Search results for: managed relocations
244 Participatory Financial Inclusion Hypothesis: A Preliminary Empirical Validation Using Survey Design
Authors: Edward A. Osifodunrin, Jose Manuel Dias Lopes
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In Nigeria, enormous efforts/resources had, over the years, been expended on promoting financial inclusion (FI); however, it is seemingly discouraging that many of its self-declared targets on FI remained unachieved, especially amongst the Rural Dwellers and Actors in the Informal Sectors (RDAIS). Expectedly, many reasons had been earmarked for these failures: low literacy level, huge informal/rural sectors, etc. This study posits that in spite of these truly-debilitating factors, these FI policy failures could have been avoided or mitigated if the principles of active and better-managed citizens’ participation had been strictly followed in the (re)design/implementation of its FI policies. In other words, in a bid to mitigate the prevalent FE in Nigeria, this study hypothesizes the positive impact of increased/active citizens’ participation on FI outcome(s), backed by a preliminary empirical validation. Also, the study introduces the RDAIS-focused participatory financial inclusion policy (PFIP) as a major FI policy regeneration/improvement tool. The three categories of respondents that served as research subjects are FI experts in Nigeria (n = 72), RDAIS from the very rural/remote village of Unguwar Dogo in Northern Nigeria (n = 43), and RDAIS from another rural village of Sekere (n = 56) in the Southern region of Nigeria. Using survey design (5-point Likert scale questionnaires), random/stratified sampling, and descriptive/inferential statistics, the study often recorded independent consensus (amongst these three categories of respondents) that RDAIS’s active participation in iterative FI policy initiation, (re)design, implementation, (re)evaluation could indeed give improved FI outcomes. However, some questionnaire items also recorded divergent opinions and various statistically significant differences in the mean scores of these three categories. The PFIP (or any customized version of it) should then be carefully integrated into the NFIS of Nigeria (and possibly in the NFIS of other developing countries) to truly/fully provide FI policy integration for these excluded RDAIS and arrest the prevalence of FE.Keywords: citizens’ participation, development, financial inclusion, formal financial services, national financial inclusion strategy, participatory financial inclusion policy, rural dwellers and actors in the informal sectors
Procedia PDF Downloads 101243 Management of Acute Biliary Pathology at Gozo General Hospital
Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti
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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management
Procedia PDF Downloads 157242 Simulation of Ester Based Mud Performance through Drilling Genting Timur Field
Authors: Lina Ismail Jassim, Robiah Yunus
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To successfully drill oil or gas well, two main characteristics of numerous other tasks of an efficient drilling fluid are required, which are suspended and carrying cuttings from the beneath wellbore to the surface and managed between pore (formation) and hydrostatic pressure (mud pressure). Several factors like mud composition and its rheology, wellbore design, drilled cuttings characteristics and drilling string rotation contribute to drill wellbore successfully. Simulation model can support an appropriate indication on the drilling fluid performance in the real field as Genting Timur field, located in Pahang in Malaysia on 4295 m depth, held the world record in Sempah Muda 1 (Vertical). A detailed 3 dimensional CFD analysis of vertical, concentric annular two phase flow was developed to study and asses Herschel Bulkley drilling fluid. The effect of Hematite, Barite and calcium carbonates types and size of cutting rock particles on such flow is analyzed. The vertical flows are also associated with a good amount of temperature variation along the depth. This causes a good amount of change in viscosity of the fluid, which is non-Newtonian in nature. Good understanding of the nature of such flows is imperative in developing and maintaining successful vertical well systems. A detailed analysis of flow characteristics due to the drill pipe rotation is done in this work. The inner cylinder of the annulus gets different rotational speed, depending upon the operating conditions. This speed induces a good swirl on the particles and primary fluids which interpret in Ester based drilling fluid cleaning well ability, which in turn determines energy loss along the pipe. Energy loss is assessed in this work in terms of wall shear stress and pressure drop along the pipe. The flow is under an adverse pressure gradient condition, which causes chance of reversed flow and transfers the rock cuttings to the surface.Keywords: concentric annulus, non-Newtonian, two phase, Herschel Bulkley
Procedia PDF Downloads 301241 Application of Thermal Dimensioning Tools to Consider Different Strategies for the Disposal of High-Heat-Generating Waste
Authors: David Holton, Michelle Dickinson, Giovanni Carta
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The principle of geological disposal is to isolate higher-activity radioactive wastes deep inside a suitable rock formation to ensure that no harmful quantities of radioactivity reach the surface environment. To achieve this, wastes will be placed in an engineered underground containment facility – the geological disposal facility (GDF) – which will be designed so that natural and man-made barriers work together to minimise the escape of radioactivity. Internationally, various multi-barrier concepts have been developed for the disposal of higher-activity radioactive wastes. High-heat-generating wastes (HLW, spent fuel and Pu) provide a number of different technical challenges to those associated with the disposal of low-heat-generating waste. Thermal management of the disposal system must be taken into consideration in GDF design; temperature constraints might apply to the wasteform, container, buffer and host rock. Of these, the temperature limit placed on the buffer component of the engineered barrier system (EBS) can be the most constraining factor. The heat must therefore be managed such that the properties of the buffer are not compromised to the extent that it cannot deliver the required level of safety. The maximum temperature of a buffer surrounding a container at the centre of a fixed array of heat-generating sources, arises due to heat diffusing from neighbouring heat-generating wastes, incrementally contributing to the temperature of the EBS. A range of strategies can be employed for managing heat in a GDF, including the spatial arrangements or patterns of those containers; different geometrical configurations can influence the overall thermal density in a disposal facility (or area within a facility) and therefore the maximum buffer temperature. A semi-analytical thermal dimensioning tool and methodology have been applied at a generic stage to explore a range of strategies to manage the disposal of high-heat-generating waste. A number of examples, including different geometrical layouts and chequer-boarding, have been illustrated to demonstrate how these tools can be used to consider safety margins and inform strategic disposal options when faced with uncertainty, at a generic stage of the development of a GDF.Keywords: buffer, geological disposal facility, high-heat-generating waste, spent fuel
Procedia PDF Downloads 278240 Sustainable Management of Gastronomy Experiences as a Mechanism to Promote the Local Economy
Authors: Marianys Fernandez
