Search results for: multiple emergency resources

Authors: Mohammad Amin Hamedirad, Seyed Javad Vaziri Kang Olyaei

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Project planning and control are one of the most critical issues in the management of construction projects. Traditional methods of project planning and control, such as the critical path method or Gantt chart, are not widely used for planning projects with discrete and repetitive activities, and one of the problems of project managers is planning the implementation process and optimal allocation of its resources. Massive concreting projects is also a project with discrete and repetitive activities. This study uses the concept of simulating discrete events to manage resources, which includes finding the optimal number of resources considering various limitations such as limitations of machinery, equipment, human resources and even technical, time and implementation limitations using analysis of resource consumption rate, project completion time and critical points analysis of the implementation process. For this purpose, the concept of discrete-event simulation has been used to model different stages of implementation. After reviewing the various scenarios, the optimal number of allocations for each resource is finally determined to reach the maximum utilization rate and also to reduce the project completion time or reduce its cost according to the existing constraints. The results showed that with the optimal allocation of resources, the project completion time could be reduced by 90%, and the resulting costs can be reduced by up to 49%. Thus, allocating the optimal number of project resources using this method will reduce its time and cost.

Keywords: simulation, massive concreting, discrete event simulation, resource management

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Authors: Chick Loveline Ayoh Epse Ndi

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Our cultural stance has deep implications for the psychological and physical well-being of the old. Cameroon is still rooted on the traditional belief that stipulates that; the aged are best catered for in the family setting where the children and grandchildren are supposed to give in return for services invested on them by the former. This is why up till date, there are no “Rest Homes” or “Convalescent hospitals” despite the rising challenges faced by the aged in this context. Beside the special measure set aside to cater for the aged, such as “Rest Homes” for the healthy, “Convalescent hospitals” are created set to cater for the health of the aged in the Western context with other facilities such as geriatric units. The health care practitioners are aware of aging diseases and have trained human resources like Gerontologists to cater for the aged and aging diseases. Meanwhile, in Africa and Cameroon in particular, such infrastructural and human resources are still to be considered in the health care system. It can be assumed that the aged and aging diseases are still to be considered in the health care system in this context. This is why we talk of therapeutic nihilism, where the aged are mixed up with other categories of patients with no special attention given to them. This qualitative study carried out in the Yaounde, the capital city of Cameroon, with their best referent hospitals, reveal that; the aged and aging diseases are still a myth in this context. Data collected in both private and public health institutions show that there is only one public institution in Cameroon that has a geriatric unit with no specialists. Patients who aretreated in this unit are considered as aged with terminal diseases that need palliative care and not intensive care. Cameroon is still lacking in terms of health care to the aged and ageing diseases. Like other patients, the aged are treated with a lot of laxity and no value. There is an emergency to create special health care units for geriatrics and and train gerontologist. Mentally or physically ill aged faced medical rational with psychodynamic treatment considered as waste of time. The aged are less likely to be regarded salvageable when they enter a hospital in serious conditions due to the lack of specialists and geriatric units for them. The implication of this study is to sensitization the stake holders for an urgent need to extend special care units for the aged and aging diseases in this context.

Keywords: challeng, therapy, agtng, diseases cameroon

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Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

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Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

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Authors: Vishwanath Pethri Kamath, Jayantha Gowda Sarapanahalli, Vishal Mishra, Siddhesh Balwant Bandgar

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Recognition of emotional information is essential in any form of communication. Growing HCI (Human-Computer Interaction) in recent times indicates the importance of understanding of emotions expressed and becomes crucial for improving the system or the interaction itself. In this research work, textual data for emotion recognition is used. The text being the least expressive amongst the multimodal resources poses various challenges such as contextual information and also sequential nature of the language construction. In this research work, the proposal is made for a neural architecture to resolve not less than 8 emotions from textual data sources derived from multiple datasets using google pre-trained word2vec word embeddings and a Multi-head attention-based bidirectional LSTM model with a one-vs-all Multi-Level Classification. The emotions targeted in this research are Anger, Disgust, Fear, Guilt, Joy, Sadness, Shame, and Surprise. Textual data from multiple datasets were used for this research work such as ISEAR, Go Emotions, Affect datasets for creating the emotions’ dataset. Data samples overlap or conflicts were considered with careful preprocessing. Our results show a significant improvement with the modeling architecture and as good as 10 points improvement in recognizing some emotions.

