Search results for: surgical approach

Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail

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Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.

Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric

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Authors: Nor Zila Abd Hamid, Mohd Salmi M. Noorani

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This study is focused on the development of prediction models of the Ozone concentration time series. Prediction model is built based on chaotic approach. Firstly, the chaotic nature of the time series is detected by means of phase space plot and the Cao method. Then, the prediction model is built and the local linear approximation method is used for the forecasting purposes. Traditional prediction of autoregressive linear model is also built. Moreover, an improvement in local linear approximation method is also performed. Prediction models are applied to the hourly ozone time series observed at the benchmark station in Malaysia. Comparison of all models through the calculation of mean absolute error, root mean squared error and correlation coefficient shows that the one with improved prediction method is the best. Thus, chaotic approach is a good approach to be used to develop a prediction model for the Ozone concentration time series.

Keywords: chaotic approach, phase space, Cao method, local linear approximation method

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Authors: Mounir Bekaik, Messaoud Ramdani

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We present in this work a new technique of stabilization for fault nonlinear systems. The approach we adopt focus on a fuzzy Luenverger observer. The T-S approximation of the nonlinear observer is based on fuzzy C-Means clustering algorithm to find local linear subsystems. The MOESP identification approach was applied to design an empirical model describing the subsystems state variables. The gain of the observer is given by the minimization of the estimation error through Lyapunov-krasovskii functional and LMI approach. We consider a three tank hydraulic system for an illustrative example.

Keywords: nonlinear system, fuzzy, faults, TS, Lyapunov-Krasovskii, observer

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Alessandro Marano

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Aim: The author describes the aesthetic modification using orthognathic surgery and closed rhinoplasty. Methods: Series of case study. After orthognathic surgery we can observe a dramatical change of aesthetic especially in the mid-face and nose projection. The advancement of maxillary bone through Le Fort I osteotomy will change the nasal tip projection and lips roundness; combining orthognathic surgery with closed approach rhinoplasty will manage both function and aesthetic of all mid face district. Results: Combining Le Fort I osteotomy with closed approach rhinoplasty resulted in good objective results with high patient satisfaction. Le Fort I osteotomy will increase projection of mid face and the closed approach rhinoplasty will modify the nasal shape to be more harmonic with the new maxillary district. The scars are not visible because hidden inside the mouth and nose. Conclusions: The orthognathic surgery combined with closed approach rhinoplasty are very effective for changing the aesthetic of the mid face. The results illustrate the difference between the use of orthognathic surgery only and to use it in association of closed approach rhinoplasty. Using both will allow to obtain a long lasting and pleasing results.

Keywords: orthognathic, rhinoplasty, aesthetic, face

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Authors: Vijayan Narayananayar

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Identifying learning gaps is crucial in ensuring learners have the necessary knowledge and skills to succeed. The Learning and Teaching (L&T) approach requires tutors to identify gaps in knowledge and improvise learning activities to close them. One approach to identifying learning gaps is through diagnostic assessment, which uses well-structured questions and answer options. The paper focuses on the use of diagnostic assessment as a learning and teaching approach in a foundational module at a polytechnic. The study used diagnostic assessment over two semesters, including the COVID and post-COVID semesters, to identify gaps in learning. The design of the diagnostic activity, pedagogical intervention, and survey responses completed by learners were analyzed. Results showed that diagnostic assessment can be an effective tool for identifying learning gaps and designing interventions to address them. Additionally, the use of diagnostic assessment provides an opportunity for tutors to engage with learners on a one-to-one basis, tailoring teaching to individual needs. The paper also discusses the design of diagnostic questions and answer options, including characteristics that need to be considered in achieving the target of identifying learning gaps. The implications of using diagnostic assessment as a learning and teaching approach include bridging the gap between theory and practice, and ensuring learners are equipped with skills necessary for their future careers. This paper can be useful in helping educators and practitioners to incorporate diagnostic assessment into their L&T approach.