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Gastronomic experiences generate a positive impact on the dynamization of the economy when they are managed in a sustainable manner, given that they value the identity of the destination, strengthen cooperation between stakeholders in the sector, contribute to the preservation of gastronomic heritage, and encourage the implementation of competitive and sustainable public policies. Having as its main aim the analysis of sustainable management of gastronomic experiences, this study analyses different elements associated with the promotion of the local economy. For this purpose, a systematic literature review was carried out to identify, select, synthesise, and evaluate the studies that respond to the research objectives in order to select more reliable articles for research and reduce the potential for bias within the review of literature. To obtain reliable, updated and relevant sources for scientific research, the Web of Science and Scopus databases were used, taking into account the following key words: (1) experiential tourism, (2) gastronomy experience, (3) sustainable destination management, (4) sustainable gastronomy, (5) sustainable economy, in which we obtained a final list of 76 articles. The analysis of the literature allowed us to identify the most pertinent elements referring to the objective of the study: (a) need for competitive policies in the gastronomic sector to promote sustainable local economic development, (b) incentive for cooperation between stakeholders in the gastronomic sector, to guarantee the competitiveness of the destination, (c) propose sustainable standards in the gastronomic tourism sector that link the local economy. Gastronomic experiences constitute a dynamic element of the local economy and promote sustainable tourism. We can highlight that sustainability is a mechanism for the preservation of regional identity in the gastronomic sector through the valuation of the attributes of gastronomy, promotion of the local economy, strengthening of strategic alliances between the stakeholders of the gastronomic sector and its relevant contribution to the competitiveness of the destination. The theoretical implications of the study are focused on suggesting planning, management, and policy criteria to promote the sustainable management of gastronomic experiences in order to promote the local economy. In the practical context, research integrates different approaches, tools, and methods to encourage the active participation of local actors in the promotion of the local economy through the sustainable management of gastronomic tourism.Keywords: experiential tourism, gastronomy experience, sustainable destination management, sustainable economy, sustainable gastronomy
Procedia PDF Downloads 68239 Central Energy Management for Optimizing Utility Grid Power Exchange with a Network of Smart Homes
Authors: Sima Aznavi, Poria Fajri, Hanif Livani
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Smart homes are small energy systems which may be equipped with renewable energy sources, storage devices, and loads. Energy management strategy plays a main role in the efficient operation of smart homes. Effective energy scheduling of the renewable energy sources and storage devices guarantees efficient energy management in households while reducing the energy imports from the grid. Nevertheless, despite such strategies, independently day ahead energy schedules for multiple households can cause undesired effects such as high power exchange with the grid at certain times of the day. Therefore, the interactions between multiple smart home day ahead energy projections is a challenging issue in a smart grid system and if not managed appropriately, the imported energy from the power network can impose additional burden on the distribution grid. In this paper, a central energy management strategy for a network consisting of multiple households each equipped with renewable energy sources, storage devices, and Plug-in Electric Vehicles (PEV) is proposed. The decision-making strategy alongside the smart home energy management system, minimizes the energy purchase cost of the end users, while at the same time reducing the stress on the utility grid. In this approach, the smart home energy management system determines different operating scenarios based on the forecasted household daily load and the components connected to the household with the objective of minimizing the end user overall cost. Then, selected projections for each household that are within the same cost range are sent to the central decision-making system. The central controller then organizes the schedules to reduce the overall peak to average ratio of the total imported energy from the grid. To validate this approach simulations are carried out for a network of five smart homes with different load requirements and the results confirm that by applying the proposed central energy management strategy, the overall power demand from the grid can be significantly flattened. This is an effective approach to alleviate the stress on the network by distributing its energy to a network of multiple households over a 24- hour period.Keywords: energy management, renewable energy sources, smart grid, smart home
Procedia PDF Downloads 240238 The Role of Artificial Intelligence in Patent Claim Interpretation: Legal Challenges and Opportunities
Authors: Mandeep Saini
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The rapid advancement of Artificial Intelligence (AI) is transforming various fields, including intellectual property law. This paper explores the emerging role of AI in interpreting patent claims, a critical and highly specialized area within intellectual property rights. Patent claims define the scope of legal protection granted to an invention, and their precise interpretation is crucial in determining the boundaries of the patent holder's rights. Traditionally, this interpretation has relied heavily on the expertise of patent examiners, legal professionals, and judges. However, the increasing complexity of modern inventions, especially in fields like biotechnology, software, and electronics, poses significant challenges to human interpretation. Introducing AI into patent claim interpretation raises several legal and ethical concerns. This paper addresses critical issues such as the reliability of AI-driven interpretations, the potential for algorithmic bias, and the lack of transparency in AI decision-making processes. It considers the legal implications of relying on AI, particularly regarding accountability for errors and the potential challenges to AI interpretations in court. The paper includes a comparative study of AI-driven patent claim interpretations versus human interpretations across different jurisdictions to provide a comprehensive analysis. This comparison highlights the variations in legal standards and practices, offering insights into how AI could impact the harmonization of international patent laws. The paper proposes policy recommendations for the responsible use of AI in patent law. It suggests legal frameworks that ensure AI tools complement, rather than replace, human expertise in patent claim interpretation. These recommendations aim to balance the benefits of AI with the need for maintaining trust, transparency, and fairness in the legal process. By addressing these critical issues, this research contributes to the ongoing discourse on integrating AI into the legal field, specifically within intellectual property rights. It provides a forward-looking perspective on how AI could reshape patent law, offering both opportunities for innovation and challenges that must be carefully managed to protect the integrity of the legal system.Keywords: artificial intelligence (ai), patent claim interpretation, intellectual property rights, algorithmic bias, natural language processing, patent law harmonization, legal ethics
Procedia PDF Downloads 8237 Analysis of Problems Faced by the Female Students in Capacity Enhancing at Intermediate Level in Girls College of Khyber Pakhtunkhwa, Pakistan
Authors: Uzma Ahmad