Keywords: text emotion recognition, bidirectional LSTM, multi-head attention, multi-level classification, google word2vec word embeddings

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Authors: O. Yeret

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Visual resources are all around us, especially in today's media-driven world, which gravitates, more and more, towards the visual. As a result, authentic resources, such as television advertisements, become testaments – authentic cultural materials – that reflect the landscape of certain groups and communities during a specific point in time. Engaging language students with popular advertisements can provide a great opportunity for developing cultural awareness, a component that is sometimes overlooked in the foreign language classroom. This paper will showcase practical examples of using Israeli Television Ads in various Modern Hebrew language courses. Several approaches for combining the study of language and culture, through the use of advertisements, will be included; for example, targeted assignments based on students' proficiency levels, such as: asking to recognize vocabulary words and answer basic information questions, as opposed to commenting on the significance of an ad and analyzing its particular cultural elements. The use of visual resources in the language classroom does not only enable students to learn more about the culture of the target language, but also to combine their language skills. Most often, interacting with an ad requires close listening and some reading (through captions or other data). As students analyze the ad, they employ their writing and speaking skills by answering questions in text or audio form. Hence, these interactions are able to elicit complex language use across the four domains: listening, speaking, writing, and reading. This paper will include examples of practical assignments that were developed for several Modern Hebrew language courses, together with the specific advertisements and questions related to them. Conclusions from the process and recent feedback notes received from students regarding the use of visual resources will be mentioned as well.

Keywords: authentic materials, cultural awareness, second language acquisition, visual resources

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Authors: Radha Tomar, Satish K. Jain, Manish Panchal, P. S. Rathore

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In the presented work, inset fed microstrip patch antenna (IFMPA) based two port MIMO Antenna system has been proposed, which is suitable for wireless local area network (WLAN) applications. IFMPA has been designed, optimized for 2.4 GHz and applied for MIMO formation. The optimized parameters of the proposed IFMPA have been used for fabrication of antenna and two port MIMO in a laboratory. Fabrication of the designed MIMO antenna has been done and tested experimentally for performance parameters like Envelope Correlation Coefficient (ECC), Mean Effective Gain (MEG), Directive Gain (DG), Channel Capacity Loss (CCL), Multiplexing Efficiency (ME) etc and results are compared with simulated parameters extracted with simulated S parameters to validate the results. The simulated and experimentally measured plots and numerical values of these MIMO performance parameters resembles very much with each other. This shows the success of MIMO antenna design methodology.

Keywords: multiple-input and multiple-output, wireless local area network, vector network analyzer, envelope correlation coefficient

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Authors: Marvin Eslava

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The over-arching aim of this research is to determine the potential contribution of local food resources to the tourism growth of Nueva Vizcaya. It reviews some of the underpinning concepts and to provide a set of considerations for stakeholders to maximize the opportunity of local food can offer to businesses and the wider community. The basis of the study is to develop a sustainable food tourism model for Nueva Vizcaya. For the purpose of this research, there were 60 total numbers of respondents classified as samples from a six municipality. The respondents of the study were stakeholder consisting of government official, local producers, businessman and Non-government organizations in the selected municipalities of Nueva Vizcaya. Stratified purposive sampling was the appropriate technique that was used to the local government officials and employees, NGOs including the businessmen who are associated with local food resources and local producers. The documentary study, focus group discussion and survey questionnaire was used in order to meet the objectives of the study. Kruskall Wallis test was used to test the variances the ratings of the participants. This was used in the computation of hypothesis. The study concluded that the province of Nueva Vizcaya is blessed for its rich farmlands and fertile mountain soil boasts to produce high quality agricultural products. It is a home of various different indigenous groups creating a wide range of local cuisine. The province has substantial local food development evidence by the various food tourism related resources, increase in facilities and celebrating food tourism related events. The local food resources provide extensive potential economic empowerment and help in building the identity of the province. In addition, the local food resources extensively enhance the agriculture sector and other attractions in the province. Finally, it helps to preserve the authenticity of the food culture and generated pride among all stakeholders extensively. All stakeholders have the same perception on the potential contribution of local food resources to the development of the province of Nueva Vizcaya. The public and private sectors are cognizant on their roles to support the production of local food resources in Nueva Vizcaya. Major challenges and barriers in the development of sustainable food tourism in Nueva Vizcaya include production or supply and marketing.

