years of data utilizing R because the data were not normally distributed, and we used Dunn tests and box and whisker plots to visually and statistically evaluate significant differences. Out of the 50 total North American Ecoregions, 11 were found that had significant data and site years to be utilized in the analysis. When examining ecoregions alone, it was observed that ER 9.2 temperate prairies had a significantly higher total N at 11.7 kg/ha/yr than ER 9.4 South Central Semi Arid Prairies with a total N of 2.4. When examining total P it was observed that ER 8.5 Mississippi Alluvial and Southeast USA Coastal Plains had a higher load at 3.0 kg/ha/yr than ER 8.2 Southeastern USA Plains with a load of 0.25 kg/ha/yr. Tillage and Land Use had severe impacts on nutrient loads. In ER 9.2 Temperate Prairies, conventional tillage had a total N load of 36.0 kg/ha/yr while conservation tillage had a total N load of 4.8 kg/ha/yr. In all relevant ecoregions, when corn was the predominant land use, total N levels significantly increased compared to grassland or other grains. In ER 8.4 Ozark-Ouachita, Corn had a total N of 22.1 kg/ha/yr while grazed grassland had a total N of 2.9 kg/ha/yr. There are further intricacies of the interactions that agricultural management practices have on one another combined with ecological conditions and their impacts on the continental aquatic nutrient loads that still need to be explored. This research provides a stepping stone to further understanding of land and resource stewardship and best management practices.

Keywords: water quality, ecoregions, nitrogen, phosphorus, agriculture, best management practices, land use

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2945 The MoEDAL-MAPP* Experiment - Expanding the Discovery Horizon of the Large Hadron Collider

Authors: James Pinfold

Abstract:

The MoEDAL (Monopole and Exotics Detector at the LHC) experiment deployed at IP8 on the Large Hadron Collider ring was the first dedicated search experiment to take data at the Large Hadron Collider (LHC) in 2010. It was designed to search for Highly Ionizing Particle (HIP) avatars of new physics such as magnetic monopoles, dyons, Q-balls, multiply charged particles, massive, slowly moving charged particles and long-lived massive charge SUSY particles. We shall report on our search at LHC’s Run-2 for Magnetic monopoles and dyons produced in p-p and photon-fusion. In more detail, we will report our most recent result in this arena: the search for magnetic monopoles via the Schwinger Mechanism in Pb-Pb collisions. The MoEDAL detector, originally the first dedicated search detector at the LHC, is being reinstalled for LHC’s Run-3 to continue the search for electrically and magnetically charged HIPs with enhanced instantaneous luminosity, detector efficiency and a factor of ten lower thresholds for HIPs. As part of this effort, we will search for massive l long-lived, singly and multiply charged particles from various scenarios for which MoEDAL has a competitive sensitivity. An upgrade to MoEDAL, the MoEDAL Apparatus for Penetrating Particles (MAPP), is now the LHC’s newest detector. The MAPP detector, positioned in UA83, expands the physics reach of MoEDAL to include sensitivity to feebly-charged particles with charge, or effective charge, as low as 10-3 e (where e is the electron charge). Also, In conjunction with MoEDAL’s trapping detector, the MAPP detector gives us a unique sensitivity to extremely long-lived charged particles. MAPP also has some sensitivity to long-lived neutral particles. The addition of an Outrigger detector for MAPP-1 to increase its acceptance for more massive milli-charged particles is currently in the Technical Proposal stage. Additionally, we will briefly report on the plans for the MAPP-2 upgrade to the MoEDAL-MAPP experiment for the High Luminosity LHC (HL-LHC). This experiment phase is designed to maximize MoEDAL-MAPP’s sensitivity to very long-lived neutral messengers of physics beyond the Standard Model. We envisage this detector being deployed in the UGC1 gallery near IP8.