Keywords: assessment, learning & teaching, diagnostic assessment, analytics

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Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

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In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

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Authors: Khaled M. Alhawiti

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Natural Language Processing (NLP) is an effective approach for bringing improvement in educational setting. This involves initiating the process of learning through the natural acquisition in the educational systems. It is based on following effective approaches for providing the solution for various problems and issues in education. Natural Language Processing provides solution in a variety of different fields associated with the social and cultural context of language learning. It is based on involving various tools and techniques such as grammar, syntax, and structure of text. It is effective approach for teachers, students, authors, and educators for providing assistance for writing, analysis, and assessment procedure. Natural Language Processing is widely integrated in the large number of educational contexts such as research, science, linguistics, e-learning, evaluations system, and various other educational settings such as schools, higher education system, and universities. Natural Language Processing is based on applying scientific approach in the educational settings. In the educational settings, NLP is an effective approach to ensure that students can learn easily in the same way as they acquired language in the natural settings.

Keywords: natural language processing, education, application, e-learning, scientific studies, educational system

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Authors: R. Pardo, P. Menendez, MA Gil-Olarte, S. Sanchez, E. García, R. Quintana, J. Martín

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Introduction : Within oncoplastic breast techniques there is increased interest in immediate partial breast reconstruction. The volume resected is greater than that of conventional conservative techniques. Central tumours of the breast have classically been treated with a mastectomy with regard to oncological safety and cosmetic secondary effects after wide central resection of the nipple and breast tissue beneath. Oncological results for central quadrantectomy have a recurrence level, disease- free period and survival identical to mastectomy. Grissoti flap is an oncoplastic surgical technique that allows the surgeon to perform a safe central quadrantectomy with excellent cosmetic results. Material and methods: The Grissoti flap is a glandular cutaneous advancement rotation flap that can fill the defect in the central portion of the excised breast. If the inferior border is affected by tumour and further surgery is decided upon at the Multidisciplinary Team Meeting, it will be necessary to perform a mastectomy. All patients with a Grisotti flap undergoing surgery since 2009 were reviewed obtaining the following data: age, hystopathological diagnosis, size, operating time, volume of tissue resected, postoperative admission time, re-excisions due to positive margins affected by tumour, wound dehiscence, complications and recurrence. Analysis and results of sentinel node biopsy were also obtained. Results: 12 patients underwent surgery between 2009-2015. The mean age was 54 years (34-67) . All had a preoperative diagnosis of ductal infiltrative carcinoma of less than 2 cm,. Diagnosis was made with Ultrasound, Mamography or both . Magnetic resonance was used in 5 cases. No patients had preoperative positive axilla after ultrasound exploration. Mean operating time was 104 minutes (84-130). Postoperative stay was 24 hours. Mean volume resected was 159 cc (70-286). In one patient the surgical border was affected by tumour and a further procedure with resection of the affected border was performed as ambulatory surgery. The sentinel node biopsy was positive for micrometastasis in only two cases. In one case lymphadenectomy was performed in 2009. In the other, treated in 2015, no lymphadenectomy was performed as the patient had a favourable histopathological prognosis and the multidisciplinary team meeting agreed that lymphadenectomy was not required. No recurrence has been diagnosed in any of the patients who underwent surgery and they are all disease free at present. Conclusions: Conservative surgery for retroareolar central tumours of the breast results in good local control of the disease with free surgical borders, including resection of the nipple areola complex and pectoral major muscle fascia. Reconstructive surgery with the inferior Grissoti flap adequately fills the defect after central quadrantectomy with creation of a new cutaneous disc where a new nipple areola complex is reconstructed with a local flap or micropigmentation. This avoids the need for contralateral symmetrization. Sentinel Node biopsy can be performed without added morbidity. When feasible, the Grissoti flap will avoid skin-sparing mastectomy for central breast tumours that will require the use of an expander, prosthesis or myocutaneous flap, with all the complications of a more complex operation.

Keywords: Grisotti flap, oncoplastic surgery, central tumours, breast

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Authors: Ouzayr Rabhi, Ibtissam Arrassen

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To provide a complete analysis of the organization and to help decision-making, leaders need to have relevant data; Data Warehouses (DW) are designed to meet such needs. However, designing DW is not trivial and there is no formal method to derive a multidimensional schema from heterogeneous databases. In this article, we present a Model-Driven based approach concerning the design of data warehouses. We describe a multidimensional meta-model and also specify a set of transformations starting from a Unified Modeling Language (UML) metamodel. In this approach, the UML metamodel and the multidimensional one are both considered as a platform-independent model (PIM). The first meta-model is mapped into the second one through transformation rules carried out by the Query View Transformation (QVT) language. This proposal is validated through the application of our approach to generating a multidimensional schema of a Balanced Scorecard (BSC) DW. We are interested in the BSC perspectives, which are highly linked to the vision and the strategies of an organization.