Keywords: local food resources, contribution, food tourism, benefits

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Authors: Masashi Kanazawa, Takaaki Nakano, Masaaki Takemoto, Tomonori Imamura, Mamiko Sugimura, Toshitaka Ito

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Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks.

Keywords: CT scan, intoxication, pulmonary edema, water-soluble paint

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Authors: David P. Horton, Gary Lynch-Wood

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Western populations are aging, prone to various lifestyle health problems, and increasing their demand for health and social care services. This demand has created enormous fiscal and regulatory challenges. In response, government institutions have deployed strategies of behavior modification to encourage people to exercise greater personal responsibility over their health and care needs (i.e., welfare responsibilisation). Policy strategies are underpinned by the assumption that people if properly supported, will make better health and lifestyle selections. Not only does this absolve governments of the responsibility for meeting all health and care needs, but it also enables government institutions to assert fiscal control over welfare spending. Looking at the regulation of health and social care in the UK, the authors identify and outline a suite of regulatory tools that are designed to extract and manage the resources of health and social care services users and to encourage them to make (‘better’) use of these resources. This is important for our understanding of how health and social care regulation is responding to ongoing social and economic challenges. It is also important because there has been a failure to systematically examine the relevance of resources for regulation, which is surprising given that resources are crucial to how and whether regulation succeeds or fails. In particular, drawing from the regulatory welfare state concept, the authors analyse the key legal and regulatory changes and mechanisms that have been introduced since the 2008 financial crisis, focusing on critical measures such as the Health and Social Care Act and regulations introduced under the National Health Service Act. The authors show how three types of user resources (i.e., tangible, labor, and data) are being used to assert fiscal control and increase welfare responsibilisation. Amongst other things, the paper concludes that service users have become more than rule followers and targets of behavioral modification; rather, they are producers of resources that regulatory systems have come to rely on.

Keywords: health care, regulation, resources, social care

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Authors: Ashagrie Getnet Flattie

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Line-of-sight (LOS) information, data rates, good quality, and flexible network service are limited by the fact that, for the duration of any given connection, they experience severe variation in signal strength due to fading and path loss. Wireless system faces major challenges in achieving wide coverage and capacity without affecting the system performance and to access data everywhere, all the time. In this paper, the cell coverage and edge rate of different Multiple-input multiple-output (MIMO) schemes in 20 MHz Long Term Evolution (LTE) system under Unmanned Air Vehicles (UAV) platform are investigated. After some background on the enormous potential of UAV, MIMO, and LTE in wireless links, the paper highlights the presented system model which attempts to realize the various benefits of MIMO being incorporated into UAV platform. The performances of the three MIMO LTE schemes are compared with the performance of 4x4 MIMO LTE in UAV scheme carried out to evaluate the improvement in cell radius, BER, and data throughput of the system in different morphology. The results show that significant performance gains such as bit error rate (BER), data rate, and coverage can be achieved by using the presented scenario.

Keywords: LTE, MIMO, path loss, UAV

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Authors: M. Sanjarani, A. Danehkar, A. Mashincheyan, A. H. Javid, S. M. R. Fatemi

