Search results for: factors of collaboration
7828 The Effectiveness of Cash Flow Management by SMEs in the Mafikeng Local Municipality of South Africa
Authors: Ateba Benedict Belobo, Faan Pelser, Ambe Marcus
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Aims: This study arise from repeated complaints from both electronic mails about the underperformance of Mafikeng Small and Medium-Size enterprises after the global financial crisis. The authors were on the view that, this poor performance experienced could be as a result of the negative effects on the cash flow of these businesses due to volatilities in the business environment in general prior to the global crisis. Thus, the paper was mainly aimed at determining the shortcomings experienced by these SMEs with regards to cash flow management. It was also aimed at suggesting possible measures to improve cash flow management of these SMEs in this tough time. Methods: A case study was conducted on 3 beverage suppliers, 27 bottle stores, 3 largest fast consumer goods super markets and 7 automobiles enterprises in the Mafikeng local municipality. A mixed method research design was employed and a purposive sampling was used in selecting SMEs that participated. Views and experiences of participants of the paper were captured through in-depth interviews. Data from the empirical investigation were interpreted using open coding and a simple percentage formula. Results: Findings from the empirical research reflected that majority of Mafikeng SMEs suffer poor operational performance prior to the global financial crisis primarily as a result of poor cash flow management. However, the empirical outcome also indicted other secondary factors contributing to this poor operational performance. Conclusion: Finally, the authorsproposed possible measures that could be used to improve cash flow management and to solve other factors affecting operational performance of SMEs in the Mafikeng local municipality in other to achieve a better business performance.Keywords: cash flow, business performance, global financial crisis, SMEs
Procedia PDF Downloads 4397827 Myomectomy and Blood Loss: A Quality Improvement Project
Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu
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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid
Procedia PDF Downloads 857826 Signal Processing of the Blood Pressure and Characterization
Authors: Hadj Abd El Kader Benghenia, Fethi Bereksi Reguig
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In clinical medicine, blood pressure, raised blood hemodynamic monitoring is rich pathophysiological information of cardiovascular system, of course described through factors such as: blood volume, arterial compliance and peripheral resistance. In this work, we are interested in analyzing these signals to propose a detection algorithm to delineate the different sequences and especially systolic blood pressure (SBP), diastolic blood pressure (DBP), and the wave and dicrotic to do their analysis in order to extract the cardiovascular parameters.Keywords: blood pressure, SBP, DBP, detection algorithm
Procedia PDF Downloads 4397825 A Model of Sustainability in the Accommodation Sector
Authors: L. S. Zavodna, J. Zavodny Pospisil
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The aim of this paper is to identify the factors for sustainability in the accommodation sector. Although sustainability is a current trend in tourism, not many facilities know how to apply the concept in practice. This paper presents a model for the implementation of sustainability in hotels, hostels, campgrounds, or other facilities. First, there are identified sections of each accommodation facility, which can contribute to sustainability. Furthermore, concrete steps are presented to transfer this model into reality.Keywords: accommodation sector, model, sustainable tourism, sustainability
Procedia PDF Downloads 3057824 Protection of Patients and Staff in External Beam Radiotherapy Using Linac in Kenya
Authors: Calvince Okome Odeny
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There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.Keywords: oncology, radiotherapy, protection, staff
Procedia PDF Downloads 757823 Sustainable Intensification of Agriculture in Victoria’s Food Bowl: Optimizing Productivity with the use of Decision-Support Tools
Authors: M. Johnson, R. Faggian, V. Sposito
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A participatory and engaged approach is key in connecting agricultural managers to sustainable agricultural systems to support and optimize production in Victoria’s food bowl. A sustainable intensification (SI) approach is well documented globally, but participation rates amongst Victorian farmers is fragmentary, and key outcomes and implementation strategies are poorly understood. Improvement in decision-support management tools and a greater understanding of the productivity gains available upon implementation of SI is necessary. This paper reviews the current understanding and uptake of SI practices amongst farmers in one of Victoria’s premier food producing regions, the Goulburn Broken; and it spatially analyses the potential for this region to adapt to climate change and optimize food production. A Geographical Information Systems (GIS) approach is taken to develop an interactive decision-support tool that can be accessible to on-ground agricultural managers. The tool encompasses multiple criteria analysis (MCA) that identifies factors during the construction phase of the tool, using expert witnesses and regional knowledge, framed within an Analytical Hierarchy Process. Given the complexities of the interrelations between each of the key outcomes, this participatory approach, in which local realities and factors inform the key outcomes and help to strategies for a particular region, results in a robust strategy for sustainably intensifying production in key food producing regions. The creation of an interactive, locally embedded, decision-support management and education tool can help to close the gap between farmer knowledge and production, increase on-farm adoption of sustainable farming strategies and techniques, and optimize farm productivity.Keywords: agriculture, decision-support management tool, Geographic Information System, GIS, sustainable intensification