Keywords: data warehouse, meta-model, model-driven architecture, transformation, UML

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Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Ersumo Tessema, Bogale Girmaye Tamrat, Mohammed Burka

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Background: Hyperthyroidism is a common thyroid disorder especially in women and characterized by increased thyroid hormone synthesis and secretion. The disorder manifests predominantly as Graves’ disease in iodine-sufficient areas and has increasing prevalence in iodine-deficient countries in patients with nodular thyroid disease and following iodine fortification. In Ethiopia, the magnitude of the disorder is unknown and, in Africa, due to scarcity of resources, its management remains suboptimal. Objective: The aim of this study was to analyze the pattern and management of patients with hyperthyroidism at the United Vision Medical Services Center, Addis Ababa between August 30, 2013, and February 1, 2018. Patients and methods: The study was a retrospective analysis of medical records of all patients with hyperthyroidism at the United Vision Private Medical Services Center, Addis Ababa. A questionnaire was filled out; the collected data entered into a computer and statistically analyzed using the SPSS package. The results were tabulated and discussed with literature review. Results: A total of 589 patients were included in this study. The median age was 40 years, and the male to female ratio was 1.0:7.9. Most patients (93%) presented with goiter and the associated features of toxic goiter except weight loss, sweating and tachycardia were uncommon. Majority of patients presented more than two years after the onset of their presenting symptoms. The most common physical finding (91%), as well as diagnosis, was toxic nodular goiter. The most frequent (83%) derangement in the thyroid function tests was a low thyroid-stimulating hormone, and the most commonly (94%) used antithyroid drug was a propylthiouracil. The most common (96%) surgical procedure in 213 patients was a near-total thyroidectomy with a postoperative course without incident in 92% of all the patients. Conclusion: The incidence and prevalence of hyperthyroidism are apparently on the increase in Addis Ababa, which may be related to the existing severe iodine-deficiency and or the salt iodation program (iodine-induced hyperthyroidism). Hyperthyroidism predominantly affects women and, in surgical services, toxic nodular goiter is more common than diffuse goiter, and the treatment of choice in experienced hands is a near-total thyroidectomy.

Keywords: Ethiopia, grave’s disease, hyperthyroidism, toxic nodular goiter

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Authors: Abder-Rahman Ali, Antoine Vacavant, Manuel Grand-Brochier, Adélaïde Albouy-Kissi, Jean-Yves Boire

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In this paper, we present a new segmentation approach for liver lesions in regions of interest within MRI (Magnetic Resonance Imaging). This approach, based on a two-cluster Fuzzy C-Means methodology, considers the parameter variable compactness to handle uncertainty. Fine boundaries are detected by a local recursive merging of ambiguous pixels with a sequential forward floating selection with Zernike moments. The method has been tested on both synthetic and real images. When applied on synthetic images, the proposed approach provides good performance, segmentations obtained are accurate, their shape is consistent with the ground truth, and the extracted information is reliable. The results obtained on MR images confirm such observations. Our approach allows, even for difficult cases of MR images, to extract a segmentation with good performance in terms of accuracy and shape, which implies that the geometry of the tumor is preserved for further clinical activities (such as automatic extraction of pharmaco-kinetics properties, lesion characterization, etc).

Keywords: defuzzification, floating search, fuzzy clustering, Zernike moments

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Authors: Mary Fargher

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This paper examines the opportunities of using a more hierarchical approach to geospatial enquiry in using GIS in school geography. A case is made that it is not just the lack of teacher technological knowledge that is stopping some teachers from using GIS in the classroom but that there is a gap in their understanding of how to link GIS use more specifically to the pedagogy of teaching geography with GIS. Using a hierarchical approach to geospatial enquiry as a theoretical framework, the analysis shows clearly how concepts of spatial distribution, interaction, relation, comparison, and temporal relationships can be used by teachers more explicitly to capitalise on the analytical power of GIS and to construct what can be interpreted as powerful geographical knowledge. An exemplar illustrating this approach on the topic of geo-hazards is then presented for critical analysis and discussion. Recommendations are then made for a model of progression for geography teacher education with GIS through hierarchical geospatial enquiry that takes into account beginner, intermediate, and more advanced users.