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hyber Pakhtunkhwa (KPK) is the most turbulent province of Pakistan, sharing a longborder with Afghanistan. For about four decades, KPK is facing a series of international events. The peak was reached after 9/11when region was labelled as posing a major theatre of militancy and terrorism which was intensified when Tehrik Taliban Pakistan (TTP) began attempts to seize the authority of state. One of the main focus of TTP was to damage and uprooting of female education system and infrastructure in KPK which later became the site of a massacre of school children of Army Public School Peshawar on 16 December 2014.It resulted to the launching of Zarb-e-Azb against the TTP insurgency,casualty and crime rates in the KPKas a whole dropped by 40.0% as compared to 2011–13. All this has badly hampered the female education both in terms of quantity and quality. Malala Yousafzai who is now an advocate of female education has been a victim of Talibans brutality in that area. And thelanguage in which she managed to express herself to the International community is English.Keeping in view the situation, the present project was designed with a sole aim to focus on female students of the area which are few in numbers and to investigate some specific area, where they have been confronting problems in the use of grammar, vocabulary,tenses and organization of ideas in writings. The reasons might be the careless attitude, insufficient reading habits, lack of interest and poor knowledge of English language. The methodology was a descriptive one as it shows the effects of the internal efficiency(independent variables) on an intermediate college’s progress(dependent variables). It was a case study since data was collected from a focused group of 60 female students of arts and humanities at Swabi college at Intermediate level. The ultimate focus was to explore the possibilities of creating a Gender friendly environment for female students. This research has proved how the correct use of English language has given them confidence to move ahead side by side with men and to acknowledge their right of self-determination.Keywords: capacity building, female education, gender friendly, internal efficiency
Procedia PDF Downloads 158236 Positive Interactions among Plants in Pinegroves over Quarzitic Sands
Authors: Enrique González Pendás, Vidal Pérez Hernández, Jorge Ferro Díaz, Nelson Careaga Pendás
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The investigation is carried out on the Protected Area of San Ubaldo, toward the interior of an open pinegrove with palm trees in a dry plainness of quar zitic sands, belonging to the Floristic Managed Reservation San Ubaldo-Sabanalamar, Guane, Pinar del Río, Cuba. This area is characterized by drastic seasonal variations, high temperatures and water evaporation, strong solar radiation, with sandy soils of almost pure quartz, which are very acid and poor in nutrients. The objective of the present work is to determine evidence of facilitation and its relationship with the structure and composition of plant communities in these peculiar ecosystems. For this study six lineal parallel transepts of 100 m are traced, in those, a general recording of the flora is carried out. To establish which plants act as nurses, is taken into account a height over 1 meter, canopy over 1.5 meter and the occurrence of several species under it. Covering was recorded using the line intercept method; the medium values of species richness for the taxa under nurses is compared with those that are located in open spaces among them. Then, it is determined which plants are better recruiter of other species (better nurses). An experiment is made to measure and compare some parameters in pine seedlings under the canopy of the Byrsonima crassifolia (L.) Kunth. and in open spaces, also the number of individuals is counted by species to calculate the frequency and total abundance in the study area. As a result, it is offered an up-to-date floristic list, a phylogenetic tree of the plant community showing a high phylodiversity, it is proven that the medium values of species richness and abundance of species under the nurses, is significantly superior to those occurring in open spaces. Furthermore, by means of phylogenetic trees it is shown that the species which cohabit under the nurses are not phylogenetically related. The former results are cited evidences of facilitation among plants, as well as it is one more time shown the importance of the nurse effect in preserving plant diversity on extreme environments.Keywords: facilitation, nurse plants, positive interactions, quarzitic sands
Procedia PDF Downloads 339235 Trends in Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients
Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte
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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results: Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients.Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome
Procedia PDF Downloads 55234 Sexually Transmitted Diseases Taboo: Time to Rethink
Authors: Kalpana Gupta
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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies
Procedia PDF Downloads 181233 The Effectiveness of Kinesio Taping in Enhancing Early Post-Operative Outcomes Inpatients after Total Knee Replacement or Anterior Cruciate Ligament Reconstruction
Authors: B. A. Alwahaby
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Background: The number of Total Knee Replacement (TKR) and Anterior Cruciate Ligament Reconstruction (ACLR) performed every year is increasing. The main aim of physiotherapy early recovery rehabilitation after these surgeries is to control pain and edema and regain Range of Motion (ROM) and physical activity. All of these outcomes need to be managed by safe and effective modalities. Kinesiotaping (KT) is an elastic non-invasive therapeutic tape that has become recognised in different physiotherapy situation as injury prevention, rehabilitation, and performance enhancement and been used with different conditions. However, there is still clinical doubt regarding the effectiveness of KT due to inconclusive supporting evidence. The aim of this systematic review is to collate all the available evidence on the effectiveness of KT in the early rehabilitation of ACLR and TKR patients and analyse whether the use of KT combined with standard rehabilitation would facilitate recovery of postoperative outcome than standard rehabilitation alone. Methodology: A systematic review was conducted. Medline, EMBASE, Scopus, AMED PEDro, CINAHL, and Web of Science databases were searched. Each study was assessed for inclusion and methodological quality appraisal was undertaken by two reviewers using the JBI critical appraisal tools. The studies were then synthesised qualitatively due to heterogeneity between studies. Results: Five moderate to low quality RCTs were located. All five studies demonstrated statistically significant improvements in pain, swelling, ROM, and functional outcomes (p < 0.05). Between group comparison, KT combined with standardised rehabilitation were shown to be significantly more effective than standardised rehabilitation alone for pain and swelling (p < 0.05). However, there were inconstant findings for ROM, and no statistically significant differences reported between groups for functional outcomes (p > 0.05). Conclusion: Research in the area is generally low quality; however, there is consistent evidence to support the use of KT combined with standardised post-operative rehabilitation for reducing pain and swelling. There is also some evidence that KT may be effective in combination with standardised rehabilitation to regain knee extension ROM faster than standardised rehabilitation alone, but further primary research is required to confirm this.Keywords: anterior cruciate ligament reconstruction, ACLR, kinesio taping, KT, postoperative, total knee replacement, TKR
