Search results for: pile head department

Authors: Priyanka Kalra

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Background: Complementary and alternative medicine (CAM) includes various practices like Ayurveda, Yoga & Meditation Acupressure Acupuncture and Reiki. These practices are frequently used by patients with spinal cord injury (SCI). They have shown effectiveness in the management of pain and stress consequently improving overall quality of life post injury. Objective: The goals of the present case series were to evaluate the feasibility of 1) Using of Ayurvedic herbal oil massages in shoulder pain management, 2) Using yoga & meditation on managing the stress in spinal cord injury. Methodology: 15 SCI cases with muscular pain around shoulder were treated with Ayurvedic herbal oil massage for 10 days in CAM Department. Each session consisted of 30 min oil massage followed by 10 min hot towel fomentation. The patients continued regular therapy medications along with CAM. Another 15 SCI cases were treated with yoga and meditation for 15 days 30 min yoga (20 min Asana+ 10 min Pranayam + 15 min Meditation) in isolated yoga room of CAM department. Results: On the VAS scale the patients reported a reduction in their pain score by 70 %. On the PSS scale, the patients reported a reduction in their stress score by 80 %. Conclusion: These case series may encourage more people to explore CAM therapies.

Keywords: spinal cord injury, Ayurveda, complementary and alternative medicine, yoga, meditation

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Authors: Abebaw Assaye, Seiichi Sakurai, Marutama Atsush, Dawit Alemu

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Rice is considered as a strategic agricultural commodity targeting national food security and import substitution in Ethiopia and diverse measures are put in place a number of initiatives to ensure the growth and development of rice sector in the country. This study assessed factors that influence smallholder farmers' level of rice commercialization in Ethiopia. The required data were generated from 594 randomly sampled rice producers using multi-stage sampling techniques from four major rice-producing regional states. Both descriptive and econometric methods were used to analyze the data. We adopted the ordered probit model to analyze factors determining output commercialization in the rice market. The ordered probit model result showed that the sex of the household head, educational status of the household head, credit use, proportion of irrigated land cultivated, membership in social groups, and land dedicated to rice production were found to influence significantly and positively the probability of being commercial-oriented. Conversely, the age of the household, total cultivated land, and distance to the main market were found to influence negatively. These findings suggest that promoting productivity-increasing technologies, development of irrigation facilities, strengthening of social institutions, and facilitating access to credit are crucial for enhancing the commercialization of rice in the study area. Since agricultural lands are limited, intensified farming through promoting improved rice technologies and mechanized farming could be an option to enhance marketable surplus and increase level of rice market particicpation.

Keywords: rice, commercialization, Tobit, ordered probit, Ethiopia

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Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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Authors: Mohamed Elshal, Hazim El-Mounayri, Omar El-Mounayri

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Emergency department (ED) is considered as a complex system of interacting entities: patients, human resources, software and hardware systems, interfaces, and other systems. This paper represents a research for implementing a detailed Systems Engineering (SE) approach in a mid-size hospital in central Indiana. This methodology will be applied by “The Initiative for Product Lifecycle Innovation (IPLI)” institution at Indiana University to study and solve the crowding problem with the aim of increasing throughput of patients and enhance their treatment experience; therefore, the nature of crowding problem needs to be investigated with all other problems that leads to it. The presented SE methods are workflow analysis and systems modeling where SE tools such as Microsoft Visio are used to construct a group of system-level diagrams that demonstrate: patient’s workflow, documentation and communication flow, data systems, human resources workflow and requirements, leadership involved, and integration between ER different systems. Finally, the ultimate goal will be managing the process through implementation of an executable model using commercialized software tools, which will identify bottlenecks, improve documentation flow, and help make the process faster.

Keywords: systems modeling, ED operation, workflow modeling, systems analysis

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Authors: Mohanad Talal Alfach

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This paper concerns the seismic behaviour of soil-piles-bridge reinforced by additional micropiles. The analysis carried out by three-dimensional finite element modelling using the FE software ABAQUS. The soil behaviour is assumed to be elastic with Rayleigh damping, while the micropiles are modeled as 3D elastic beam elements. The bridge deck slab was represented by a concentrated mass at the top of the pier column. The interaction between the added micropiles and the existing piles as well as the performance of the retrofitted soil-pile-superstructure system were investigated for different configurations of additional micropiles (number, position, inclination). Numerical simulation results show that additional micropiles constitute an efficient retrofitting solution. Analysis of results also shows that spacing between existing piles and retrofitting micropiles has little effect; while it is observed a substantial improvement (in case of weak piles/micropiles - soil interface) with reducing the inclination angle of retrofitting micropiles.