Procedia PDF Downloads 1667822 Disadvantages and Drawbacks of Concrete Blocks and Fix Their Defects
Authors: Ehsan Sadie
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Today, the cost of repair and maintenance of structures is very important and by studying the behavior of reinforced concrete structures Will become specified several factors such as : Design and calculation errors, lack of proper implementation of structural changes, the damage caused by the introduction of random loads, concrete corrosion and environmental conditions reduce durability of the structures . Meanwhile building codes alteration also cause changes in the assessment and review of the design and structure rather if necessary will be improved and strengthened in the future.Keywords: concrete building , expandable cement, honeycombed surface , reinforcement corrosion
Procedia PDF Downloads 4427821 Risk Factors Associated to Low Back Pain among Active Adults: Cross-Sectional Study among Workers in Tunisian Public Hospital
Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari
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Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.Keywords: health care workers, low back pain, prevention, risk factor
Procedia PDF Downloads 1537820 The Feasibility of Glycerol Steam Reforming in an Industrial Sized Fixed Bed Reactor Using Computational Fluid Dynamic (CFD) Simulations
Authors: Mahendra Singh, Narasimhareddy Ravuru
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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
Procedia PDF Downloads 3087819 Parameters Influencing Human Machine Interaction in Hospitals
Authors: Hind Bouami
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Handling life-critical systems complexity requires to be equipped with appropriate technology and the right human agents’ functions such as knowledge, experience, and competence in problem’s prevention and solving. Human agents are involved in the management and control of human-machine system’s performance. Documenting human agent’s situation awareness is crucial to support human-machine designers’ decision-making. Knowledge about risks, critical parameters and factors that can impact and threaten automation system’s performance should be collected using preventive and retrospective approaches. This paper aims to document operators’ situation awareness through the analysis of automated organizations’ feedback. The analysis of automated hospital pharmacies feedbacks helps to identify and control critical parameters influencing human machine interaction in order to enhance system’s performance and security. Our human machine system evaluation approach has been deployed in Macon hospital center’s pharmacy which is equipped with automated drug dispensing systems since 2015. Automation’s specifications are related to technical aspects, human-machine interaction, and human aspects. The evaluation of drug delivery automation performance in Macon hospital center has shown that the performance of the automated activity depends on the performance of the automated solution chosen, and also on the control of systemic factors. In fact, 80.95% of automation specification related to the chosen Sinteco’s automated solution is met. The performance of the chosen automated solution is involved in 28.38% of automation specifications performance in Macon hospital center. The remaining systemic parameters involved in automation specifications performance need to be controlled.Keywords: life-critical systems, situation awareness, human-machine interaction, decision-making
Procedia PDF Downloads 1817818 Towards an Environmental Knowledge System in Water Management
Authors: Mareike Dornhoefer, Madjid Fathi
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Water supply and water quality are key problems of mankind at the moment and - due to increasing population - in the future. Management disciplines like water, environment and quality management therefore need to closely interact, to establish a high level of water quality and to guarantee water supply in all parts of the world. Groundwater remediation is one aspect in this process. From a knowledge management perspective it is only possible to solve complex ecological or environmental problems if different factors, expert knowledge of various stakeholders and formal regulations regarding water, waste or chemical management are interconnected in form of a knowledge base. In general knowledge management focuses the processes of gathering and representing existing and new knowledge in a way, which allows for inference or deduction of knowledge for e.g. a situation where a problem solution or decision support are required. A knowledge base is no sole data repository, but a key element in a knowledge based system, thus providing or allowing for inference mechanisms to deduct further knowledge from existing facts. In consequence this knowledge provides decision support. The given paper introduces an environmental knowledge system in water management. The proposed environmental knowledge system is part of a research concept called Green Knowledge Management. It applies semantic technologies or concepts such as ontology or linked open data to interconnect different data and information sources about environmental aspects, in this case, water quality, as well as background material enriching an established knowledge base. Examples for the aforementioned ecological or environmental factors threatening water quality are among others industrial pollution (e.g. leakage of chemicals), environmental changes (e.g. rise in temperature) or floods, where all kinds of waste are merged and transferred into natural water environments. Water quality is usually determined with the help of measuring different indicators (e.g. chemical or biological), which are gathered with the help of laboratory testing, continuous monitoring equipment or other measuring processes. During all of these processes data are gathered and stored in different databases. Meanwhile the knowledge base needs to be established through interconnecting data of these different data sources and enriching its semantics. Experts may add their knowledge or experiences of previous incidents or influencing factors. In consequence querying or inference mechanisms are applied for the deduction of coherence between indicators, predictive developments or environmental threats. Relevant processes or steps of action may be modeled in form of a rule based approach. Overall the environmental knowledge system supports the interconnection of information and adding semantics to create environmental knowledge about water environment, supply chain as well as quality. The proposed concept itself is a holistic approach, which links to associated disciplines like environmental and quality management. Quality indicators and quality management steps need to be considered e.g. for the process and inference layers of the environmental knowledge system, thus integrating the aforementioned management disciplines in one water management application.Keywords: water quality, environmental knowledge system, green knowledge management, semantic technologies, quality management