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The oil spill in marine water has direct impact on coastal resources and community. Environmental Sensitivity Index (ESI) map is the first step to assess the potential impact of an oil spill and minimize the damage of coastal resources. In order to create Environmental Sensitivity Maps for the Chabahar bay (Iran), information has been collected in three different layers (Shoreline Classification, Biological and Human- uses resources) by means of field observations and measurements of beach morphology, personal interviews with professionals of different areas and the collection of bibliographic information. In this paper an attempt made to prepare an ESI map for sensitivity to oil spills of Chabahar bay coast. The Chabahar bay is subjected to high threaten to oil spill because of port, dense mangrove forest,only coral spot in Oman Sea and many industrial activities. Mapping the coastal resources, shoreline and coastal structures was carried out using Satellite images and GIS technology. The coastal features classified into three major categories as: Shoreline Classification, Biological and Human uses resources. The important resources classified into mangrove, Exposed tidal flats, sandy beach, etc. The sensitivity of shore was ranked as low to high (1 = low sensitivity,10 = high sensitivity) based on geomorphology of Chabahar bay coast using NOAA standards (sensitivity to oil, ease of clean up, etc). Eight ESI types were found in the area namely; ESI 1A, 1C, 3A, 6B, 7, 8B,9A and 10D. Therefore, in the study area, 50% were defined as High sensitivity, less than 1% as Medium, and 49% as low sensitivity areas. The ESI maps are useful to the oil spill responders, coastal managers and contingency planners. The overall ESI mapping product can provide a valuable management tool not only for oil spill response but for better integrated coastal zone management.

Keywords: ESI, oil spill, GIS, Chabahar Bay, Iran

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Authors: M. El Mousadik, F. Elkandoussi

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The concern for increased rigor in social management has led more and more Moroccan business leaders to question the value of applying social audit as an essential tool in the management of human resources. Hotel companies are not excluded; in fact, they are expected to implement such an audit to develop sound and credible human resources management (HRM) policies. The main objective of this paper is to establish the relationship between the practice of social audit as a tool, and its impact on the tourism sector, especially on hotels at one of the Morocco’s first and most popular city for tourism, Agadir. This exploratory study of properties in Agadir has revealed that hotel executives are aware of the importance of social auditing to hone their decisions in the field of HRM.

Keywords: social audit, hotel companies, human resources management, social piloting

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Authors: A. Al Hajeri, M. E. Minton, B. Haskins, F. H. Cummins

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The pre-hospital endotracheal intubation is fraught with difficulties; one solution offered has been video laryngoscopy (VL) which permits better visualization of the glottis than the standard method of direct laryngoscopy (DL). This method has resulted in a higher first attempt success rate and fewer failed intubations. However, VL has mainly been evaluated by experienced providers (experienced anesthetists), and as such the utility of this device for those whom infrequently intubate has not been thoroughly assessed. We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct. DL and two VL methods (C-Mac with distal screen/C-Mac with attached screen) were evaluated by simulating practice on a Laerdal airway management trainer manikin. Twenty Emergency Medical Technicians (basics) were recruited as novice practitioners. This group was used to eliminate bias, as these clinicians had no pre-hospital experience of intubation (although they did have basic airway skills). The following areas were assessed: Time taken to intubate, number of attempts required to successfully intubate, ease of use of equipment VL (attached screen) took on average longer for novice clinicians to successfully intubate and had a lower success rate and reported higher rating of difficulty compared to DL. However, VL (with distal screen) and DL were comparable on intubation times, success rate, gastric inflation rate and rating of difficulty by the user. This study highlights the routine use of VL by inexperienced clinicians would be of no added benefit over DL. Further studies are required to determine whether Emergency Medical Technicians (Paramedics) would benefit from this airway adjunct, and ascertain whether after initial mastery of VL (with a distal screen), lower intubation times and difficulty rating may be achievable.

Keywords: direct laryngoscopy, endotracheal intubation, pre-hospital, video laryngoscopy

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Describing clinical cases according to a clinical charting standard that enforces interoperability and enables connected care services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. This article presented a multi-tenant extension to the problem-oriented medical record that we have prototyped previously upon using the GraphQL Application Programming Interface to represent the notion of a problem list. Our implemented extension enables physicians and patients to collaboratively describe the patient case via using multi chatbots to collaboratively describe the patient case using the SOAP charting standard. Our extension also connects the described SOAP patient case with the HL7 FHIR (Health Interoperability Resources) medical record for connecting the patient case to the bench data.