Keywords: LHC, beyond the standard model, dedicated search experiment, highly ionizing particles, long-lived particles, milli-charged particles

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2944 A Quantitative Analysis for the Correlation between Corporate Financial and Social Performance

Authors: Wafaa Salah, Mostafa A. Salama, Jane Doe

Abstract:

Recently, the corporate social performance (CSP) is not less important than the corporate financial performance (CFP). Debate still exists about the nature of the relationship between the CSP and CFP, whether it is a positive, negative or a neutral correlation. The objective of this study is to explore the relationship between corporate social responsibility (CSR) reports and CFP. The study uses the accounting-based and market-based quantitative measures to quantify the financial performance of seven organizations listed on the Egyptian Stock Exchange in 2007-2014. Then uses the information retrieval technologies to quantify the contribution of each of the three dimensions of the corporate social responsibility report (environmental, social and economic). Finally, the correlation between these two sets of variables is viewed together in a model to detect the correlations between them. This model is applied on seven firms that generate social responsibility reports. The results show a positive correlation between the Earnings per share (market based measure) and the economical dimension in the CSR report. On the other hand, total assets and property, plant and equipment (accounting-based measure) are positively correlated to the environmental and social dimensions of the CSR reports. While there is not any significant relationship between ROA, ROE, Operating income and corporate social responsibility. This study contributes to the literature by providing more clarification of the relationship between CFP and the isolated CSR activities in a developing country.

Keywords: financial, social, machine learning, corporate social performance, corporate social responsibility

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2943 Male Versatile Sexual Offenders in Taiwan

Authors: Huang Yueh Chen, Sheng Ang Shen

Abstract:

Purpose: Sexual assault has always been a highly anticipated crime in Taiwan. People assume that the career of sexual offenders tends to be highly specialized. This study hopes to analyze the crime career and risk factors of offenders by means of another classification. Methods: A total of 145 sexual offenders were sentenced on the parole or expiration date from 2009 to 2011, through analysis of official existing documents such as ‘Re-infringement risk assessment report’ and ‘case assessment report’. Results: The section ‘Various Types of Crimes ‘ of criminal career is analyzed. The highest number of ‘ versatile sexual offender’ followed by ‘adult sexual offender’ is about 2.5, representing more than 1.5 kinds of non-sex crimes besides sexual crimes. Different specialized sexual offenders have had extensive experience in the ‘Sexual Assault Experiences in Children and School’, ‘Static 99 Levels’, ‘Pre-Commuted Substance Use’, ‘Excited Deviant Sexual Behavior’, ‘Various Types of Crimes,’ and ‘Sexual Crime in Forerunner’ , ‘Type of Index Crime’ and other projects to achieve significant differences. Conclusions: Resources continue to be devoted to specialized offenders, the character of first-time sexual offender depends on further research and makes the public aware of the different assumptions of diversified offenders from traditional professional offenses that reduce unnecessary panic in society.

Keywords: versatile sexual offender, specialized sexual offender, criminal career, risk factor

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2942 Association of Temperature Factors with Seropositive Results against Selected Pathogens in Dairy Cow Herds from Central and Northern Greece

Authors: Marina Sofia, Alexios Giannakopoulos, Antonia Touloudi, Dimitris C Chatzopoulos, Zoi Athanasakopoulou, Vassiliki Spyrou, Charalambos Billinis

Abstract:

Fertility of dairy cattle can be affected by heat stress when the ambient temperature increases above 30°C and the relative humidity ranges from 35% to 50%. The present study was conducted on dairy cattle farms during summer months in Greece and aimed to identify the serological profile against pathogens that could affect fertility and to associate the positive serological results at herd level with temperature factors. A total of 323 serum samples were collected from clinically healthy dairy cows of 8 herds, located in Central and Northern Greece. ELISA tests were performed to detect antibodies against selected pathogens that affect fertility, namely Chlamydophila abortus, Coxiella burnetii, Neospora caninum, Toxoplasma gondii and Infectious Bovine Rhinotracheitis Virus (IBRV). Eleven climatic variables were derived from the WorldClim version 1.4. and ArcGIS V.10.1 software was used for analysis of the spatial information. Five different MaxEnt models were applied to associate the temperature variables with the locations of seropositive Chl. abortus, C. burnetii, N. caninum, T. gondii and IBRV herds (one for each pathogen). The logistic outputs were used for the interpretation of the results. ROC analyses were performed to evaluate the goodness of fit of the models’ predictions. Jackknife tests were used to identify the variables with a substantial contribution to each model. The seropositivity rates of pathogens varied among the 8 herds (0.85-4.76% for Chl. abortus, 4.76-62.71% for N. caninum, 3.8-43.47% for C. burnetii, 4.76-39.28% for T. gondii and 47.83-78.57% for IBRV). The variables of annual temperature range, mean diurnal range and maximum temperature of the warmest month gave a contribution to all five models. The regularized training gains, the training AUCs and the unregularized training gains were estimated. The mean diurnal range gave the highest gain when used in isolation and decreased the gain the most when it was omitted in the two models for seropositive Chl.abortus and IBRV herds. The annual temperature range increased the gain when used alone and decreased the gain the most when it was omitted in the models for seropositive C. burnetii, N. caninum and T. gondii herds. In conclusion, antibodies against Chl. abortus, C. burnetii, N. caninum, T. gondii and IBRV were detected in most herds suggesting circulation of pathogens that could cause infertility. The results of the spatial analyses demonstrated that the annual temperature range, mean diurnal range and maximum temperature of the warmest month could affect positively the possible pathogens’ presence. Acknowledgment: This research has been co‐financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH–CREATE–INNOVATE (project code: T1EDK-01078).

Keywords: dairy cows, seropositivity, spatial analysis, temperature factors

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2941 Infection Risk of Fecal Coliform Contamination in Drinking Water Sources of Urban Slum Dwellers: Application of Quantitative Microbiological Risk Assessment

Authors: Sri Yusnita Irda Sari, Deni Kurniadi Sunjaya, Ardini Saptaningsih Raksanagara

Abstract:

Water is one of the fundamental basic needs for human life, particularly drinking water sources. Although water quality is getting better, fecal-contamination of water is still found around the world, especially in the slum area of mid-low income countries. Drinking water source contamination in urban slum dwellers increases the risk of water borne diseases. Low level of sanitation and poor drinking water supply known as risk factors for diarrhea, moreover bacteria-contaminated drinking water source is the main cause of diarrhea in developing countries. This study aimed to assess risk infection due to Fecal Coliform contamination in various drinking water sources in urban area by applying Quantitative Microbiological Risk Assessment (QMRA). A Cross-sectional survey was conducted in a period of August to October 2015. Water samples were taken by simple random sampling from households in Cikapundung river basin which was one of urban slum area in the center of Bandung city, Indonesia. About 379 water samples from 199 households and 15 common wells were tested. Half of the households used treated drinking water from water gallon mostly refill water gallon which was produced in drinking water refill station. Others used raw water sources which need treatment before consume as drinking water such as tap water, borehole, dug well and spring water source. Annual risk to get infection due to Fecal Coliform contamination from highest to lowest risk was dug well (1127.9 x 10-5), spring water (49.7 x 10-5), borehole (1.383 x 10-5) and tap water (1.121 x 10-5). Annual risk infection of refill drinking water was 1.577 x 10-5 which is comparable to borehole and tap water. Household water treatment and storage to make raw water sources drinkable is essential to prevent risk of water borne diseases. Strong regulation and intense monitoring of refill water gallon quality should be prioritized by the government; moreover, distribution of tap water should be more accessible and affordable especially in urban slum area.