Procedia PDF Downloads 114232 Evaluation of Environmental Management System Implementation of Construction Projects in Turkey
Authors: Aydemir Akyürek, Osman Nuri Ağdağ
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Construction industry is in a rapid development for many years around the world and especially in Turkey. In the last three years sector has 10% growth and provides significant support on Turkey’s national economy. Many construction projects are on-going at urban and rural areas of Turkey which have substantial environmental impacts. Environmental impacts during construction phase are quite diversified and widespread. Environmental impacts of construction industry cannot be inspected properly in all cases and negative impacts may occur frequently in many projects in Turkey. In this study, implementation of ISO 14001 Environmental Management System (EMS) in construction plants is evaluated. In the beginning stage quality management systems generally reviewed and ISO 14001 EMS is selected for implementation. Standard requirements are examined first and implementation of every standard requirement is elaborated for the selected construction plant in the following stage. Key issues and common problems, gained benefits by execution of this type of international EMS standard are examined. As can be seen in sample projects, construction projects are being completed very fast and contractors are working in a highly competitive environment with low profit ratios in our country and mostly qualified work force cannot be accessible. Addition to this there are deficits on waste handling and environmental infrastructure. Besides construction companies which have substantial investments on EMSs can be faced with difficulties on competitiveness in domestic market, however professional Turkish contractors which implementing managements systems in larger scale at international projects are gaining successful results. Also the concept of ‘construction project management’ which is being implemented in successful projects worldwide cannot be implemented except larger projects in Turkey. In case of nonexistence of main management system (quality) implementation of EMSs cannot be managed. Despite all constraints, EMSs that will be implemented in this industry with commitment of top managements and demand of customers will be an enabling, facilitating tool to determine environmental aspects and impacts of construction sites, will provide higher compliance levels for environmental legislation, to establish best available methods for operational control on waste management, chemicals management etc. and to plan monitoring and measurement, to prioritize environmental aspects for investment schedules and waste management.Keywords: environmental management system, construction projects, ISO 14001, quality
Procedia PDF Downloads 354231 Efficacy and Safety of Electrical Vestibular Stimulation on Adults with Symptoms of Insomnia: A Double-Blind, Randomized, Sham-Controlled Trial
Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Calvin Pak-Wing Cheng, Julie Sittlington, Yu-Tao Xiang, Tim Man Ho Li
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Insomnia is one of the most common health problems in the general population. Insomnia can be acute, intermittent, and become chronic, often due to comorbidity with other physical and mental health conditions. Although there are conventional pharmaceutical and psychotherapeutic treatments to treat symptoms of insomnia, however; there is no robust and novel randomized controlled trial (RCT) using transdermal neurostimulation on individuals with insomnia symptoms. This gives us the impetus to execute the first nationwide RCT. Aim: To evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. Design: This study was a two-armed, double blinded, randomized, sham-controlled trial. Sampling: 60 community-dwelling adults aged 18 and 60 years with moderate insomnia symptoms or above (Insomnia Severity Index > 14) were recruited. All subjects were computerized randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. Intervention: All participants received a home-use VeNS device and used 30-min VeNS sessions during five consecutive days across a 4-week period (total treatment hours: 10). Baseline measurements and post-VeNS evaluation of the psychological outcomes, including 1) insomnia severity, 2) sleep quality, and 3) quality of life were investigated. The short-and long-term sustainability of the VeNS intervention was assessed immediately after poststim and at a 1-month and 3-month follow-up period. Data analysis: A mixed GEE model was used to analyze the repeated measures data. Missing data were managed by multiple imputations. The level of significance was set to p < 0.05. Significance of the study: This is the first trial to examine the efficacy and safety of VeNS among adults with insomnia symptoms in Hong Kong. Findings that emerged were used to determine whether this VeNS device can be considered a self-help technological device to reduce the severity of insomnia in the community setting and to reduce the global disease burden. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04452981.Keywords: adults, insomnia, neuromodulation, rct, vestibular stimulation
Procedia PDF Downloads 74230 The First Trial of Transcranial Pulse Stimulation on Young Adolescents With Autism Spectrum Disorder in Hong Kong
Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Yuen Shan Ho, Tim Man Ho Li, Andy Choi-Yeung Tse, Cheng-Ta Li, Calvin Pak-Wing Cheng, Roland Beisteiner
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Transcranial pulse stimulation (TPS) is a non-intrusive brain stimulation technology that has been proven effective in older adults with mild neurocognitive disorders and adults with major depressive disorder. Given these robust evidences, TPS might be an adjunct treatment options in neuropsychiatric disorders, for example, autism spectrum disorder (ASD) – which is a common neurodevelopmental disorder in children. This trial aimed to investigate the effects of TPS on right temporoparietal junction, a key node for social cognition for Autism Spectrum Disorder (ASD), and to examine the association between TPS, executive functions and social functions. Design: This trial adopted a two-armed (verum TPS group vs. sham TPS group), double-blinded, randomized, sham-controlled design. Sampling: 32 subjects aged between 12 and 17, diagnosed with ASD were recruited. All subjects were computerized randomized into either verum TPS group or the sham TPS group on a 1:1 ratio. All subjects undertook functional MRI before and after the TPS interventions. Intervention: Six 30-min TPS sessions were administered to subjects in 2 weeks’ time on alternate days assessing neural connectivity changes. Baseline measurements and post-TPS evaluation of the ASD symptoms, executive functions, and social functions were conducted. Participants were followed up at 2-weeks, at 1-month and 3-month, assessing the short-and long-term sustainability of the TPS intervention. Data analysis: Generalized Estimating Equations with repeated measures were used to analyze the group and time difference. Missing data were managed by multiple imputations. The level of significance was set at p < 0.05. To our best knowledge, this is the first study evaluating the efficacy and safety of TPS among adolescents with ASD in Hong Kong and nationwide. Results emerging from this study will develop insight on whether TPS can be used as an adjunct treatment on ASD in neuroscience and clinical psychiatry. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT05408793.Keywords: adolescents, autism spectrum disorder, neuromodulation, rct, transcranial pulse stimulation
Procedia PDF Downloads 67229 Corporate Governance and Minority Shareholders Protection in the United Kingdom
Authors: Meltem Karatepe Kaya