Keywords: digital geography, GIS, education, hierarchical geospatial enquiry, powerful geographical knowledge

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Authors: Anurag Jain, Rajneesh Kumar

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Cloud computing is the outcome of rapid growth of internet. Due to elastic nature of cloud computing and unpredictable behavior of user, load balancing is the major issue in cloud computing paradigm. An efficient load balancing technique can improve the performance in terms of efficient resource utilization and higher customer satisfaction. Load balancing can be implemented through task scheduling, resource allocation and task migration. Various parameters to analyze the performance of load balancing approach are response time, cost, data processing time and throughput. This paper demonstrates a two level load balancer approach by combining join idle queue and join shortest queue approach. Authors have used cloud analyst simulator to test proposed two level load balancer approach. The results are analyzed and compared with the existing algorithms and as observed, proposed work is one step ahead of existing techniques.

Keywords: cloud analyst, cloud computing, join idle queue, join shortest queue, load balancing, task scheduling

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Authors: Robert Roznowski

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The thought process of the character is never more evident than when singing alone onstage. The composer scores the emotional state and the lyricist voices the inner conflict as the character shares with an audience her or his deepest feelings. It is at these moments that a character may be thought of as voicing her or his inner monologue. Using examples from several musical theatre songs, this presentation will look at a codified approach to analyze a song from a more psychological perspective. Using the clues from the score, traditional character analysis and a psychological-based scoring method an actor may explore more fully inhabit and express the sung and unsung thoughts of the character. The approach yields a richer and more complex approach to acting the song.

Keywords: acting, analysis, musical theatre, psychology

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Authors: Apollinaire Barme, Simon Tamayo, Arthur Gaudron

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This paper presents a statistical approach to identify explanatory variables linearly related to e-commerce sales. The proposed methodology allows specifying a regression model in order to quantify the relevance between openly available data (economic and demographic) and national e-commerce sales. The proposed methodology consists in collecting data, preselecting input variables, performing regressions for choosing variables and models, testing and validating. The usefulness of the proposed approach is twofold: on the one hand, it allows identifying the variables that influence e- commerce sales with an accessible approach. And on the other hand, it can be used to model future sales from the input variables. Results show that e-commerce is linearly dependent on 11 economic and demographic indicators.

Keywords: e-commerce, statistical modeling, regression, empirical research

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Authors: Denis Spirjakin, Alexander Baranov, Saba Akbari, Natalia Kalenova, Vladimir Sleptsov

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In this paper we propose the approach to power management in wireless combustible gas sensors. This approach makes possible drastically prolong sensor nodes autonomous lifetime. That is necessary to tie battery replacement to every year technical service procedures which are claimed by safety standards. Using this approach the current consumption of the wireless combustible gas sensor node was decreased from 80 mA to less than 2 mA and the power consumption from more than 220 mW to 4.6 mW. These values provide autonomous lifetime of the node more than one year.

Keywords: Gas sensors, power management, wireless sensor network

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Authors: Artsiom Zinchanka

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The world faces now one of the largest migration crisis and the European Union meets challenges in accepting the flow of migrants that could not be handled finally at this step. This crisis is complicated with many factors, such as military conflict in the Middle East; absence of the appropriate conditions in the refugees’ camps; but also with the complicity of the migration flow consisting of the Sub-Saharan migrants. This type of migrants leave their homelands for many reasons including poverty, not appropriate level of social and economic conditions, absence of infrastructure and access to the education and medical care. In practice, when the restrictive approach directed to limit the flow of illicit migration and to send illicit migrants back to their homelands is not always working, the approach directed to the root causes of the migration crisis can be more effective in settling the crisis. The Cotonou Agreement and the following treaties concluded between the European Union, and Sub-Saharan states show that the European Union considers the development of human rights and appropriate social and economic conditions in the Sub-Saharan states as one of the most important factors addressing the migration crisis. The preventive approach as the efforts of the European Union to develop appropriate social and economic conditions in Sub-Saharan states is considered in this article, as well as its evolution and current condition. This article also considers pros and cons of this approach and the obstacles that this approach faces. The research methods include review of literature and documents, analytical and descriptive methods.