Keywords: retrofitting, seismic, finite element, micropiles, elastic

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Authors: Ł. Morawiński, C. Jasiński, M. Jurkiewicz, S. Bou Habib, M. Bondyra

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With the development of optics, electronics, and computers, vision systems are increasingly used in various areas of life, science, and industry. Vision systems have a huge number of applications. They can be used in quality control, object detection, data reading, e.g., QR-code, etc. A large part of them is used for measurement purposes. Some of them make it possible to obtain a 3D reconstruction of the tested objects or measurement areas. 3D reconstruction algorithms are mostly based on creating depth maps from data that can be acquired from active or passive methods. Due to the specific appliance in airfield technology, only passive methods are applicable because of other existing systems working on the site, which can be blinded on most spectral levels. Furthermore, reconstruction is required to work long distances ranging from hundreds of meters to tens of kilometers with low loss of accuracy even with harsh conditions such as fog, rain, or snow. In response to those requirements, HRESS (Heliport REmote Safeguard System) was developed; which main part is a rotational head with a two-camera stereovision rig gathering images around the head in 360 degrees along with stereovision 3D reconstruction and point cloud combination. The sub-pixel analysis introduced in the HRESS system makes it possible to obtain an increased distance measurement resolution and accuracy of about 3% for distances over one kilometer. Ultimately, this leads to more accurate and reliable measurement data in the form of a point cloud. Moreover, the program algorithm introduces operations enabling the filtering of erroneously collected data in the point cloud. All activities from the programming, mechanical and optical side are aimed at obtaining the most accurate 3D reconstruction of the environment in the measurement area.

Keywords: airfield monitoring, artificial intelligence, stereovision, 3D reconstruction

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Authors: Reza Ziaie Moayed, Javad Shamsi Soosahab

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Helical piles are being used extensively in engineering applications all over the world. There are insufficient studies on the helical piles' behavior in anisotropic soils. In this paper, numerical modeling was adopted to investigate the effect of elastic modulus anisotropy on helical pile behavior resting on anisotropic sand by using a finite element limit analysis. The load-displacement behavior of helical piles under compression and tension loads is investigated in different relative densities of soils, and the effect of the ratio of horizontal elastic modulus with respect to vertical elastic modulus (EH/EV) is evaluated. The obtained results illustrate that in sandy soils, the anisotropic ratio of elastic modulus (EH/EV) has notable effect on bearing capacity of helical piles in different relative density. Therefore, it may be recommended that the effect of anisotropic condition of soil elastic modulus should be considered in helical piles behavior.

Keywords: helical piles, bearing capacity, numerical modeling, soil anisotropy

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Authors: Hasan Frookh Jamal

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This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

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Authors: Utkan Mutman, Omer Ayhan

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In highway work in a field that is selected in Kocaeli/TURKEY district to the ground improvement and piling is done. In this study, the degree of improvement was observed on the ground after the columns made of stone and bored piles in the field and compared. In this context, improving the ground before and after analysis and solution analysis made with values obtained by the finite element method, which was made Plaxis program. On the improved ground, in order to control of manufactured bored piles, continuity of bored piles and pile load tests were carried out. In addition, the test of load capacity specified in the project is made of stone columns. Test results of the soil improvement were observed to be successful, the results obtained in the field and the results obtained from Plaxis program were compared.

Keywords: bored piling, stone columns, plaxis, soil improvement

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Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

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Authors: Mahmoud Hassanin, Amita Gupta

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Background: During current practice, Thiopentone is not cost-effectively added to resources wastage, risk of drug error with antibiotics, short shelf life, infection risk, and risk of delay while preparing during category one cesarean section. There is no significant difference or preference to the other alternative as per current use. Aims and Objectives: Patient safety, Cost-effective use of trust resources, problem awareness, Consider improvising on the current practice. Methods: In conjunction with the local department survey results, many studies support the change. Results: More than 50%(15 from 29) are already using Propofol, more than 75% of the participant are willing to shift to Propofol if it becomes standard, and the cost analysis also revealed that Thiopentone 10 X500=£60 Propofol 10X200= £5.20, Cost of Thiopentone/year =£2190. Approximately GA in a year =35-40 could cost approximately £20 Propofol, given it is a well-established practice. We could save not only money, but it will be environmentally friendly also to avoid adding any carbon footprints. Recommendation: Thiopentone is rarely used as an induction agent for the category one Caesarean section in our obstetric emergency theatres. Most obstetric anesthetists are using Propofol. Keep both Propofol and thiopentone(powder not withdrawn) in the cat one cesarean section emergency drugs tray ready until the department completely changes the practice protocol. A further retrospective study is required to compare the outcomes for these induction agents through the local database.