Procedia PDF Downloads 2217817 An Investigation into Root Causes of Sabotage and Vandalism of Pipes: A Major Environmental Effluence in Niger Delta, Nigeria
Authors: Oshienemen Albert
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Human’s activities could be pointed as the root cause of almost all environmental damages/ disasters as we contribute to the activities that are currently damaging the ozone layers (global warming), unusual environmental changes and extreme weather conditions (climate change) in recent times. Nigeria just as every other disaster-prone nation is faced with different types of disasters and environmental calamities, starting from terrorist displacement disasters, flood, drought and oil spill hazards. Oil spillage as an environmental disaster has great consequences not just on the environment but on human health, economy and the entire populace that might be involved, which deem necessary to look into the root causes of the incidents and how it can be curtailed. The different incidents of oil spillages and other oil production consequent on the environment is alarming in the Nigerian context and cannot be overemphasized without a critical investigation and synthesis. This paper investigates the root causes of environmental pollution induced by oil spill hazards from petroleum activities within Niger Delta communities of effects and detailed the potential solutions to reduce the causal factors and reoccurrence of the incidents. This study adopts a desk-based approach, interviews with key members of communities which consist of chiefs, youth leaders, and key women within the high environmental damaged communities. Also, Interviews were conducted with environmental expertise representatives from the oil and gas sectors and representatives from oil spill-related agency. Data were analyzed using thematic techniques. The study shows different influencing factors of sabotage and vandalism of oil facilities as such; marginalization, deprivation of resources utility and resource derivation principles were identified as major contributors to vandalism and sabotage act. The study proposed potential strategies to curtail the root causes of sabotage and vandalism as the major causes of environmental devastations in Nigeria.Keywords: environment, oil spill hazards, Niger delta, Nigeria
Procedia PDF Downloads 1917816 A Study on the Correlation Analysis between the Pre-Sale Competition Rate and the Apartment Unit Plan Factor through Machine Learning
Authors: Seongjun Kim, Jinwooung Kim, Sung-Ah Kim
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The development of information and communication technology also affects human cognition and thinking, especially in the field of design, new techniques are being tried. In architecture, new design methodologies such as machine learning or data-driven design are being applied. In particular, these methodologies are used in analyzing the factors related to the value of real estate or analyzing the feasibility in the early planning stage of the apartment housing. However, since the value of apartment buildings is often determined by external factors such as location and traffic conditions, rather than the interior elements of buildings, data is rarely used in the design process. Therefore, although the technical conditions are provided, the internal elements of the apartment are difficult to apply the data-driven design in the design process of the apartment. As a result, the designers of apartment housing were forced to rely on designer experience or modular design alternatives rather than data-driven design at the design stage, resulting in a uniform arrangement of space in the apartment house. The purpose of this study is to propose a methodology to support the designers to design the apartment unit plan with high consumer preference by deriving the correlation and importance of the floor plan elements of the apartment preferred by the consumers through the machine learning and reflecting this information from the early design process. The data on the pre-sale competition rate and the elements of the floor plan are collected as data, and the correlation between pre-sale competition rate and independent variables is analyzed through machine learning. This analytical model can be used to review the apartment unit plan produced by the designer and to assist the designer. Therefore, it is possible to make a floor plan of apartment housing with high preference because it is possible to feedback apartment unit plan by using trained model when it is used in floor plan design of apartment housing.Keywords: apartment unit plan, data-driven design, design methodology, machine learning
Procedia PDF Downloads 2687815 Adoption of Climate-Smart Agriculture Practices Among Farmers and Its Effect on Crop Revenue in Ethiopia
Authors: Fikiru Temesgen Gelata