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The concept of corporate governance is not new but, due to the recent international financial crisis, it has become prominent in contemporary business, accounting and legal debates. There is a wealth of anecdotal evidence which shows that protection of minority shareholders is an important issue in the corporate governance literature. Minority shareholders typically hold low amounts of stocks, so the benefits gained from their participation in shareholder meetings are very asymmetric to the cost. Therefore, the presence of a good corporate governance structure is the proper protection of and respect for the rights and interests of shareholders, particularly those of minority shareholders. The research will attempt to find answers to the following questions: Why minority shareholders’ rights should be protected? How minority shareholders’ rights could be improved? Does the legal framework in the United Kingdom provide adequate protection for minority shareholders? This study will assess regulations about the legal protections of minority shareholders and try to find answer this question: ’Why is it inevitable for company law to treat in a successful way the problems arising from minority shareholders' conflict with other shareholders of a company?’The protection of minority shareholders is not only a corporate governance objective in its own right but also has added importance particularly in developing countries. In the United Kingdom(UK) and the United States of America(USA), there are diffused ownership structures so that any shareholders do not influence the management of the company. This is in stark contrast to companies in developing countries such as Turkey where controlling shareholders and related insiders are a well-known feature of ownership structures, and where companies are often governed and managed by controlling shareholders such as family firms and associated companies through cross-shareholdings and pyramiding ownership structures. In Turkey, the agency problem is not between shareholders and management. Rather it gives rise to another dimension of the agency problem – a conflict of interest between majority shareholders (controlling) and minority shareholders. This research will make a particularly useful contribution to knowledge-based information and understanding of company law in the UK, particularly minority shareholders' remedies. It will not only give information about law and regulations of minority shareholders' remedies but also it will provide some knowledge about doctrinal discussions and relevant cases. The major contribution to study will be in the knowledge of law and regulation in the legal protections of minority shareholders in the United Kingdom and Turkey. In this study, the recommendations will be given for the development of the legal framework and practices of protections for minority shareholders and small investors.Keywords: controlling shareholders, corporate governance, derivative actions, minority shareholders
Procedia PDF Downloads 171228 Comparison of Existing Predictor and Development of Computational Method for S- Palmitoylation Site Identification in Arabidopsis Thaliana
Authors: Ayesha Sanjana Kawser Parsha
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S-acylation is an irreversible bond in which cysteine residues are linked to fatty acids palmitate (74%) or stearate (22%), either at the COOH or NH2 terminal, via a thioester linkage. There are several experimental methods that can be used to identify the S-palmitoylation site; however, since they require a lot of time, computational methods are becoming increasingly necessary. There aren't many predictors, however, that can locate S- palmitoylation sites in Arabidopsis Thaliana with sufficient accuracy. This research is based on the importance of building a better prediction tool. To identify the type of machine learning algorithm that predicts this site more accurately for the experimental dataset, several prediction tools were examined in this research, including the GPS PALM 6.0, pCysMod, GPS LIPID 1.0, CSS PALM 4.0, and NBA PALM. These analyses were conducted by constructing the receiver operating characteristics plot and the area under the curve score. An AI-driven deep learning-based prediction tool has been developed utilizing the analysis and three sequence-based input data, such as the amino acid composition, binary encoding profile, and autocorrelation features. The model was developed using five layers, two activation functions, associated parameters, and hyperparameters. The model was built using various combinations of features, and after training and validation, it performed better when all the features were present while using the experimental dataset for 8 and 10-fold cross-validations. While testing the model with unseen and new data, such as the GPS PALM 6.0 plant and pCysMod mouse, the model performed better, and the area under the curve score was near 1. It can be demonstrated that this model outperforms the prior tools in predicting the S- palmitoylation site in the experimental data set by comparing the area under curve score of 10-fold cross-validation of the new model with the established tools' area under curve score with their respective training sets. The objective of this study is to develop a prediction tool for Arabidopsis Thaliana that is more accurate than current tools, as measured by the area under the curve score. Plant food production and immunological treatment targets can both be managed by utilizing this method to forecast S- palmitoylation sites.Keywords: S- palmitoylation, ROC PLOT, area under the curve, cross- validation score
Procedia PDF Downloads 67227 Optimized Scheduling of Domestic Load Based on User Defined Constraints in a Real-Time Tariff Scenario
Authors: Madia Safdar, G. Amjad Hussain, Mashhood Ahmad
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One of the major challenges of today’s era is peak demand which causes stress on the transmission lines and also raises the cost of energy generation and ultimately higher electricity bills to the end users, and it was used to be managed by the supply side management. However, nowadays this has been withdrawn because of existence of potential in the demand side management (DSM) having its economic and- environmental advantages. DSM in domestic load can play a vital role in reducing the peak load demand on the network provides a significant cost saving. In this paper the potential of demand response (DR) in reducing the peak load demands and electricity bills to the electric users is elaborated. For this purpose the domestic appliances are modeled in MATLAB Simulink and controlled by a module called energy management controller. The devices are categorized into controllable and uncontrollable loads and are operated according to real-time tariff pricing pattern instead of fixed time pricing or variable pricing. Energy management controller decides the switching instants of the controllable appliances based on the results from optimization algorithms. In GAMS software, the MILP (mixed integer linear programming) algorithm is used for optimization. In different cases, different constraints are used for optimization, considering the comforts, needs and priorities of the end users. Results are compared and the savings in electricity bills are discussed in this paper considering real time pricing and fixed tariff pricing, which exhibits the existence of potential to reduce electricity bills and peak loads in demand side management. It is seen that using real time pricing tariff instead of fixed tariff pricing helps to save in the electricity bills. Moreover the simulation results of the proposed energy management system show that the gained power savings lie in high range. It is anticipated that the result of this research will prove to be highly effective to the utility companies as well as in the improvement of domestic DR.Keywords: controllable and uncontrollable domestic loads, demand response, demand side management, optimization, MILP (mixed integer linear programming)