Keywords: migration crisis, preventive approach, Sub-Saharan States, the European Union

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Authors: Govindaraj Ramanathan

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The time delay and the structural stability are major issues in big size projects due to several factors. Improper planning and poor coordination lead to delay in construction, which sometimes result in reworking or rebuilding. This definitely increases the cost and time of project. This situation stresses the structural engineers to plan out of the limits of contemporary technology utilizing non-chronological approach with creative ideas. One of the strategies to solve this issue is through structural integrity solutions in a cost-effective way. We have faced several problems in a project worth 470 million USD, and one such issue is crane girder installation with composite steel beams. We have applied structural integrity approach with the proper and revised planning schedule to solve the problem efficiently with minimal expenses.

Keywords: construction management, delay, non-chronological approach, composite beam, structural integrity

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Authors: J. H. Park, S. K. Lee, Y. W. Kim, D. C. Ko

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A large variety of pipe flange is required in marine and construction industry.Pipe flanges are usually welded or screwed to the pipe end and are connected with bolts.This approach is very simple and widely used for a long time, however, it results in high development cost and low productivity, and the productions made by this approach usually have safety problem at the welding area.In this research, a new approach of forming pipe flange based on cold forging and floating die concept is presented.This innovative approach increases the effectiveness of the material usage and save the time cost compared with conventional welding method. To ensure the dimensional accuracy of the final product, the finite element analysis (FEA) was carried out to simulate the process of cold forging, and the orthogonal experiment methods were used to investigate the influence of four manufacturing factors (pin die angle, pipe flange angle, rpm, pin die distance from clamp jig) and predicted the best combination of them. The manufacturing factors were obtained by numerical and experimental studies and it shows that the approach is very useful and effective for the forming of pipe flange, and can be widely used later.

Keywords: cold forging, FEA (finite element analysis), forge-3D, rotating forming, tubes

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Authors: Sait Ozsoy, Asude Gokmen, Mehtap Yondem, Hanife A. Alkan, Gulnaz T. Javan

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Deep neck infection often develops due to upper respiratory tract and odontogenic infections. Gastrointestinal System perforation can occur for many reasons and is in need of the early diagnosis and prompt surgical treatment. In both cases late or incorrect diagnosis may lead to increase morbidity and high mortality. A patient with a diagnosis of deep neck abscess died while under treatment due to sepsis and multiple organ failure. Autopsy finding showed duodenal ulcer and this is reported in the literature.

Keywords: peptic ulcer perforation, peritonitis, retropharyngeal abscess, sepsis

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Authors: Taye O. Famuditi, Jonathan Potts, Malcolm Bray

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This paper examines the shoreline management planning policy in England and its suitability for ameliorating the diverse environmental problems associated with Nigeria’s coastal zones. It examines the success of SMPs in England since the mid-1990s and progress achieved, with the aim of understudying the current management approach that can be transferred to Nigeria to strengthen its adoption, and as a necessary corollary, implementation of the SMPs. This paper also examines key elements of the shoreline management frameworks in England and provides answers to the question: Would shoreline management planning approach in England be appropriate and feasible in Nigeria? It further concludes that many of the action plans and principles of participation should be adoptable provided that a participatory approach that involves all stakeholders including community members and relevant sectorial ministries as well as appropriate legal framework is encouraged.

Keywords: shoreline management plans, coastal zone management, stakeholder engagement, participatory approach, Nigeria

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Authors: R. K. Chaurasiya, N. D. Londhe, S. Ghosh

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The study of the electrical signals produced by neural activities of human brain is called Electroencephalography. In this paper, we propose an automatic and efficient EEG signal classification approach. The proposed approach is used to classify the EEG signal into two classes: epileptic seizure or not. In the proposed approach, we start with extracting the features by applying Discrete Wavelet Transform (DWT) in order to decompose the EEG signals into sub-bands. These features, extracted from details and approximation coefficients of DWT sub-bands, are used as input to Principal Component Analysis (PCA). The classification is based on reducing the feature dimension using PCA and deriving the support-vectors using Support Vector Machine (SVM). The experimental are performed on real and standard dataset. A very high level of classification accuracy is obtained in the result of classification.