Keywords: thiopentone, propofol, category 1 caesarean, induction agents

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Authors: Geetha Jayapathy, Lakshmi Muthukrishnan, Manoj Kumar Reddy Pulim , Radhika Raman

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Introduction: Ketones are the end products of fatty acid metabolism and a source of energy for vital organs such as the brain, heart and skeletal muscles. Ketones are produced in excess when glucose is not available as a source of energy or it cannot be utilized as in diabetic ketoacidosis. Children admitted in the emergency department often have starvation ketosis which is not clinically manifested. Decision on admission of children to the emergency room with subtle signs can be difficult at times. Point of care blood ketone testing can be done at the bedside even in a primary level care setting to supplement and guide us in our management decisions. Hence this study was done to explore the utility of this simple bedside parameter as a supplement in assessing pediatric patients presenting to the emergency department. Objectives: To estimate blood ketones of children admitted in the emergency department. To analyze the significance of blood ketones in various disease conditions. Methods: Blood ketones using point of care testing instrument (ABOTTprecision Xceed Pro meters) was done in patients getting admitted in emergency room and in out-patients (through sample collection centre). Study population: Children aged 1 month to 18 years were included in the study. 250 cases (In-patients) and 250 controls (out-patients) were collected. Study design: Prospective observational study. Data on details of illness and physiological status were documented. Blood ketones were compared between the two groups and all in patients were categorized into various system groups and analysed. Results: Mean blood ketones were high in in-patients ranging from 0 to 7.2, with a mean of 1.28 compared to out-patients ranging from 0 to 1.9 with a mean of 0.35. This difference was statistically significant with a p value < 0.001. In-patients with shock (mean of 4.15) and diarrheal dehydration (mean of 1.85) had a significantly higher blood ketone values compared to patients with other system involvement. Conclusion: Blood ketones were significantly high (above the normal range) in pediatric patients who are sick requiring admission. Patients with various forms of shock had very high blood ketone values as found in diabetic ketoacidosis. Ketone values in diarrheal dehydration were moderately high correlating to the degree of dehydration.

Keywords: admission, blood ketones, paediatric emergencies, point of care testing

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Authors: Jun Yang, Norbert Schulz, Claude Canizares

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Knowing the dust content in the interstellar matter is necessary to understand the composition and evolution of the interstellar medium (ISM). The metal composition of the ISM enables us to study the cooling and heating processes that dominate the star formation rates in our Galaxy. The Chandra High Energy Transmission Grating (HETG) Spectrometer provides a unique opportunity to measure element dust compositions through X-ray edge absorption structure. We measure gas to dust optical depth ratios towards 9 bright Low-Mass X-ray Binaries (LMXBs) in the Galactic Bulge with the highest precision so far. Well calibrated and pile-up free optical depths are measured with the HETG spectrometer with respect to broadband hydrogen equivalent absorption in bright LMXBs: 4U 1636-53, Ser X-1, GX 3+1, 4U 1728-34, 4U 1705-44, GX 340+0, GX 13+1, GX 5-1, and GX 349+2. From the optical depths results, we deduce gas to dust ratios for various silicates in the ISM and present our results for the Si K edge in different lines of sight towards the Galactic Bulge.

Keywords: low-mass X-ray binaries, interstellar medium, gas to dust ratio, spectrometer

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Authors: Marie Louis

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Even though many stakeholders are doing their very best to promote public transportation around the world, many areas are still public transportation non-accessible. With travelers purchasing and driving their private vehicles can be considered as a threat to all three aspects of the sustainability (e.g., economical, social, environmental). However, most studies that considered simultaneously all three aspects of the sustainability concept when planning and designing public transportation for a corridor have found tradeoffs among the said three aspects.One of the tradeoffs was identified by looking at tipping points of the travel demands to question whether transit agencies/and or transportation policymakers should either operate smaller buses or provide incentives to purchase Leadership in Energy and Environmental Design (LEED)-Qualified low-emission vehicles or greener vehicles (e.g., hybrid). However, how and when do the department of environmental protection (DEP) and the department of revenue (DOR) figure out how much incentives to give to each traveler who lives in a zoning that is considered as public transportation inaccessible or accessible? To answer this policy question, this study aims to compare the greenhouse gases (GHGs) emissions when hybrid and conventional cars are used to access public transportation stops/stations. Additionally, this study also intends to review previous states that have already adopted low-emissions vehicle (LEVs) or Zero-Emissions Vehicles (ZEVs) to diminish the daily GHGs pollutants.