Procedia PDF Downloads 298226 Latitudinal Impact on Spatial and Temporal Variability of 7Be Activity Concentrations in Surface Air along Europe
Authors: M. A. Hernández-Ceballos, M. Marín-Ferrer, G. Cinelli, L. De Felice, T. Tollefsen, E. Nweke, P. V. Tognoli, S. Vanzo, M. De Cort
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This study analyses the latitudinal impact of the spatial and temporal distribution on the cosmogenic isotope 7Be in surface air along Europe. The long-term database of the 6 sampling sites (Ivalo, Helsinki, Berlin, Freiburg, Sevilla and La Laguna), that regularly provide data to the Radioactivity Environmental Monitoring (REM) network managed by the Joint Research Centre (JRC) in Ispra, were used. The selection of the stations was performed attending to different factors, such as 1) heterogeneity in terms of latitude and altitude, and 2) long database coverage. The combination of these two parameters ensures a high degree of representativeness of the results. In the later, the temporal coverage varies between stations, being used in the present study sampling stations with a database more or less continuously from 1984 to 2011. The mean values of 7Be activity concentration presented a spatial distribution value ranging from 2.0 ± 0.9 mBq/m3 (Ivalo, north) to 4.8 ± 1.5 mBq/m3 (La Laguna, south). An increasing gradient with latitude was observed from the north to the south, 0.06 mBq/m3. However, there was no correlation with altitude, since all stations are sited within the atmospheric boundary layer. The analyses of the data indicated a dynamic range of 7Be activity for solar cycle and phase (maximum or minimum), having been observed different impact on stations according to their location. The results indicated a significant seasonal behavior, with the maximum concentrations occurring in the summer and minimum in the winter, although with differences in the values reached and in the month registered. Due to the large heterogeneity in the temporal pattern with which the individual radionuclide analyses were performed in each station, the 7Be monthly index was calculated to normalize the measurements and perform the direct comparison of monthly evolution among stations. Different intensity and evolution of the mean monthly index were observed. The knowledge of the spatial and temporal distribution of this natural radionuclide in the atmosphere is a key parameter for modeling studies of atmospheric processes, which are important phenomena to be taken into account in the case of a nuclear accident.Keywords: Berilium-7, latitudinal impact in Europe, seasonal and monthly variability, solar cycle
Procedia PDF Downloads 333225 Yield Level, Variability and Yield Gap of Maize (Zea Mays L.) Under Variable Climate Condition of the Semi-arid Central Rift Valley of Ethiopia
Authors: Fitih Ademe, Kibebew Kibret, Sheleme Beyene, Mezgebu Getnet, Gashaw Meteke
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Soil moisture and nutrient availability are the two key edaphic factors that affect crop yields and are directly or indirectly affected by climate variability and change. The study examined climate-induced yield level, yield variability and gap of maize during 1981-2010 main growing season in the Central Rift Valley (CRV) of Ethiopia. Pearson correlation test was employed to see the relationship between climate variables and yield. The coefficient of variation (CV) was used to analyze annual yield variability. Decision Support System for Agro-technology Transfer cropping system model (DSSAT-CSM) was used to simulate the growth and yield of maize for the study period. The result indicated that maize grain yield was strongly (P<0.01) and positively correlated with seasonal rainfall (r=0.67 at Melkassa and r = 0.69 at Ziway) in the CRV while day temperature affected grain yield negatively (r= -0.44) at Ziway (P<0.05) during the simulation period. Variations in total seasonal rainfall at Melkassa and Ziway explained 44.9 and 48.5% of the variation in yield, respectively, under optimum nutrition. Following variation in rainfall, high yield variability (CV=23.5%, Melkassa and CV=25.3%, Ziway) was observed for optimum nutrient simulation than the corresponding nutrient limited simulation (CV=16%, Melkassa and 24.1%, Ziway) in the study period. The observed farmers’ yield was 72, 52 and 43% of the researcher-managed, water-limited and potential yield of the crop, respectively, indicating a wide maize yield gap in the region. The study revealed rainfed crop production in the CRV is prone to yield variabilities due to its high dependence on seasonal rainfall and nutrient level. Moreover, the high coefficient of variation in the yield gap for the 30-year period also foretells the need for dependable water supply at both locations. Given the wide yield gap especially during lower rainfall years across the simulation periods, it signifies the requirement for a more dependable application of irrigation water and a potential shift to irrigated agriculture; hence, adopting options that can improve water availability and nutrient use efficiency would be crucial for crop production in the area.Keywords: climate variability, crop model, water availability, yield gap, yield variability
Procedia PDF Downloads 62224 Peer Support Groups as a Tool to Increase Chances of Passing General Practice UK Qualification Exams
Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie
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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.Keywords: peer support, medical education, pastoral support, MRCGP exams
Procedia PDF Downloads 125223 Construction and Demolition Waste Management in Indian Cities
Authors: Vaibhav Rathi, Soumen Maity, Achu R. Sekhar, Abhijit Banerjee
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Construction sector in India is extremely resource and carbon intensive. It contributes to significantly to national greenhouse emissions. At the resource end the industry consumes significant portions of the output from mining. Resources such as sand and soil are most exploited and their rampant extraction is becoming constant source of impact on environment and society. Cement is another resource that is used in abundance in building and construction and has a direct impact on limestone resources. Though India is rich in cement grade limestone resource, efforts have to be made for sustainable consumption of this resource to ensure future availability. Use of these resources in high volumes in India is a result of rapid urbanization. More cities have grown to a population of million plus in the last decade and million plus cities are growing further. To cater to needs of growing urban population of construction activities are inevitable in the coming future thereby increasing material consumption. Increased construction will also lead to substantial increase in end of life waste generation from Construction and Demolition (C&D). Therefore proper management of C&D waste has the potential to reduce environmental pollution as well as contribute to the resource efficiency in the construction sector. The present study deals with estimation, characterisation and documenting current management practices of C&D waste in 10 Indian cities of different geographies and classes. Based on primary data the study draws conclusions on the potential of C&D waste to be used as an alternative to primary raw materials. The estimation results show that India generates 716 million tons of C&D waste annually, placing the country as second largest C&D waste generator in the world after China. The study also aimed at utilization of C&D waste in to building materials. The waste samples collected from various cities have been used to replace 100% stone aggregates in paver blocks without any decrease in strength. However, management practices of C&D waste in cities still remains poor instead of notification of rules and regulations notified for C&D waste management. Only a few cities have managed to install processing plant and set up management systems for C&D waste. Therefore there is immense opportunity for management and reuse of C&D waste in Indian cities.Keywords: building materials, construction and demolition waste, cities, environmental pollution, resource efficiency