Keywords: discrete wavelet transform, electroencephalogram, pattern recognition, principal component analysis, support vector machine

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Authors: Abdelkrim Belhaoua, Jean-Pierre Radoux, Mariana Kuras, Vincent Récamier, Martial Piotto, Karim Elbayed, François Proust, Izzie Namer

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This paper proposes an augmented reality system dedicated to neurosurgery in order to assist the surgeon during an operation. This work is part of the ExtempoRMN project (Funded by Bpifrance) which aims at analyzing during a surgical operation the metabolic content of tumoral brain biopsy specimens by HRMAS NMR. Patients affected with a brain tumor (gliomas) frequently need to undergo an operation in order to remove the tumoral mass. During the operation, the neurosurgeon removes biopsy specimens using image-guided surgery. The biopsy specimens removed are then sent for HRMAS NMR analysis in order to obtain a better diagnosis and prognosis. Image-guided refers to the use of MRI images and a computer to precisely locate and target a lesion (abnormal tissue) within the brain. This is performed using preoperative MRI images and the BrainLab neuro-navigation system. With the patient MRI images loaded on the Brainlab Cranial neuro-navigation system in the operating theater, surgeons can better identify their approach before making an incision. The Brainlab neuro-navigation tool tracks in real time the position of the instruments and displays their position on the patient MRI data. The results of the biopsy analysis by 1H HRMAS NMR are then sent back to the operating theater and superimposed on the 3D localization system directly on the MRI images. The method we have developed to communicate between the HRMAS NMR analysis software and Brainlab makes use of a combination of C++, VTK and the Insight Toolkit using OpenIGTLink protocol.

Keywords: neuro-navigation, augmented reality, biopsy, BrainLab, HR-MAS NMR

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Authors: Anduela Lile

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The purpose of this cross sectional study was to investigate the effectiveness of teaching and learning Statistics from a student centered perspective in higher education institutions. Statistics education has emphasized the application of tangible and interesting examples in order to motivate students learning about statistical concepts. Participants in this study were 112 bachelor students enrolled in the ‘Applied Statistics’ course in Sports University of Tirana. Experimental group students received a student-centered teaching approach; Control group students received an instructor-centered teaching approach. This study found student-centered approach student group had statistically significantly higher assessments scores (52.1 ± 18.9) at the end of the evaluation compared to instructor-centered approach student group (61.8 ± 16.4), (t (108) = 2.848, p = 0.005). Results concluded that student-centered perspective can improve student positive attitude to statistical methods and to motivate project work. Therefore, findings of this study may be very useful to the higher education institutions to establish their learning strategies especially for courses related to Statistics.

Keywords: student-centered, instructor-centered, course assessment, learning outcomes, applied statistics

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Authors: Eunice Tan

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The purpose of this presentation is to look at an alternative to the approach and methodologies of working with special needs. The strength-based approach to education embodies a paradigm shift. It is a strategy to move away from a deficit-based methodology which inadvertently may lead to an extensive list of things that the child cannot do or is unable to do. Today, many parents of individuals with special needs are focused on the child’s deficits rather than on his or her strengths. Even when parents Recognise and identify their child’s strengths to be valuable and wish to develop their abilities, they face the challenge that there are insufficient programs committed to supporting the development and improvement of such abilities. What is a strength-based approach in education? A strength-based approach in education focuses on students' positive qualities and contributions to class instead of the skills and abilities they may not have. Many schools are focused on the child’s special educational needs rather than the whole child. Parents interviewed have said that they have to engage external tutors to help hone in on their child’s interests and strengths.