Keywords: LEED-qualified vehicles, public transit accessibility, hybrid vehicles incentives, sustainability trade-offs

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Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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Authors: Nyathi Mpumelelo; Moeng Thabiso Maria

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BACKGROUND AND OBJECTIVES: Radiopharmaceuticals are used for diagnosis, treatment, staging and follow up of various diseases. However, there is concern that the ionizing radiation (gamma rays, α and ß particles) emitted by radiopharmaceuticals may result in exposure of radiographers and nurses with limited knowledge of the principles of radiation protection and safety, raising the risk of cancer induction. This study aimed at investigation radiation safety awareness levels among radiographers and nurses at a small tertiary hospital in South Africa. METHODS: An analytical cross-sectional study. A validated two-part questionnaire was implemented to consenting radiographers and nurses working in a Nuclear Medicine Department. Part 1 gathered demographic information (age, gender, work experience, attendance to/or passing ionizing radiation protection courses). Part 2 covered questions related to knowledge and awareness of radiation protection principles. RESULTS: Six radiographers and five nurses participated (27% males and 73% females). The mean age was 45 years (age range 20-60 years). The study revealed that neither professional development courses nor radiation protection courses are offered at the Nuclear Medicine Department understudy. However, 6/6 (100%) radiographers exhibited a high level of awareness of radiation safety principles on handling and working with radiopharmaceuticals which correlated to their years of experience. As for nurses, 4/5 (80%) showed limited knowledge and awareness of radiation protection principles irrespective of the number of years in the profession. CONCLUSION: Despite their major role of caring for patients undergoing diagnostic and therapeutic treatments, the nurses showed limited knowledge of ionizing radiation and associated side effects. This was not surprising since they never received any formal basic radiation safety course. These findings were not unique to this Centre. A study conducted in a Kuwaiti Radiology Department also established that the vast majority of nurses did not understand the risks of working with ionizing radiation. Similarly, nurses in an Australian hospital exhibited knowledge limitations. However, nursing managers did provide the necessary radiation safety training when requested. In Guatemala and Saudi Arabia, where there was shortage of professional radiographers, nurses underwent radiography training, a course that equipped them with basic radiation safety principles. The radiographers in the Centre understudy unlike others in various parts of the world demonstrated substantial knowledge and awareness on radiation protection. Radiations safety courses attended when an opportunity arose played a critical role in their awareness. The knowledge and awareness levels of these radiographers were comparable to their counterparts in Sudan. However, it was much more above that of their counterparts in Jordan, Nigeria, Nepal and Iran who were found to have limited awareness and inadequate knowledge on radiation dose. Formal radiation safety and awareness courses and workshops can play a crucial role in raising the awareness of nurses and radiographers on radiation safety for their personal benefit and that of their patients.

Keywords: radiation safety, radiation awareness, training, nuclear medicine

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Authors: Petr Daniel Kovarik, Matt Kennedy, James Adams, Ajay Wilson, Andy Burns, Charles Kelly, Malcolm Jackson, Rahul Patil, Shahid Iqbal

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Introduction: Osteoradionecrosis (ORN) is a recognised toxicity of radiotherapy (RT) for head and neck cancer (HNC). Existing literature lacks any generally accepted definition and staging system for this toxicity. Objective: The objective is to analyse the outcome of the surgical and nonsurgical treatments of ORN. Material and Method: Data on 2303 patients treated for HNC with radical or adjuvant RT or RT-chemotherapy from January 2010 - December 2021 were retrospectively analysed. Median follow-up to the whole group of patients was 37 months (range 0–148 months). Results: ORN developed in 185 patients (8.1%). The location of ORN was as follows; mandible=170, maxilla=10, and extra oral cavity=5. Multiple ORNs developed in 7 patients. 5 patients with extra oral cavity ORN were excluded from treatment analysis as the management is different. In 180 patients with oral cavity ORN, median follow-up was 59 months (range 5–148 months). ORN healed in 106 patients, treatment failed in 74 patients (improving=10, stable=43, and deteriorating=21). Median healing time was 14 months (range 3-86 months). Notani staging is available in 158 patients with jaw ORN with no previous surgery to the mandible (Notani class I=56, Notani class II=27, and Notani class III=76). 28 ORN (mandible=27, maxilla=1; Notani class I=23, Notani II=3, Notani III=1) healed spontaneously with a median healing time 7 months (range 3–46 months). In 20 patients, ORN developed after dental extraction, in 1 patient in the neomandible after radical surgery as a part of the primary treatment. In 7 patients, ORN developed and spontaneously healed in irradiated bone with no previous surgical/dental intervention. Radical resection of the ORN (segmentectomy, hemi-mandibulectomy with fibula flap) was performed in 43 patients (all mandible; Notani II=1, Notani III=39, Notani class was not established in 3 patients as ORN developed in the neomandible). 27 patients healed (63%); 15 patients failed (improving=2, stable=5, deteriorating=8). The median time from resection to healing was 6 months (range 2–30 months). 109 patients (mandible=100, maxilla=9; Notani I=3, Notani II=23, Notani III=35, Notani class was not established in 9 patients as ORN developed in the maxilla/neomandible) were treated conservatively using a combination of debridement, antibiotics and Pentoclo. 50 patients healed (46%) with a median healing time 14 months (range 3–70 months), 59 patients are recorded with persistent ORN (improving=8, stable=38, deteriorating=13). Out of 109 patients treated conservatively, 13 patients were treated with Pentoclo only (all mandible; Notani I=6, Notani II=3, Notani III=3, 1 patient with neomandible). In total, 8 patients healed (61.5%), treatment failed in 5 patients (stable=4, deteriorating=1). Median healing time was 14 months (range 4–24 months). Extra orally (n=5), 3 cases of ORN were in the auditory canal and 2 in mastoid. ORN healed in one patient (auditory canal after 32 months. Treatment failed in 4 patients (improving=3, stable=1). Conclusion: The outcome of the treatment of ORN remains in general, poor. Every effort should therefore be made to minimise the risk of development of this devastating toxicity.