Procedia PDF Downloads 298222 Estimation of Carbon Losses in Rice: Wheat Cropping System of Punjab, Pakistan
Authors: Saeed Qaisrani
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The study was conducted to observe carbon and nutrient loss by burning of rice residues on rice-wheat cropping system The rice crop was harvested to conduct the experiment in a randomized complete block design (RCBD) with factors and 4 replications with a net plot size of 10 m x 20 m. Rice stubbles were managed by two methods i.e. Incorporation & burning of rice residues. Soil samples were taken to a depth of 30 cm before sowing & after harvesting of wheat. Wheat was sown after harvesting of rice by three practices i.e. Conventional tillage, Minimum tillage and Zero tillage to observe best tillage practices. Laboratory and field experiments were conducted on wheat to assess best tillage practice and residues management method with estimation of carbon losses. Data on the following parameters; establishment count, plant height, spike length, number of grains per spike, biological yield, fat content, carbohydrate content, protein content, and harvest index were recorded to check wheat quality & ensuring food security in the region. Soil physico-chemical analysis i.e. pH, electrical conductivity, organic matter, nitrogen, phosphorus, potassium, and carbon were done in soil fertility laboratory. Substantial results were found on growth, yield and related parameters of wheat crop. The collected data were examined statistically with economic analysis to estimate the cost-benefit ratio of using different tillage techniques and residue management practices. Obtained results depicted that Zero tillage method have positive impacts on growth, yield and quality of wheat, Moreover, it is cost effective methodology. Similarly, Incorporation is suitable and beneficial method for soil due to more nutrients provision and reduce the need of fertilizers. Burning of rice stubbles has negative impact including air pollution, nutrient loss, microbes died and carbon loss. Recommended the zero tillage technology to reduce carbon losses along with food security in Pakistan.Keywords: agricultural agronomy, food security, carbon sequestration, rice-wheat cropping system
Procedia PDF Downloads 273221 Early Outcomes and Lessons from the Implementation of a Geriatric Hip Fracture Protocol at a Level 1 Trauma Center
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
Procedia PDF Downloads 69220 Effectiveness of Centromedullary Fixation by Metaizeau Technique in Challenging Pediatric Fractures
Authors: Mohammad Arshad Ikram
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We report three cases of challenging fractures in children treated by intramedullary fixation using the Metaizeau method and achieved anatomical reduction with excellent clinical results. Jean-Paul Metaizeau described the centromedullary fixation for the radial neck in 1980 using K-wires Radial neck fractures are uncommon in children. Treatment of severely displaced fractures is always challenging. Closed reduction techniques are more popular as compared to open reduction due to the low risk of complications. Metaizeau technique of closed reduction with centromedullary pinning is a commonly preferred method of treatment. We present two cases with a severely displaced radial neck fracture, treated by this method and achieved sound union; anatomical position of the radial head and full function were observed two months after surgery. Proximal humerus fractures are another uncommon injury in children accounting for less than 5% of all pediatric fractures. Most of these injuries occur through the growth plate because of its relative weakness. Salter-Harris type I is commonly seen in the younger age group, whereas type II & III occurs in older children and adolescents. In contrast to adults, traumatic glenohumeral dislocation is an infrequently observed condition among children. A combination of proximal humerus fracture and glenohumeral dislocation is extremely rare and occurs in less than 2% of the pediatric population. The management of this injury is always challenging. Treatment ranged from closed reduction with and without internal fixation and open reduction with internal fixation. The children who had closed reduction with centromedullary fixation by the Metaizeau method showed excellent results with the return of full movements at the shoulder in a short time without any complication. We present the case of a child with anterior dislocation of the shoulder associated with a complete displaced proximal humerus metaphyseal fracture. The fracture was managed by closed reduction and then fixation by two centromedullary K-wires using the Metaizeau method, achieving the anatomical reduction of the fracture and dislocation. This method of treatment enables us to achieve excellent radiological and clinical results in a short time.Keywords: glenohumeral, Metaizeau method, pediatric fractures, radial neck
Procedia PDF Downloads 99219 Effect of Psychosocial, Behavioural and Disease Characteristics on Health-Related Quality of Life after Breast Cancer Surgery: A Cross-Sectional Study of a Regional Australian Population
Authors: Lakmali Anthony, Madeline Gillies
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Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.Keywords: breast cancer, surgery, quality of life, regional population
Procedia PDF Downloads 63218 Applications of Artificial Intelligence (AI) in Cardiac imaging
Authors: Angelis P. Barlampas
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The purpose of this study is to inform the reader, about the various applications of artificial intelligence (AI), in cardiac imaging. AI grows fast and its role is crucial in medical specialties, which use large amounts of digital data, that are very difficult or even impossible to be managed by human beings and especially doctors.Artificial intelligence (AI) refers to the ability of computers to mimic human cognitive function, performing tasks such as learning, problem-solving, and autonomous decision making based on digital data. Whereas AI describes the concept of using computers to mimic human cognitive tasks, machine learning (ML) describes the category of algorithms that enable most current applications described as AI. Some of the current applications of AI in cardiac imaging are the follows: Ultrasound: Automated segmentation of cardiac chambers across five common views and consequently quantify chamber volumes/mass, ascertain ejection fraction and determine longitudinal strain through speckle tracking. Determine the severity of mitral regurgitation (accuracy > 99% for every degree of severity). Identify myocardial infarction. Distinguish between Athlete’s heart and hypertrophic cardiomyopathy, as well as restrictive cardiomyopathy and constrictive pericarditis. Predict all-cause mortality. CT Reduce radiation doses. Calculate the calcium score. Diagnose coronary artery disease (CAD). Predict all-cause 5-year mortality. Predict major cardiovascular events in patients with suspected CAD. MRI Segment of cardiac structures and infarct tissue. Calculate cardiac mass and function parameters. Distinguish between patients with myocardial infarction and control subjects. It could potentially reduce costs since it would preclude the need for gadolinium-enhanced CMR. Predict 4-year survival in patients with pulmonary hypertension. Nuclear Imaging Classify normal and abnormal myocardium in CAD. Detect locations with abnormal myocardium. Predict cardiac death. ML was comparable to or better than two experienced readers in predicting the need for revascularization. AI emerge as a helpful tool in cardiac imaging and for the doctors who can not manage the overall increasing demand, in examinations such as ultrasound, computed tomography, MRI, or nuclear imaging studies.Keywords: artificial intelligence, cardiac imaging, ultrasound, MRI, CT, nuclear medicine