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Food security, adaptation, and climate change mitigation are all problems that can be resolved simultaneously with Climate-Smart Agriculture (CSA). This study examines determinants of climate-smart agriculture (CSA) practices among smallholder farmers, aiming to understand the factors guiding adoption decisions and evaluate the impact of CSA on smallholder farmer income in the study areas. For this study, three-stage sampling techniques were applied to select 230 smallholders randomly. Mann-Kendal test and multinomial endogenous switching regression model were used to analyze trends of decrease or increase within long-term temporal data and the impact of CSA on the smallholder farmer income, respectively. Findings revealed education level, household size, land ownership, off-farm income, climate information, and contact with extension agents found to be highly adopted CSA practices. On the contrary, erosion exerted a detrimental impact on all the agricultural practices examined within the study region. Various factors such as farming methods, the size of farms, proximity to irrigated farmlands, availability of extension services, distance to market hubs, and access to weather forecasts were recognized as key determinants influencing the adoption of CSA practices. The multinomial endogenous switching regression model (MESR) revealed that joint adoption of crop rotation and soil and water conservation practices significantly increased farm income by 1,107,245 ETB. The study recommends that counties and governments should prioritize addressing climate change in their development agendas to increase the adoption of climate-smart farming techniques.Keywords: climate-smart practices, food security, Oincome, MERM, Ethiopia
Procedia PDF Downloads 377814 Causes of Death in Neuromuscular Disease Patients: 15-Year Experience in a Tertiary Care Hospital
Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong
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Background:Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods:From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results:Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences
Procedia PDF Downloads 5337813 Destined Failure of Interactions between Israeli-Arabs and Jews - An Analysis of Creative Works’ Presentation of Issues from the Israeli Side
Authors: Tianqi Yin
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Following the establishment of the state of Israel, how to harmonize the relationship between Palestinians and Jews in Israel has always been an intractable problem. As the number of Palestinian Arabs in Israel has increased to over two million, the issue has become more severe. Due to a variety of factors, Israeli Palestinians and Israeli Jews often find it hard to interact with each other, let alone form a relationship. Multiple authors and directors have produced cultural works to touch on the issue, exposing the reasons for the irreconcilable relation between the two ethnic groups. This paper analyzes the representation scenes of the Palestinian-Jewish relationship in three prominent cultural works, each from a distinct perspective, to examine the intrinsic challenges from the Israeli side that curb the two ethnicities from interacting successfully. The first scene is from the Jewish perspective in Amos Oz’s memoir A Tale of Love and Darkness, in which young Oz, a Jewish boy, attempts to interact with Aisha, a young Israeli-Arab girl, but eventually failed because of an accident. The second scene is from a short Israeli film Bus Station which, from an outsider perspective, depicted a brief encounter between an Arab woman and a Jewish woman in Jerusalem. The third scene is the initially successful yet eventually failed relationship between Eyad, a Palestinian boy, and Naomi, a Jewish girl, in an elite Israeli high school from the 2014 film A Borrowed Identity, which is depicted through Eyad’s Arab perspective. Through the analysis of these three narratives, this paper argues that the burden of national responsibility, family influences, and Israeli government’s discriminatory policies are the three main factors on the Jewish side, in ascender order of importance, that make Arab-Jewish interaction hard in Israel.Keywords: arab-Jewish interaction, ethnographic conflicts, israel, Jewish narrative, narrative styles
Procedia PDF Downloads 977812 Education of Mothers and Influence on the Development of Intrauterine Growth Restriction
Authors: Sabina Garayeva
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To determine the significant risk factors for intrauterine growth restriction (IUGR), we carried out a thorough study of the social status of the parents of children with IUGR. We observed 315 mothers who gave birth to children with (IUGR), of which 172 mothers with asymmetric type and 143 mothers with symmetric type of IUGR. Through a detailed survey was gathered detailed information about education of parents. The results show that the majority of mothers with IUGR had secondary education (44,8 ± 2,8%), and fathers - higher education (35,2 ± 2,7%). Whereas in the control group, the largest number of parents had higher education (mother 35,3 ± 4,4%, fathers 42,9 ± 4,5%). Number of mothers with secondary education with IUGR was significantly (p1 <0,01; χ2 = 22,67) differs from the number of mothers with physiological pregnancy with the same level of education. Meanwhile, in the group with a symmetrical embodiment of IUGR mothers with secondary formation of significantly greater 53,1 ± 4,2%, than the asymmetric embodiment IUGR 37,8 ± 3,7% (p2 <0,05; χ2 = 8 06). Among fathers with secondary education significant difference was noted in the symmetric version of IUGR 37,8 ± 4,1% more than in the control group (p1 <0,05), and among parents of children with asymmetric IUGR option prevailed fathers with higher education - 37 2 ± 3,7%. Thus, our results revealed a low educational level of the mother as a risk factor for IUGR, which further help to develop preventive and therapeutic measures to eliminate the severity of its consequences. As seen from the data presented, mothers of children with asymmetric IUGR had a school education and fathers - higher education, while in the symmetric type of both parents had secondary education. It is found that frequency of children, born with IUGR, of mothers - housewives and fathers, engage in physical labor, was high. Thus, the analysis conducted by the social status of the parents with IUGR revealed a low level of education and unemployed mothers as risk factors for this disease, which in the future will help to develop preventive and therapeutic measures to eliminate the severity of its.Keywords: intrauterine growth restriction, education of mothers, education influence, IUGR
Procedia PDF Downloads 3877811 Operations Training Using Immersive Technologies: A Development Experience
Authors: A. Aman, S. M. Tang, F. H. Alharrassy