Keywords: head and neck cancer, radiotherapy, osteoradionecrosis, treatment outcome

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Authors: Umm E. Aimen Minhas, Sameen Tahira, Haneen Kamran, Syed Saad Ul Hassan, Haris Bin Khalid, Hadia Nadeem, Ahmed Sanan

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In coronary artery bypass grafting (CABG) patients, vasodilators play a key role in optimizing graft patency by preventing vasospasm and enhancing blood flow. Limited literature is available comparing the effectiveness of various vasodilators on IMA flow in CABG patients. Thus, the rationale for conducting this Network-meta-analysis is to identify the most efficacious vasodilator for increasing IMA flow in CABG patients. A systematic search of 3 databases yielded 357 studies, with 19 meeting inclusion criteria (18 RCTs, 1 observational study). The primary outcome was IMA flow, with secondary outcomes including central venous pressure (CVP) and mean arterial pressure (MAP). Analyses were conducted on an intention-to-treat basis using the net meta package in R. A frequentist random-effects model was employed, with consistency assessed via node-splitting and heterogeneity evaluated. The risk of bias was assessed using RoB 2 and ROBINS-I tools. Out of 92 possible pairwise comparisons, 11 were direct, and 3 included both direct and indirect evidence. Network ranking identified milrinone as the most effective vasodilator for improving IMA flow (SMD: 1.12; 95% CI: 0.36–1.87), followed by nitroglycerin (SMD: 0.51; 95% CI: 0.01–1.00). On the contrary, CO₂ insufflation significantly reduced IMA flow (SMD: -1.17; 95% CI: -2.28 to -0.06). Dobutamine significantly increased CVP, favoring placebo, with no notable differences in MAP across interventions. This analysis positions milrinone as a potentially superior agent for enhancing IMA flow in CABG, warranting its consideration as a first-line therapy. However, moderate to high heterogeneity and limited direct evidence highlight the need for more head-to-head trials.

Keywords: IMA flow, vasodilators, CABG, milrinone, cardiac outcomes

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Authors: Víctor Cecilio, Roberto Gómez, J. Alberto Escobar, Héctor Guerrero

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The study of the structural behavior of a support/pier of an elevated viaduct in Mexico City is presented. Detection of foundation piles with uncertain integrity prompted the review of possible situations that could jeopardy the structural safety of the pier. The objective of this paper is to evaluate the structural conditions of the support, taking into account the type of anomaly reported and the depth at which it is located, the position of the pile with uncertain integrity in the foundation system, the stratigraphy of the surrounding soil and the geometry and structural characteristics of the pier. To carry out the above, dynamic analysis, spectral modal, and step-by-step, with elastic and inelastic material models, were performed. Results were evaluated in accordance with the standards used for the design of the original structural project and with the Construction Regulations for Mexico’s Federal District (RCDF-2017, 2017). Comments on the response of the analyzed models are issued, and the conclusions are presented from a structural point of view.

Keywords: dynamic analysis, inelastic models, dubious foundation, bridge pier

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Authors: Xianlu Zeng

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China has undergone rapid economic growth over the last three decades. During this time, China-focused study has become one of the most popular areas of research. However, even though China has one of the oldest legal traditions in the world, there is limited research available regarding the development and operation of China’s juvenile justice system. This article will provide general information about China’s juvenile justice tradition along with a review of its reformation in 2013. A discussion is presented that provides some thoughts about how successful these reforms have been and where China may need to head.