Procedia PDF Downloads 72217 Exploration of Classic Models of Precipitation in Iran: A Case Study of Sistan and Baluchestan Province
Authors: Mohammad Borhani, Ahmad Jamshidzaei, Mehdi Koohsari
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The study of climate has captivated human interest throughout history. In response to this fascination, individuals historically organized their daily activities in alignment with prevailing climatic conditions and seasonal variations. Understanding the elements and specific climatic parameters of each region, such as precipitation, which directly impacts human life, is essential because, in recent years, there has been a significant increase in heavy rainfall in various parts of the world attributed to the effects of climate change. Climate prediction models suggest a future scenario characterized by an increase in severe precipitation events and related floods on a global scale. This is a result of human-induced greenhouse gas emissions causing changes in the natural precipitation patterns. The Intergovernmental Panel on Climate Change reported global warming in 2001. The average global temperature has shown an increasing trend since 1861. In the 20th century, this increase has been between (0/2 ± 0/6) °C. The present study focused on examining the trend of monthly, seasonal, and annual precipitation in Sistan and Baluchestan provinces. The study employed data obtained from 13 precipitation measurement stations managed by the Iran Water Resources Management Company, encompassing daily precipitation records spanning the period from 1997 to 2016. The results indicated that the total monthly precipitation at the studied stations in Sistan and Baluchestan province follows a sinusoidal trend. The highest intense precipitation was observed in January, February, and March, while the lowest occurred in September, October, and then November. The investigation of the trend of seasonal precipitation in this province showed that precipitation follows an upward trend in the autumn season, reaching its peak in winter, and then shows a decreasing trend in spring and summer. Also, the examination of average precipitation indicated that the highest yearly precipitation occurred in 1997 and then in 2004, while the lowest annual precipitation took place between 1999 and 2001. The analysis of the annual precipitation trend demonstrates a decrease in precipitation from 1997 to 2016 in Sistan and Baluchestan province.Keywords: climate change, extreme precipitation, greenhouse gas, trend analysis
Procedia PDF Downloads 55216 From Waste Recycling to Waste Prevention by Households : Could Eco-Feedback Strategies Fill the Gap?
Authors: I. Dangeard, S. Meineri, M. Dupré
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large body of research on energy consumption reveals that regular information on energy consumption produces a positive effect on behavior. The present research aims to test this feedback paradigm on waste management. A small-scale experiment on residual household waste was performed in a large french urban area, in partnership with local authorities, as part of the development of larger-scale project. A two-step door-to-door recruitment scheme led to 85 households answering a questionnaire. Among them, 54 accepted to participate in a study on waste (second step). Participants were then randomly assigned to one of the 3 experimental conditions : self-reported feedback on curbside waste, external feedback on waste weight based on information technologies, and no feedback for the control group. An additional control group was added, including households who were not requested to answer the questionnaire. Household residual waste was collected every week, and tags on curbside bins fed a database with waste weight of households. The feedback period lasted 14 weeks (february-may 2014). Quantitative data on waste weight were analysed, including these 14 weeks and the 7 previous weeks. Households were then contacted by phone in order to confirm the quantitative results. Regarding the recruitment questionnaire, results revealed high pro-environmental attitude on the NEP scale, high recycling behavior level and moderate level of source reduction behavior on the adapted 3R scale, but no statistical difference between the 3 experimental groups. Regarding the feedback manipulation paradigm, waste weight reveals important differences between households, but doesn't prove any statistical difference between the experimental conditions. Qualitative phone interviews confirm that recycling is a current practice among participants, whereas source reduction of waste is not, and mainly appears as a producer problem of packaging limitation. We conclude that triggering waste prevention behaviors among recycling households involves long-term feedback and should promote benchmarking, in order to clearly set waste reduction as an objective to be managed through feedback figures.Keywords: eco-feedback, household waste, waste reduction, experimental research
Procedia PDF Downloads 385215 Rural Population Participation in Minsu Industry as the Method for Rural Revitalization in China
Authors: Xiaoxin Zhao
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Because of the long-time dual structure development in urban and rural areas, the rapid urbanization in China devours the rural resources and causes the unbalanced development of cities and the countryside. On one side, the urban sprawl is swallowing the villages in the peripheral area of cities and forms the ‘urban village’. On the other side, people from traditional and vernacular villages immigrate to the metropolis that their homeland becomes the ‘hollowed village’. In 2005, the national state council noticed the significance of rural development and promoted the ‘beautiful countryside’ project when Minsu was rising. In the 19th National Congress of the Communist Party of China (2017), president Xi Jinping announces the importance of ‘rural revitalization’ and states that the relationship between urban and rural areas should be an integrated development model. However, most Minsu projects in China was invested and managed by individual or group investors and focused on the profits but not the vernacular culture and rural development, and enhanced the urban-rural distinction. This paper introduces two Minsu projects in China designed by star-architects and advertised by social network media as case studies through photos and public comments collections. Architects as the servant to the investors, designed fancy houses, brings the urban life mode but expelled the real vernacular lifestyle as a cultural experience in rural areas. Moreover, to advertise the Minsu hotel, the social media propagates a distorted value that ‘luxury is good taste’ and motivates the vanity of people. Lastly, to maximize the profits, the investors set a high price that caused another unbalanced development in rural area since the price for one night in the Minsu hotel may exceed the monthly income of a local inhabitant. With these material, the author discusses the problems in Chinese Minsu industry and argues that the media, architects and investors play the negative role in the separation between Minsu cultural tourism and rural population. As a result, the author points out the significance of rural population participation that sharing the profits with them if we take Minsu industry as a method for rural revitalization in China.Keywords: Minsu, vernacular, rural development, rural population participation
Procedia PDF Downloads 254