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Omanisation was established to increase job opportunities for national employment in Sultanate of Oman. With half of the population below 25 years of age, the sultanate is striving to diversify the economy fast enough to meet the burgeoning number of jobseekers annually. On the other hand, training personnel to be competent oil and gas operators and technicians is a difficult task in a complex reservoir structures in Oman using highly advanced and sophisticated extracting processes. Coupled towards Omanisation which encourages nationals into the oil and gas sector so as to create sustainable employment for the local population, the challenge to churn out competent manpower became a daunting task. Immersive technologies provided the impetus to create a new digital media sector which provided job opportunities as well as the learning contents to enhance the competency-based training for the oil and gas sector in the Sultanate. This lead to a win-win-win collaboration amongst the government represented by the Information Technology Authority (ITA), private sector specialised company (represented by ASM Technologies), jobseekers and oil and gas organisations. This is also one of the first private-public partnership model in the Information Communication Technology (ICT) sector in Oman. A pilot phase was conducted for 8 months to develop four virtual applications for training in equipment and process engineering; oil rig familiarisation, Health Safety Environment (HSE) application, turbine application and the mechanical vapour compressor (MVC) water recycling plant in order to enhance the competency level of the trainees. The immersive applications were installed in operational settings which enabled new employees to practice and understand various processes and procedures regarding enhanced oil recovery. Existing employees used the application to review the working principles in order to carry out troubleshooting scenarios. Concurrently, these applications were also developed by local Omani resources within the country. This created job opportunities for job-seekers as well the establishment of a digital media sector. The purpose of this paper is to discuss how immersive technologies can enhance operational competencies, create job and establish a digital media sector in the Sultanate of Oman.Keywords: immersive, virtual reality, operations training, Omanisation
Procedia PDF Downloads 2317810 The Role of Surgery to Remove the Primary Tumor in Patients with Metastatic Breast Cancer
Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko
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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor
Procedia PDF Downloads 4167809 Exploration of Sweet Potato Cultivar Markets Availability in North West Province, South Africa
Authors: V. M. Mmbengwa, J. R. M. Mabuso, C. P. Du Plooy, S. Laurrie, H. D. van Schalkwyk
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Sweet potato products are necessary for the provision of essential nutrients in every household, regardless of their poverty status. Their consumption appears to be highly influenced by socio-economic factors, such as malnutrition, food insecurity and unemployment. Therefore, market availability is crucial for these cultivars to resolve some of the socio-economic factors. The aim of the study was to investigate market availability of sweet potato cultivars in the North West Province. In this study, both qualitative and quantitative research methodologies were used. Qualitative methodology was used to explain the quantitative outcomes of the variables. On the other hand, quantitative results were used to test the hypothesis. The study used SPSS software to analyse the data. Cross-tabulation and Chi-square statistics were used to obtain the descriptive and inferential analyses, respectively. The study found that the Blesbok cultivar is dominating the markets of the North West Province, with the Monate cultivar dominating in the Bojanala Platinum (75 %) and Dr Ruth Segomotsi Mompati (25 %) districts. It is also found that a unit increase in the supply of sweet potato cultivars in both local and district municipal markets is accompanied by a reduced demand of 28 % and 33 % at district and local markets, respectively. All these results were found to be significant at p<0.05. The results further revealed that in four out of nine local municipality markets, the Blesbok cultivar seems to be solely available in those four local municipal markets of North West Province. It can be concluded that Blesbok, relative to other cultivars, is the most commercialised sweet potato variety and that consumers across this Province are highly aware of it. For other cultivars to assume market prominence in this Province, a well-designed marketing campaign for creating awareness may be required. This campaign may be based on nutritional advantages of different cultivars, of which Blesbok is relatively inferior, compared to orange-fleshed sweet potato varieties.Keywords: cultivar, malnutrition, markets, sweet potato
Procedia PDF Downloads 2947808 Proposed Organizational Development Interventions in Managing Occupational Stressors for Business Schools in Batangas City
Authors: Marlon P. Perez
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The study intended to determine the level of occupational stress that was experienced by faculty members of private and public business schools in Batangas City with the end in view of proposing organizational development interventions in managing occupational stressors. Stressors such as factors intrinsic to the job, role in the organization, relationships at work, career development and organizational structure and climate were used as determinants of occupational stress level. Descriptive method of research was used as its research design. There were only 64 full-time faculty members coming from private and public business schools in Batangas City – University of Batangas, Lyceum of the Philippines University-Batangas, Golden Gate Colleges, Batangas State University and Colegio ng Lungsod ng Batangas. Survey questionnaire was used as data gathering instrument. It was found out that all occupational stressors were assessed stressful when grouped according to its classification of tertiary schools while response of subject respondents differs on their assessment of occupational stressors. Age variable has become significantly related to respondents’ assessments on factors intrinsic to the job and career development; however, it was not significantly related to role in the organization, relationships at work and organizational structure and climate. On the other hand, gender, marital status, highest educational attainment, employment status, length of service, area of specialization and classification of tertiary school were revealed to be not significantly related to all occupational stressors. Various organizational development interventions have been proposed to manage the occupational stressors that are experienced by business faculty members in the institution.Keywords: occupational stress, business school, organizational development, intervention, stressors, faculty members, assessment, manage