Keywords: China, history, juvenile justice, legal traditions

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Authors: Gary Peach, Furqan Hameed

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Musaimeer outfall tunnel is one of the longest storm water tunnels in the world, with a total length of 10.15 km. The tunnel will accommodate surface and rain water received from the drainage networks from 270 km of urban areas in southern Doha with a pumping capacity of 19.7m³/sec. The tunnel is excavated by Tunnel Boring Machine (TBM) through Rus Formation, Midra Shales, and Simsima Limestone. Water inflows at high pressure, complex mixed ground, and weaker ground strata prone to karstification with the presence of vertical and lateral fractures connected to the sea bed were also encountered during mining. In addition to pre-tender geotechnical investigations, the Contractor carried out a supplementary offshore geophysical investigation in order to fine-tune the existing results of geophysical and geotechnical investigations. Electric resistivity tomography (ERT) and Seismic Reflection survey was carried out. Offshore geophysical survey was performed, and interpretations of rock mass conditions were made to provide an overall picture of underground conditions along the tunnel alignment. This allowed the critical tunnelling area and cutter head intervention to be planned accordingly. Karstification was monitored with a non-intrusive radar system facility installed on the TBM. The Boring Electric Ahead Monitoring(BEAM) was installed at the cutter head and was able to predict the rock mass up to 3 tunnel diameters ahead of the cutter head. BEAM system was provided with an online system for real time monitoring of rock mass condition and then correlated with the rock mass conditions predicted during the interpretation phase of offshore geophysical surveys. The further correlation was carried by Samples of the rock mass taken from tunnel face inspections and excavated material produced by the TBM. The BEAM data was continuously monitored to check the variations in resistivity and percentage frequency effect (PFE) of the ground. This system provided information about rock mass condition, potential karst risk, and potential of water inflow. BEAM system was found to be more than 50% accurate in picking up the difficult ground conditions and faults as predicted in the geotechnical interpretative report before the start of tunnelling operations. Upon completion of the project, it was concluded that the combined use of different geophysical investigation results can make the execution stage be carried out in a more confident way with the less geotechnical risk involved. The approach used for the prediction of rock mass condition in Geotechnical Interpretative Report (GIR) and Geophysical Reflection and electric resistivity tomography survey (ERT) Geophysical Reflection surveys were concluded to be reliable as the same rock mass conditions were encountered during tunnelling operations.

Keywords: tunnel boring machine (TBM), subsea, karstification, seismic reflection survey

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Authors: Riza Yilmaz, Samet Kiyak, Sezin Nur Yilmaz, Yasemin Yilmaz

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Child delinquency has been increasing in our country as well as in many countries of the world. Child intelligence, abilities, family's social environment and life conditions are the factors which affect the child delinquency. The reports of 73 cases ages of 12-15 which were sent to the University of Bulent Ecevit, School of Medicine, Forensic Medicine Department between January 2011-September 2015, in order to evaluate medically, children pushed to crime by the judicial authorities are examined in terms of age, gender, educational background, place of residence, reasons for being sent, whether it’s a repeating crime or not, type of intelligence test, results revealed by forensic medicine and department of mental and neurological disorders. When children pushed to crime examined in terms of their crimes, the most common type of crime was identified as theft (n = 24). The crimes with 19 physical attacks and 12 sexual abuse were seen. Following that other 12 crimes were determined as damage to property, hemp crop, insult, incitement to crime, forgery of private documents, illegal excavation, threatening, involuntary manslaughter. The alleged crimes in 6 cases were more than one. The children pushed to crime are one of the major social problems of many countries. In this sense, it is not only the responsibility of government agencies to protect children pushed to crime, also, the civil society organizations should take place in this struggle.

Keywords: delinquent behaviour, forensic medicine, crime, punishment

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Authors: Noha Desouky Aly, Maged Makram Habib

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Given the imperative role educational institutions have in the creation of a motivational learning community that develops and engages their students, the influence of evoking the same environment for their teachers needs to be examined. Teachers and their role lie at the core of the efficiency of the learning experience. One exigent aspect in the process of providing professional development to teachers is to involve them in this process, and the best manner would be through creating a learning community in which they are directly engaged and responsible for their own learning. An educational institution that thinks first of its teachers learning and growth would achieve its goals in providing an effective education for its students. The purpose of this research paper is to examine the effect of engaging teachers in a learning community in which they are responsible for their own learning through conducting and providing the material required for the training on their self efficacy, engagement, and perceived autonomy. The sample includes twenty instructors at the German University in Cairo teaching Academic skills at the Department of English and Scientific Methods. The courses taught at the department include Academic skills, writing argumentative essays, critical thinking, communication and presentation skills, and research paper writing. Procedures for the duration of eight weeks will entail pre-post measures to include The Teachers Self Efficacy Scale and an interview. During the weekly departmental meeting, teachers are to share resources and experiences or research and present a topic of their choice that contributes to their professional development. Results are yet to be found.