Keywords: problem-oriented medical record, graphQL, chatbots, SOAP

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Authors: Terence Soule, Tami Al Ghamdi

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To study how to transfer knowledge from multiple source problems to the target problem, we modeled the Transfer Learning (TL) process using Genetic Algorithms as the model solver. TL is the process that aims to transfer learned data from one problem to another problem. The TL process aims to help Machine Learning (ML) algorithms find a solution to the problems. The Genetic Algorithms (GA) give researchers access to information that we have about how the old problem is solved. In this paper, we have five different source problems, and we transfer the knowledge to the target problem. We studied different scenarios of the target problem. The results showed combined knowledge from multiple source problems improves the GA performance. Also, the process of combining knowledge from several problems results in promoting diversity of the transferred population.

Keywords: transfer learning, genetic algorithm, evolutionary computation, source and target

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Authors: Bhawat Chiamjinnawat

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The agri-food market transformation has implied market growth for the fruit industry in Thailand. This article focuses on analysis of farmer competence and farm resources which affect market strategies used by fruit farmers in Chanthaburi province of Thailand. The survey data were collected through the use of face-to-face interviews with structured questionnaires. This study identified 14 drivers related to farmer competence and farm resources of which some had significant effect on the decision to use either high-value markets or traditional markets. The results suggest that farmers who used high-value markets were better educated and they had longer experience and larger sized business. Identifying the important factors that match with the market transformation provides policy with opportunities to support the fruit farmers to increase their market power. Policies that promote business expansion of agricultural cooperatives and knowledge sharing among farmers are recommended to reduce limitations due to limited knowledge, low experience, and small business sizes.

Keywords: farmer competence, farm resources, fruit industry, high-value markets, Thailand

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Authors: Lahaina U. Dilangalen

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Using descriptive-experimental research methods, this study aimed to identify the main resources of water, assessed the water quality, sanitation and hygiene practices, and extent of implementation. Complete enumeration was done in 28 elementary public schools of Datu Odin Sinsuat Municipality. Questionnaires were given to the school advisers. Water samples were obtained from the same schools and were submitted to the Department of Science and Technology (DOST) Region XII for microbial analysis, specifically the presence of fecal coliform bacteria. Four water resources such as hand pump, faucet, deep well and spring were found being used in the 28 schools. Of water resources, the only treated was from the faucet. Most of the schools used the water for drinking and washing. Two schools strongly agreed, nine schools agreed and seventeen schools disagreed that they implemented DepEd Order no.56 s. 2009. In addition, two schools strongly agreed and twenty six agreed that they implemented DepEd Order No. 65 s. 2009. Five schools had water supply that were safe to drink while sixteen schools had water supply that were not safe to drink due to high fecal coliform count and did not undergo chemical treatment. The only safe for drinking were water resources that came from faucet because they were chemically treated. Seven out of 28 schools did not have water supply due to their location in mountainous areas. More than half of the schools did not comply with the DepEd Order No. 56 s. 2009 due to the lack of funds and support from the PTA and LGU. It is recommended that the Department of Education must have an urgent assessment of implementing both DepEd Orders No.56 and 65, to assure that the schoolchildren be protected from water and sanitation related ailments. Also, all water resources that are not treated must be used for washing only. Ideally, all the water resources must be treated to assure the safety of all school constituents. Moreover, the school administrators and teachers in the municipality must be provided copies of the results of this study for reference in implementing the said programs.

Keywords: assessment, drinking water, fecal coliform, groundwater

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Authors: Zeinab Papi

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This study was aimed at analyzing the copyright laws of Iran, Australia, the U.S., and library portals, thereby providing a proposed framework for the copyright of library resources for the NLAI and other Iranian libraries while considering the current situation and the internal Iranian laws. This is an applied study falling in the category of qualitative approach research. Documentary analysis method and comparative method were used to resolve the problem and answer the questions of the research. The two National Library of Australia (NLA) and Library of Congress (LC), together with the NLAI formed the research community. In addition, the Iranian Law for the Protection of Authors, Composers and Artists Rights (1970); the Australian Copyright Act (1968), and the U.S. Copyright Law (1976) were purposefully selected as three main resources among other documents and resources. Findings revealed that the dimensions of fair and non-profit use, duration of copyright, license, and agreement, copyright policy, moral rights, economic rights, and infringement of copyright were the main dimensions that, along with 49 main components, formed the proposed framework for the copyright of information resources for the NLAI and other Iranian libraries. It should be acknowledged that there are some differences in different copyright fields between countries' laws, and each country takes into account its internal conditions to compile and revise the laws. By following the laws of other countries, it is possible to effectively improve and develop copyright laws. The researcher hopes that this research can have its effects in creating awareness and ability among librarians, formulating a copyright policy in Iranian libraries, and helping legislators in revising copyright laws regarding library exceptions and exemptions.