Keywords: drinking water, quantitative microbiological risk assessment, slum, urban

Procedia PDF Downloads 281
2940 The Mitigation Strategy Analysis of Kuosheng Nuclear Power Plant Spent Fuel Pool Using MELCOR2.1/SNAP

Authors: Y. Chiang, J. R. Wang, J. H. Yang, Y. S. Tseng, C. Shih, S. W. Chen

Abstract:

Kuosheng nuclear power plant (NPP) is a BWR/6 plant in Taiwan. There is more concern for the safety of Spent Fuel Pools (SFPs) in Taiwan after Fukushima event. In order to estimate the safety of Kuosheng NPP SFP, by using MELCOR2.1 and SNAP, the safety analysis of Kuosheng NPP SFP was performed combined with the mitigation strategy of NEI 06-12 report. There were several steps in this research. First, the Kuosheng NPP SFP models were established by MELCOR2.1/SNAP. Second, the Station Blackout (SBO) analysis of Kuosheng SFP was done by TRACE and MELCOR under the cooling system failure condition. The results showed that the calculations of MELCOR and TRACE were very similar in this case. Second, the mitigation strategy analysis was done with the MELCOR model by following the NEI 06-12 report. The results showed the effectiveness of NEI 06-12 strategy in Kuosheng NPP SFP. Finally, a sensitivity study of SFP quenching was done to check the differences of different water injection time and the phenomena during the quenching. The results showed that if the cladding temperature was over 1600 K, the water injection may have chance to cause the accident more severe with more hydrogen generation. It was because of the oxidation heat and the “Breakaway” effect of the zirconium-water reaction. An animation model built by SNAP was also shown in this study.

Keywords: MELCOR, SNAP, spent fuel pool, quenching

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2939 An Unusual Presentation of Uveal Melanoma

Authors: Natasha Goh, Sebastian Brown

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Purpose: This case report describes an unusual presentation of uveal melanoma. Method: Case notes, imaging, and histopathological specimen were reviewed for this case report. Result: The patient is a 62-year-old lady of Chinese heritage who had been receiving follow-up at the eye clinic of a tertiary hospital. She had a longstanding history of poor vision in her right eye after sustaining trauma to the eye at age 3. She was found to have a carotid-cavernous sinus fistula in the right eye in 2009 and underwent stenting in China. Unfortunately, this was unsuccessful and resulted in a painful blind eye. She had represented with headaches, worsening eye pain, and ptosis in Sydney in 2016. Her CT angiogram showed a calcified vascular structure in the orbit and globe, and she was offered a digital subtraction angiography by the neurosurgical team, which she ultimately declined. She had since been followed up at the eye clinic for the pthisical eye. Due to chronic ocular pain and recurrent conjunctivitis, the decision was made for an evisceration in 2021. The specimen was sent for routine histopathological examination and returned positive for uveal melanoma. The patient was subsequently referred to a melanoma center for further follow-up, which comprised serial imaging and radiotherapy treatment. Conclusion: Clinicians should bear in mind that uveal melanomas may present in a longstanding phthisical eye and in patients with no or little apparent risk factors.

Keywords: uveal melanoma, pthisical eye, carotid cavernous fistula, uveal melanoma risk factors

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2938 Attitude and Knowledge of Primary Health Care Physicians and Local Inhabitants about Leishmaniasis and Sandfly in West Alexandria, Egypt

Authors: Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad

Abstract:

Background: Leishmaniasis is a worldwide disease, affecting 88 countries, it is estimated that about 350 million people are at risk of leishmaniasis. Overall prevalence is 12 million people with annual mortality of about 60,000. Annual incidence is 1,500,000 cases of cutaneous leishmaniasis (CL) worldwide and half million cases of visceral Leishmaniasis (VL). Objectives: The objective of this study was to assess primary health care physicians knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. Methods: This study was a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study, only 20 PHP completed the questionnaire. 60 local inhabitant were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results: 11(55%) percent of the physicians had satisfactory knowledge, they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. The second part of the questionnaire is concerned with attitude of the primary health care physicians about leishmaniasis, 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandly as a vector of the disease is poor and needs to be corrected. Most of the respondents (90%) had not heard about leishmaniasis, Only 3 (5%) of the interviewed inhabitants said they know sandfly and its role in transmission of leishmaniasis. Conclusions: knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of lesihmaniasis. Moreover, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that if the inhabitants do not perceive mosquitoes to be responsible for diseases such as malaria they do not take enough measures to protect themselves against the vector.

Keywords: leishmaniasis, PHP, knowledge, attitude, local inhabitants

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