Keywords: learning community, self- efficacy, teachers, learning experience

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Authors: Carrollyne Aasen, Laverne Seales

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With increased Latinx communities within the United States, specifically in California, and more universities receiving designations of Hispanic-Serving institutions, Spanish programs have evolved to include more targeted and applicable practical skills. The Spanish program in the Languages and Cultures Department at California Lutheran University incorporated an interdisciplinary project with the Communication Department to create student-generated Spanish-language news inserts, which serve as a sister publication to the English-language student newspaper, The Echo. California Lutheran University is a Hispanic-Serving Institution, meaning it is an accredited undergraduate institution with full-time Hispanic/Latinx students equivalent to at least 25 percent of the total students enrolled. As a Hispanic Serving Institution with growing numbers of bilingual students, faculty, staff, and community members, the need for more information aimed at Hispanic/Latinx communities increased, resulting in the opportunity to reflect topics of interest by community members. This project was developed to fulfill the Spanish program's goals for proficiency by using the American Council on the Teaching of Foreign Languages guidelines and the university's need to support students and the community's voices. This article describes the stages from inception to production and the incorporation of journalism principles into the Spanish curriculum.

Keywords: interdisciplinary, media, foreign languages, HSI

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Authors: Chukwuma Anya

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Foundation is popularly defined as the lowest load-bearing part of a building typically below the ground level. It serves as an underlying base which acts as the principle on which every building stands. There are various types of foundations in practice which includes the strip, pile, pad, and raft foundations, and each of these have their various applications in building construction. However due to lack of professional knowledge, cost, or scheduled time frame to complete a certain project, some of these foundation types are some times neglected or used interchangeably resulting to a misuse or abuse of the building materials, man power, and sometimes altering the stability, balance and aesthetics of most buildings. This research work is aimed at educating the academic community on the proper application of the various foundation types to suit different environments such as the rain forest, desert, swampy area, rocky area etc. A proper application of the foundation will ensure the safety of the building from acid grounds, damping and weakening of the foundation, and even building settlement and stability. In addition to those, it will improve aesthetics and maintain cost effectiveness, both construction cost and maintenance cost. Finally, it will ensure the safety of the building and its inhabitants.

Keywords: foundation, stability, balance, aesthetic

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Authors: Jafar Razmi

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Integral abutment bridges are bridges that do not have joints. If these bridges are subject to large seasonal and daily temperature variations, the expansion and contraction of the bridge slab is transferred to the piles. Since the piles are deep into the soil, displacement induced by slab can cause bending and stresses in piles. These stresses cause fatigue and failure of piles. A complex mechanical interaction exists between the slab, pile, soil and abutment. This complex interaction needs to be understood in order to calculate the stresses in piles. This paper uses a mechanical approach in developing analytical equations for the complex structure to determine the stresses in piles. The solution to these analytical solutions is developed and compared with finite element analysis results and experimental data. Our comparison shows that using analytical approach can accurately predict the displacement in piles. This approach offers a simplified technique that can be utilized without the need for computationally extensive finite element model.

Keywords: integral abutment bridges, piles, thermo-mechanical stress, stress and strains

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Authors: Saad M. Howladar, Mostafa M. Rady, Wael M. Semida

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A field experiment was conducted during the two successive seasons of 2012 and 2013 in the Experimental Farm (newly-reclaimed saline soil; EC = 7.8 dS m-1), Faculty of Agriculture, Fayoum University, Fayoum, Egypt to investigate the effect of vitamin C foliar application at the rates of 1, 2, 3 and 4 mM on the possibility of improving growth, seed and oil yields, and some chemical constituents of Helianthus annuus L. plants under the adverse conditions of the selected soil. Significant positive influences of all vitamin C treatments were observed on growth, seed and oil yields and some chemical constituents in both seasons. Compared to unsprayed plants (control), spraying plants with various rates of vitamin C significantly increased vegetative growth traits (i.e. plant height, No. of leaves plant-1, leaf area leaf-1, total leaves area plant-1, and dry weights of leaves and shoot plant-1) and seed and oil yields and their components (i.e. head diameter, seed weight head-1, 100-seed weight, seed yield feddan-1 and oil yield feddan-1). In addition, the concentrations of chlorophyll a, chlorophyll b, total chlorophylls, total carotenoids and total phenols in fresh leaves, and total carbohydrates, total soluble sugars, free proline and some nutrients (i.e. N, P, K, Fe, Mn, and Zn) in dry leaves were also increased significantly with all vitamin C applications. Vitamin C treatment at the rate of 3 mM was generated the best results. These results are important as the potential of vitamin C to alleviate the harmful effects of salt stress offer an opportunity to increase the resistance of sunflower plants to grow under saline conditions of the newly-reclaimed soils.