Procedia PDF Downloads 4317807 Physical Health, Depression and Related Factors for Elementary School Students in Seoul, South Korea
Authors: Kyung-Sook Bang
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Background: The health status of school-age children has a great influence on their growth and life-long health. The purposes of this study were to identify physical and mental health status of late school-age children in Seoul, South Korea and to investigate the related factors for their health. Methods: After gaining the approval from Institutional Review Board (IRB), a cross-sectional study was conducted with elementary students in grade 4 or 5. Questionnaires were distributed to eight elementary schools located different regions of Seoul in November, 2016, and 302 participants were finally included. From all participants, informed consents from the parents, and assents from children were received. Children's socioeconomic status, family functioning, peer relations, physical health symptoms, and depression were measured with self-reported questionnaires. Data were analyzed with descriptive statistics, t-test, Pearson’s correlations, and multiple regression. Results: Children's physical health symptoms and depression were not significantly different, and only their peer relations were significantly different according to their socioeconomic status (t=-3.93, p<.001). Depression showed significant positive correlation with physical health symptoms (r=.720, p<.001) and negative correlations with family functioning (r=-.428, p<.001) and peer relations (r=-.775, p<.001). The multiple regression model, which explained 73.5% of variance, showed peer relations (r2 =.604), physical health symptoms (r2 change=.125), and family functioning (r2 change=.005) as significant predictors for depression. Only the peer relations was significant predictor for their physical health symptoms and explained 50.6% of it. Conclusions: The peer relations was the most important factor in their physical and mental health at this age, and it can be affected by their socioeconomic status. Nursing interventions for promoting social relations and family functioning are required to improve children’s physical and mental health, especially for vulnerable population.Keywords: child, depression, health, peer relation
Procedia PDF Downloads 2297806 Proficiency Testing of English for Specific Academic Purpose: Using a Pilot Test in a Taiwanese University as an Example
Authors: Wenli Tsou, Jessica Wu
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Courses of English for specific academic purposes (ESAP) have become popular for higher education in Taiwan; however, no standardized tests have been developed for evaluating learners’ English proficiency in individual designated fields. Assuming a learner’s proficiency in a specific academic area is built up with one’s general proficiency in English with specific knowledge and vocabulary in the content areas, an adequate ESAP proficiency test may be constructed by some selected test items related to the designated academic areas. In this study, through collaboration between a language testing institution and a university in Taiwan, three sets of ESAP tests, covering three disciplinary areas of business and the workplace, science and engineering, and health and medicine majors, were developed and administered to sophomore students (N=1704) who were enrolled in ESAP courses at a university in southern Taiwan. For this study, the courses were grouped into the above-mentioned three disciplines, and students took the specialized proficiency test based on the ESAP course they were taking. Because students were free to select which ESAP course to take, each course had both major and non-major students. Toward the end of the one-semester course, ending in January, 2015, each student took two tests, one of general English (General English Proficiency Test, or GEPT) and the other ESAP. Following each test, students filled out a survey, reporting their test taking experiences. After comparing students’ two test scores, it was found that business majors and health and medical students performed better in ESAP than the non-majors in the class, whereas science and engineering majors did about the same as their non-major counterparts. In addition, test takers with CERF B2 (upper intermediate) level or above performed well in both tests, while students who are below B2 did slightly better in ESAP. The findings suggest that students’ test performance have been enhanced by their specialist content and vocabulary knowledge. Furthermore, results of the survey show that the difficulty levels reported by students are consistent with their test performances. Based on the item analysis, the findings can be used to develop proficiency tests for specific disciplines and to identify ability indicators for college students in their designated fields.Keywords: english for specific academic purposes (ESAP), general english proficiency test (GEPT), higher education, proficiency test
Procedia PDF Downloads 5297805 Assessment of Biotic and Abiotic Water Factors of Antiao and Jiabong Rivers for Benthic Algae
Authors: Geno Paul S. Cumla, Jan Mariel M. Gentiles, M. Brenda Gajelan-Samson