Keywords: copyright, library resources, National Library and Archives of the I.R. of Iran, National Library of Australia, Library of Congress, copyright law

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis

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Authors: Olivier Mulisya, Guelord Barasima, Henry Mark Lugobe, Philémon Matumo, Bienfait Mumbere Vahwere, Hilaire Mutuka, Zawadi Léocadie, Wesley Lumika

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Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in most poor-resource settings because of poor antenatal coverage, low socioeconomic status in most of the patients as well as lack of adequate medical resources. Clinical diagnosis can be very difficult and an ultrasound scan is very helpful during the early stages of gestation but can also be disappointing in the later stages. We report a case of a 25-year-old woman with severe abdominal pain not amended with any medication. A clinical picture of shock lead to an emergency laparotomy which confirmed the diagnosis of abdominal pregnancy. The ministry of health in developing countries should make an effort to make routine early ultrasounds accessible to pregnant women, and obstetricians should keep in mind the possibility of ectopic pregnancy, irrespective of the gestational age.

Keywords: abdominal pregnancy, live new bron, ultrasound imaging, abdominal pain

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Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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Authors: Ivana R. Moser, Joao C. Souza

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Building fires are random phenomena that can be extremely violent, and safe evacuation of people is the most guaranteed tactic in saving lives. The correct evacuation of buildings, and other spaces occupied by people, means leaving the place in a short time and by the appropriate way. It depends on the perception of spaces by the individual, the architectural layout and the presence of appropriate routing systems. As historical buildings were constructed in other times, when, as in general, the current security requirements were not available yet, it is necessary to adapt these spaces to make them safe. Computer models of evacuation simulation are widely used tools for assessing the safety of people in a building or agglomeration sites and these are associated with the analysis of human behaviour, makes the results of emergency evacuation more correct and conclusive. The objective of this research is the performance evaluation of historical interest buildings, regarding the safe evacuation of people, through computer simulation, using PTV Viswalk software. The buildings objects of study are the Colégio Catarinense, centennial building, located in the city of Florianópolis, Santa Catarina / Brazil. The software used uses the variables of human behaviour, such as: avoid collision with other pedestrians and avoid obstacles. Scenarios were run on the three-dimensional models and the contribution to safety in risk situations was verified as an alternative measure, especially in the impossibility of applying those measures foreseen by the current fire safety codes in Brazil. The simulations verified the evacuation time in situations of normality and emergency situations, as well as indicate the bottlenecks and critical points of the studied buildings, to seek solutions to prevent and correct these undesirable events. It is understood that adopting an advanced computational performance-based approach promotes greater knowledge of the building and how people behave in these specific environments, in emergency situations.

Keywords: computer simulation, escape routes, fire safety, historic buildings, human behavior

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Authors: Saqib Ali

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Sources are classified into two depending upon the factor of reviving. These sources, which cannot be revived into their original shape once they are consumed, are considered as nonrenewable energy resources, i.e., (coal, fuel) Moreover, those energy resources which are revivable to the original condition even after being consumed are known as renewable energy resources, i.e., (wind, solar, hydel) Renewable energy is a cost-effective way to generate clean and green electrical energy Now a day’s majority of the countries are paying heed to energy generation from RES Pakistan is mostly relying on conventional energy resources which are mostly nonrenewable in nature coal, fuel is one of the major resources, and with the advent of time their prices are increasing on the other hand RES have great potential in the country with the deployment of RES greater reliability and an effective power system can be obtained In this thesis, a similar concept is being used and a hybrid power system is proposed which is composed of intermixing of renewable and nonrenewable sources The Source side is composed of solar, wind, fuel cells which will be used in an optimal manner to serve load The goal is to provide an economical, reliable, uninterruptable power supply. This is achieved by optimal controller (PI, PD, PID, FOPID) Optimization techniques are applied to the controllers to achieve the desired results. Advanced algorithms (Particle swarm optimization, Flower Pollination Algorithm) will be used to extract the desired output from the controller Detailed comparison in the form of tables and results will be provided, which will highlight the efficiency of the proposed system.