Keywords: sunflower, Helianthus annuus L., ascorbic acid, salinity, growth, seed yield, oil content, chemical composition

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Authors: Ari Istiany, Guspri Devi Artanti, M. Si

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Based on the results Riskesdas, it is known that breastfeeding awareness about the importance of exclusive breastfeeding is still low at only 15.3 %. These conditions resulted in a very infant at risk for infectious diseases, such as diarrhea and acute respiratory infection. Therefore, the aim of this study to evaluate the video development about exclusive breastfeeding as a nutrition education media for posyandu cadre. This research used development methods for making the video about exclusive breastfeeding. The study was conducted in urban areas Rawamangun, East Jakarta. Respondents of this study were 1 media experts from the Department of Educational Technology - UNJ, 2 subject matter experts from Department of Home Economics - UNJ and 20 posyandu cadres to assess the quality of the video. Aspects assessed include the legibility of text, image display quality, color composition, clarity of sound, music appropriateness, duration, suitability of the material and language. Data were analyzed descriptively likes frequency distribution table, the average value, and deviation standard. The result of this study showed that the average score assessment according to media experts, subject matter experts, and posyandu cadres respectively was 3.43 ± 0.51 (good), 4.37 ± 0.52 (very good) and 3.6 ± 0.73 (good). The conclusion is on exclusive breastfeeding video as feasible as a media for nutrition education. While suggestions for the improvement of visual media is multiply illustrations, add material about the correct way of breastfeeding and healthy baby pictures.

Keywords: exclusive breastfeeding, posyandu cadre, video, nutrition education

Procedia PDF Downloads 412

Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

Procedia PDF Downloads 377

Authors: Alessandro Evangelista, Vito M. Manghisi, Michele Gattullo, Enricoandrea Laviola

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In this work, we propose a custom visualization technique for Out-Of-View-Objects in Virtual and Augmented Reality applications using Head Mounted Displays. In the last two decades, Augmented Reality (AR) and Virtual Reality (VR) technologies experienced a remarkable growth of applications for navigation, interaction, and collaboration in different types of environments, real or virtual. Both environments can be potentially very complex, as they can include many virtual objects located in different places. Given the natural limitation of the human Field of View (about 210° horizontal and 150° vertical), humans cannot perceive objects outside this angular range. Moreover, despite recent technological advances in AR e VR Head-Mounted Displays (HMDs), these devices still suffer from a limited Field of View, especially regarding Optical See-Through displays, thus greatly amplifying the challenge of visualizing out-of-view objects. This problem is not negligible when the user needs to be aware of the number and the position of the out-of-view objects in the environment. For instance, during a maintenance operation on a construction site where virtual objects serve to improve the dangers' awareness. Providing such information can enhance the comprehension of the scene, enable fast navigation and focused search, and improve users' safety. In our research, we investigated how to represent out-of-view-objects in HMD User Interfaces (UI). Inspired by commercial video games such as Call of Duty Modern Warfare, we designed a customized Compass. By exploiting the Unity 3D graphics engine, we implemented our custom solution that can be used both in AR and VR environments. The Compass Bar consists of a graduated bar (in degrees) at the top center of the UI. The values of the bar range from -180 (far left) to +180 (far right), the zero is placed in front of the user. Two vertical lines on the bar show the amplitude of the user's field of view. Every virtual object within the scene is represented onto the compass bar as a specific color-coded proxy icon (a circular ring with a colored dot at its center). To provide the user with information about the distance, we implemented a specific algorithm that increases the size of the inner dot as the user approaches the virtual object (i.e., when the user reaches the object, the dot fills the ring). This visualization technique for out-of-view objects has some advantages. It allows users to be quickly aware of the number and the position of the virtual objects in the environment. For instance, if the compass bar displays the proxy icon at about +90, users will immediately know that the virtual object is to their right and so on. Furthermore, by having qualitative information about the distance, users can optimize their speed, thus gaining effectiveness in their work. Given the small size and position of the Compass Bar, our solution also helps lessening the occlusion problem thus increasing user acceptance and engagement. As soon as the lockdown measures will allow, we will carry out user-tests comparing this solution with other state-of-the-art existing ones such as 3D Radar, SidebARs and EyeSee360.

Keywords: augmented reality, situation awareness, virtual reality, visualization design

Procedia PDF Downloads 127