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Eutrophication is a process where in there is a surplus of nutrients present in a lake or river. Harmful cyanobacteria, hypoxia, and primarily algae, which contain toxins, grow because of the excess nutrients. Algal blooms can cause fish kills, limiting the light penetration which reduces growth of aquatic organisms, causing die-offs of plants and produce conditions that are dangerous to aquatic and human life. The main cause for eutrophication is the presence of excessive amounts of phosphorus (P) and nitrogen (N). Nitrogen is necessary for the production of the plant tissues and is usually used to synthesize proteins. Nitrate is a compound that contains nitrogen, and at elevated levels it can cause harmful effects. Excessive amounts of phosphorus, displaced through human activity, is the major cause of algae growth and as well as degraded water quality. To accomplish this study the Assessment of Soluble inorganic nitrogen (SIN), Assessment of Soluble reactive phosphate (SRP), Determination of Chlorophyll a (Chl-a) concentration, and Determination of Dominating Taxa were done. The study addresses the high probability of algal blooms in Maqueda Bay by assessing the biotic and abiotic factors of Antiao and Jiabong rivers. The data predicts the overgrowth of algae and to create awareness to prevent the event from taking place. The study assesses the adverse effects that could be prevented by understanding and controlling algae. This should predict future cases of algal blooms and allow government agencies which require data to create programs to prevent and assess these issues.Keywords: eutrophication, chlorophyll a, nitrogen, phosphorus, red tide, Kjeldahl method, spectrophotometer, assessment of soluble inorganic nitrogen, SIN, assessment of soluble reactive phosphate, SRP
Procedia PDF Downloads 1437804 Case Study Analysis of 2017 European Railway Traffic Management Incident: The Application of System for Investigation of Railway Interfaces Methodology
Authors: Sanjeev Kumar Appicharla
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This paper presents the results of the modelling and analysis of the European Railway Traffic Management (ERTMS) safety-critical incident to raise awareness of biases in the systems engineering process on the Cambrian Railway in the UK using the RAIB 17/2019 as a primary input. The RAIB, the UK independent accident investigator, published the Report- RAIB 17/2019 giving the details of their investigation of the focal event in the form of immediate cause, causal factors, and underlying factors and recommendations to prevent a repeat of the safety-critical incident on the Cambrian Line. The Systems for Investigation of Railway Interfaces (SIRI) is the methodology used to model and analyze the safety-critical incident. The SIRI methodology uses the Swiss Cheese Model to model the incident and identify latent failure conditions (potentially less than adequate conditions) by means of the management oversight and risk tree technique. The benefits of the systems for investigation of railway interfaces methodology (SIRI) are threefold: first is that it incorporates the “Heuristics and Biases” approach advanced by 2002 Nobel laureate in Economic Sciences, Prof Daniel Kahneman, in the management oversight and risk tree technique to identify systematic errors. Civil engineering and programme management railway professionals are aware of the role “optimism bias” plays in programme cost overruns and are aware of bow tie (fault and event tree) model-based safety risk modelling techniques. However, the role of systematic errors due to “Heuristics and Biases” is not appreciated as yet. This overcomes the problems of omission of human and organizational factors from accident analysis. Second, the scope of the investigation includes all levels of the socio-technical system, including government, regulatory, railway safety bodies, duty holders, signaling firms and transport planners, and front-line staff such that lessons are learned at the decision making and implementation level as well. Third, the author’s past accident case studies are supplemented with research pieces of evidence drawn from the practitioner's and academic researchers’ publications as well. This is to discuss the role of system thinking to improve the decision-making and risk management processes and practices in the IEC 15288 systems engineering standard and in the industrial context such as the GB railways and artificial intelligence (AI) contexts as well.Keywords: accident analysis, AI algorithm internal audit, bounded rationality, Byzantine failures, heuristics and biases approach
Procedia PDF Downloads 1887803 The Development of an Agent-Based Model to Support a Science-Based Evacuation and Shelter-in-Place Planning Process within the United States
Authors: Kyle Burke Pfeiffer, Carmella Burdi, Karen Marsh
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The evacuation and shelter-in-place planning process employed by most jurisdictions within the United States is not informed by a scientifically-derived framework that is inclusive of the behavioral and policy-related indicators of public compliance with evacuation orders. While a significant body of work exists to define these indicators, the research findings have not been well-integrated nor translated into useable planning factors for public safety officials. Additionally, refinement of the planning factors alone is insufficient to support science-based evacuation planning as the behavioral elements of evacuees—even with consideration of policy-related indicators—must be examined in the context of specific regional transportation and shelter networks. To address this problem, the Federal Emergency Management Agency and Argonne National Laboratory developed an agent-based model to support regional analysis of zone-based evacuation in southeastern Georgia. In particular, this model allows public safety officials to analyze the consequences that a range of hazards may have upon a community, assess evacuation and shelter-in-place decisions in the context of specified evacuation and response plans, and predict outcomes based on community compliance with orders and the capacity of the regional (to include extra-jurisdictional) transportation and shelter networks. The intention is to use this model to aid evacuation planning and decision-making. Applications for the model include developing a science-driven risk communication strategy and, ultimately, in the case of evacuation, the shortest possible travel distance and clearance times for evacuees within the regional boundary conditions.Keywords: agent-based modeling for evacuation, decision-support for evacuation planning, evacuation planning, human behavior in evacuation
Procedia PDF Downloads 2357802 Nutritional Status of Children in a Rural Food Environment, Haryana: A Paradox for the Policy Action