Keywords: distributed generation, demand-side management, hybrid power system, micro grid, renewable energy resources, supply-side management

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Authors: Noa Nelson, Meitar Moshe, Dana Cohen

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Work-family conflict (WFC) is a significant source of stress for contemporary employees, with research indicating its heightened severity for women. The conservation of resources theory argues that individuals experience stress when their resources fall short of demands, and attempt to reach balance by obtaining resources. Presumably then, to achieve work-family balance women would need to negotiate for resources such as spouse support, employer support and work flexibility. The current research tested the hypotheses that competent negotiation at home and at work associated with increased family and job resources and with decreased WFC, as well as with higher work, marital and life satisfaction. In the first study, 113 employed mothers, married or cohabiting, reported to what extent they conducted satisfactory negotiation with spouse over division of housework, and their actual housework load compared to spouse. They answered a WFC questionnaire, measuring how much work interferes with family (WIF) and how much family interferes with work (FIW), and finally, measurements of satisfaction. In the second study, 94 employed mothers, married or cohabiting reported to what extent they conducted satisfactory negotiation with their boss over balancing work demands with family needs. They reported the levels of three job resources: flexibility, control and family-friendly organizational culture. Finally, they answered the same WFC and satisfaction measurements from study 1. Statistical analyses –t-tests, correlations, and hierarchical linear regressions- showed that in both studies, women reported higher WIF than FIW. Negotiations associated with increased resources: support from spouse, work flexibility and control and a family-friendly culture; negotiation with spouse associated also with satisfaction measurements. However, negotiations or resources (except family-friendly culture) did not associate with reduced conflict. The studies demonstrate the role of negotiation in obtaining family and job resources. Causation cannot be determined, but the fact is that employed mothers who enjoyed more support (at both home and work), flexibility and control, were more likely to keep active interactions to increase them. This finding has theoretical and practical implications, especially in view of research on female avoidance of negotiation. It is intriguing that negotiations and resources generally did not associate with reduced WFC. This finding might reflect the severity of the conflict, especially of work interfering with family, which characterizes many contemporary jobs. It might also suggest that employed mothers have high expectations from themselves, and even under supportive circumstances, experience the challenge of balancing two significant and demanding roles. The research contributes to the fields of negotiation, gender, and work-life balance. It calls for further studies, to test its model in additional populations and validate the role employees have in actively negotiating for the balance that they need. It also calls for further research to understand the contributions of job and family resources to reducing work-family conflict, and the circumstances under which they contribute.

Keywords: sork-family conflict, work-life balance, negotiation, gender, job resources, family resources

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Authors: Aliaksei Patsekha, Michael Hohenberger, Harald Raupenstrauch

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An effective emergency response to accidents with chemical, biological, radiological, nuclear, or explosive materials (CBRNE) that represent highly dynamic situations needs immediate actions within limited time, information and resources. The aim of the study is to provide the foundation for division of unsafe area into risk zones according to the impact of hazardous parameters (heat radiation, thermal dose, overpressure, chemical concentrations). A decision on the boundary values for three risk zones is based on the vulnerability analysis that covered a variety of accident scenarios containing the release of a toxic or flammable substance which either evaporates, ignites and/or explodes. Critical values are selected for the boundary definition of the Red, Orange and Yellow risk zones upon the examination of harmful effects that are likely to cause injuries of varying severity to people and different levels of damage to structures. The obtained results provide the basis for creating a comprehensive real-time risk map for a decision support at CBRNE operations.