Keywords: differential learning needs, special needs, instructional style, talents

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Authors: Nurwati Djaman, Suradi Tahmir, Nurdin Arsyad

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The major objective of this study was to implement and evaluate the use of the implementation of social responsibility with the approach of Indonesian Realistic Mathematics Education (PMRI) in teaching and learning mathematics on students’ engagement and learning. The research problems investigated in this research: 1) What were the effects of the implementation of social responsibility with PMRI approach to learning mathematics? 2) What were the effects of the approach to students’ engagement? An action research and grounded theory methodology were adopted for the study. This study used mixed methods to collect, describe, and interpret the data. The data were collected through focus group discussion, classroom observations, questionnaire, interview, and students’ work. The participants in this study consisted of 45 students. The study revealed that the approach has given students the opportunity to develop their understanding of concepts and procedures, problem-solving ability, and communication ability. Also, students’ involvement in the approach improved their engagement in learning mathematics in the three domains of cognitive engagement, effective engagement, and behavioral engagement. In particular, the data collection from the focus group, classroom observations, and interviews suggest that, during this study, the students became more active participants in the mathematics lessons.

Keywords: Indonesian Realistic Mathematics Education, PMRI, learning mathematics, social responsibility, students' engagement

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Authors: Gete Umbrey, Saifur Rahman

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Graphs are found to be most capable in computing, and its abstract structures have been applied in some specific computations and algorithms like in phase encoding controller, processor microcontroller, and synthesis of a CMOS switching network, etc. Being motivated by these works, we develop an independent approach to study semiring structures and various properties by defining the binary operations which in fact, seems analogous to an existing definition in some sense but with a different approach. This work emphasizes specifically on the construction of semigroup and semiring structures on the set of undirected graphs, and their properties are investigated therein. It is expected that the investigation done here may have some interesting applications in theoretical computer science, networking and decision making, and also on joining of two network systems.

Keywords: graphs, join and union of graphs, semiring, weighted graphs

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Authors: Tadele Araya, Tsehaye Asmelash, Girmatsion Fiseha

Abstract:

Background: Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV) constitute serious healthcare problems worldwide. Blood-borne pathogens HBV, HCV and HIV are commonly associated with infections among substance or Injection Drug Users (IDUs). The objective of this study was to determine the prevalence of HBV, HCV, and HIV infections among substance users in Mekelle Substance users Treatment and Rehabilitation Centers. Methods: A cross-sectional study design was used from Dec 2020 to Sep / 2021 to conduct the study. A total of 600 substance users were included. Data regarding the socio-demographic, clinical and sexual behaviors of the substance users were collected using a structured questionnaire. For laboratory analysis, 5-10 ml of venous blood was taken from the substance users. The laboratory analysis was performed by Enzyme-Linked Immunosorbent Assay (ELISA) at Mekelle University, Department of Medical Microbiology and Immunology Research Laboratory. The Data was analyzed using SPSS and Epi-data. The association of variables with HBV, HCV and HIV infections was determined using multivariate analysis and a P value < 0.05 was considered statistically significant. Result: The overall prevalence rate of HBV, HCV and HIV infections were 10%, 6.6%, and 7.5%, respectively. The mean age of the study participants was 28.12 ± 6.9. A higher prevalence of HBV infection was seen in participants who were users of drug injections and in those who were infected with HIV. HCV was comparatively higher in those who had a previous history of unsafe surgical procedures than their counterparts. Homeless participants were highly exposed to HCV and HIV infections than their counterparts. The HBV/HIV Co-infection prevalence was 3.5%. Those doing unprotected sexual practices [P= 0.03], Injection Drug users [P= 0.03], those who had an HBV-infected person in their family [P=0.02], infected with HIV [P= 0.025] were statistically associated with HBV infection. HCV was significantly associated with Substance users and previous history of unsafe surgical procedures [p=0.03, p=0.04), respectively. HIV was significantly associated with unprotected sexual practices and being homeless [p=0.045, p=0.05) respectively. Conclusion-The highly prevalent viral infection was HBV compared to others. There was a High prevalence of HBV/HIV co-infection. The presence of HBV-infected persons in a family, unprotected sexual practices and sharing of needles for drug injection were the risk factors associated with HBV, HIV, and HCV. Continuous health education and screening of the viral infection coupled with medical and psychological treatment is mandatory for the prevention and control of the infections.

Keywords: hepatitis b virus, hepatitis c virus, HIV, substance users

Procedia PDF Downloads 70