Authors: Neha Gupta, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora
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The concurrent increasing prevalence of underweight and overweight/obesity among children with changing lifestyle and the rapid transitioning society has necessitated the need for a unifying/multi-level approach to understand the determinants of the problem. The present community-based cross-sectional research study was conducted to assess the associations between lifestyle behavior and food environment of the child at household, neighborhood, and school with the BMI of children (6-12 year old) (n=612) residing in three rural clusters of Palwal district, Haryana. The study used innovative and robust methods for assessing the lifestyle and various components of food environment in the study. The three rural clusters selected for the study were located at three different locations according to their access to highways in the SOMAARTH surveillance site. These clusters were significantly different from each other in terms of their socio-demographic and socio-economic profile, living conditions, environmental hygiene, health seeking behavior and retail density. Despite of being different, the quality of living conditions and environmental hygiene was poor across three clusters. The children had higher intakes of dietary energy and sugars; one-fifth share of the energy being derived from unhealthy foods, engagement in high levels of physical activity and significantly different food environment at home, neighborhood and school level. However, despite having a high energy intake, 22.5% of the recruited children were thin/severe thin, and 3% were overweight/obese as per their BMI-for-age categories. The analysis was done using multi-variate logistic regression at three-tier hierarchy including individual, household and community level. The factors significantly explained the variability in governing the risk of getting thin/severe thin among children in rural area (p-value: 0.0001; Adjusted R2: 0.156) included age (>10years) (OR: 2.1; 95% CI: 1.0-4.4), the interaction between minority category and poor SES of the household (OR: 4.4; 95% CI: 1.6-12.1), availability of sweets (OR: 0.9; 95% CI: 0.8-0.99) and cereals (OR: 0.9; 95% CI: 0.8-1.0) in the household and poor street condition (proxy indicator of the hygiene and cleanliness in the neighborhood) (OR: 0.3; 95% CI: 0.1-1.1). The homogeneity of other factors at neighborhood and school level food environment diluted the heterogeneity in the lifestyles and home environment of the recruited children and their households. However, it is evident that when various individual factors interplay at multiple levels amplifies the risk of undernutrition in a rural community. Conclusion: These rural areas in Haryana are undergoing developmental, economic and societal transition. In correspondence, no improvements in the nutritional status of children have happened. Easy access to the unhealthy foods has become a paradox.Keywords: transition, food environment, lifestyle, undernutrition, overnutrition
Procedia PDF Downloads 1807801 Alternative Method of Determining Seismic Loads on Buildings Without Response Spectrum Application
Authors: Razmik Atabekyan, V. Atabekyan
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This article discusses a new alternative method for determination of seismic loads on buildings, based on resistance of structures to deformations of vibrations. The basic principles for determining seismic loads by spectral method were developed in 40… 50ies of the last century and further have been improved to pursuit true assessments of seismic effects. The base of the existing methods to determine seismic loads is response spectrum or dynamicity coefficient β (norms of RF), which are not definitively established. To this day there is no single, universal method for the determination of seismic loads and when trying to apply the norms of different countries, significant discrepancies between the results are obtained. On the other hand there is a contradiction of the results of macro seismic surveys of strong earthquakes with the principle of the calculation based on accelerations. It is well-known, on soft soils there is an increase of destructions (mainly due to large displacements), even though the accelerations decreases. Obviously, the seismic impacts are transmitted to the building through foundation, but paradoxically, the existing methods do not even include foundation data. Meanwhile acceleration of foundation of the building can differ several times from the acceleration of the ground. During earthquakes each building has its own peculiarities of behavior, depending on the interaction between the soil and the foundations, their dynamic characteristics and many other factors. In this paper we consider a new, alternative method of determining the seismic loads on buildings, without the use of response spectrum. The following main conclusions: 1) Seismic loads are revealed at the foundation level, which leads to redistribution and reduction of seismic loads on structures. 2) The proposed method is universal and allows determine the seismic loads without the use of response spectrum and any implicit coefficients. 3) The possibility of taking into account important factors such as the strength characteristics of the soils, the size of the foundation, the angle of incidence of the seismic ray and others. 4) Existing methods can adequately determine the seismic loads on buildings only for first form of vibrations, at an average soil conditions.Keywords: seismic loads, response spectrum, dynamic characteristics of buildings, momentum
Procedia PDF Downloads 5057800 Association of Musculoskeletal and Radiological Features with Clinical and Serological Findings in Systemic Sclerosis: A Single-Centre Registry Study
Authors: Rezvan Hosseinian
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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.Keywords: disease subsets, hand radiography, joint erosion, sclerosis
Procedia PDF Downloads 917799 Association of Musculoskeletal and Radiological Features with Clinical and Serological Findings in Systemic Sclerosis: A Single-Centre Registry Study
Authors: Nasrin Azarbani
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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal
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