Keywords: boundary values, CBRNE threats, decision making process, hazardous effects, vulnerability analysis, risk zones

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Authors: Amin Alvani

Abstract:

Multiple sclerosis (MS) is a chronic, often disabling disease in which the immune system attacks the myelin sheath of neurons in the central nervous system. The present study aimed to investigate the Relationship between behavioral inhibition/approach system (BIS-BAS) and perceived stress (PS) whit control white blood cell (WBC). 60 MS patients (male=36.7, female=63.3%; age range=15-65 participated in the study and completed the demographic questionnaire, the count blood cell (CBC) test, the behavioral Activation and behavioral inhibition scale (BIS-BAS), and the perceived stress Questionnaire (PSS-14). The results revealed that Between of BAS-reward responsiveness (BAS-DR) subscale and PS, in more than MS patient (BIS), there are increase WBC.

Keywords: behavioral inhibition/approach system, perceived stress, white blood cell, multiple sclerosis

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Authors: Chao-xun Liu, Shi-hong Lu

Abstract:

In spite of its importance to the aerospace and automobile industries, little or no attention has been devoted to the accurate modeling of the ultrasonic shot peening (USP) process. It is therefore the purpose of this study to conduct finite element analysis of the process using a realistic multiple pin impacts model with the explicit solver of ABAQUS. In this paper, we research the effect of several key parameters on the residual stress distribution within the target, including impact velocity, incident angle, friction coefficient between pins and target and impact number of times were investigated. The results reveal that the impact velocity and impact number of times have obvious effect and impacting vertically could produce the most perfect residual stress distribution. Then we compare the results with the date in USP experiment and verify the exactness of the model. The analysis of the multiple pin impacts date reveal the relationships between peening process parameters and peening quality, which are useful for identifying the parameters which need to be controlled and regulated in order to produce a more beneficial compressive residual stress distribution within the target.

Keywords: ultrasonic shot peening, finite element, multiple pins, residual stress, numerical simulation

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Authors: Alldila Hendy, Agi Satria

Abstract:

Background: A colostomy procedure is an important part in the management of surgical procedures in some diseases involving the gastrointestinal tract. So it is necessary to find the factors that influence the occurrence of complications. Methods: This is a retrospective cross-sectional analytic study in Cipto Mangunkusumo Hospital noting medical records of patients after the colostomy from January 2012 to December 2014 at the Division of Digestive Surgery. Results: In 136 cases of post-colostomy, 66 cases have complications, 14 is early-onset, and 52 is late-onset. 70 is without complications. Most complications are dermatitis, which is 31 (22.8%), cases of infection/abscess/fistula and intestinal obstruction are 13 (9.6%) and 5 patients (4.4%). A rare complication is colostomy retraction by 2 patients (1.5%), colostomy prolapse and necrosis/gangrene, which is only 3 patients (2.2%). A colostomy procedure in emergency surgery is riskier than elective surgery for complications after colostomy (p < 0.007, OR 2.85), Based on the operator who performs a colostomy procedure, the consultant had a lower risk of complications than fellow or resident (p < 0.0001). Based on the age factor, where the age of about 50 years has a risk of complications after colostomy (p < 0.018). Conclusion: The timing of operation (emergency or elective), age, and operator who perform a colostomy procedure have a significant relationship with an increased prevalence of complications after colostomy in RSCM.

Keywords: colostomy, complications, factors, procedure

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Authors: Jerome Dalphinis, Vishal Patel

Abstract:

The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

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Authors: Mihaela Munteanu Pila

Abstract:

Abstract The Republic of Moldova has a high potential for commercial growth of fish, due to its rich natural resources. Every year, national actions are implemented for the development and improvement of wetlands through acclimatization of hydrobionts, cleaning of adjacent waste areas and repopulation with valuable fish species. Due to aggressive environmental factors, anthropogenic factors, poaching or insufficient financial resources allocated to the authorities, there is a strong degradation of aquatic resources in the area. The main issue of the study is to identify priority areas for the development of fish farming in the area and maintain potential reserves to increase the efficiency of fish production in the pond. The rational operation of pond-type reservoirs will make it possible to maintain the breeding base of many fish species and will in future become a valuable source of local marketable products, in order to increase the productivity of fish in ponds and exploit the region's resources. The research looked at the problems that led to a decline in local fish production and identified a number of long-term measures needed to develop aquaculture.

Keywords: Development, , Republic of Moldova, , fisheries, , productivity

Procedia PDF Downloads 105