Search results for: multiple emergency resources

Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

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After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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Authors: Nicholas Burica, Nina Selak

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The ADHCAT (Automated Distribution Hosting Capacity Assessment Tool) was designed to run Hosting Capacity Analysis on the ComEd system via a stochastic DER (Distributed Energy Resource) placement on multiple power flow simulations against a set of violation criteria. The violation criteria in the initial version of the tool captured a limited amount of issues that individual departments design against for DER interconnections. Enhancements were made to the tool to further align with individual department violation and operation criteria, as well as the addition of new modules for use for future load profile analysis. A reporting engine was created for future analytical use based on the simulations and observations in the tool.

Keywords: distributed energy resources, hosting capacity, interconnect, voltage optimization

Procedia PDF Downloads 189

Authors: Sina Mahdavi

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Background and Objective: Multiple sclerosis (MS) is the most common inflammatory autoimmune disease of the central nervous system (CNS) that affects the myelination process in the CNS. Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially the John Cunningham virus (JCV) and MS is one potential cause that is not well understood. This study aims to summarize the available data on JCV infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis", " John Cunningham virus ", and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2019 and 2022 were searched, and 12 articles were chosen, studied, and analyzed. Results: MS patients are candidates for natalizumab therapy, which inhibits lymphocyte migration and increases the risk of progressive multifocal leukoencephalopathy (PML), a rare lytic infection of glial cells caused by JCV. Oligodendrocytes may be the target of JCV infection in the central nervous system (CNS). Conclusion: There is a high expression of JCV during the natalizumab treatment period for MS patients, suggesting that the virus may play a role in the development of MS by inducing an inflammatory state. Therefore, it is necessary to evaluate anti-JCV antibody serum as an important risk factor for the development of PML before deciding on the treatment course for these patients.

Keywords: multiple sclerosis, John Cunningham virus, central nervous system, autoimmunity

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Authors: Öykü Barutçu, Mehmet Özgür Kuzdan

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Aim: Laparoscopy is very risky in patients undergoing, multiple open abdominal surgeries. The aim of this study, to define a safe method for the first trocar placement in children with a history of multiple open abdominal surgeries. Methods: Children who underwent laparoscopic surgery between March 2019 and April 2020 with a history of three or more open abdominal surgeries were included in the retrospective study. Patient information was obtained from the hospital automation system. Ultrasonography was used to determine the location of adhesions preoperatively. The first trocar was placed according to ultrasonography findings, using the Hasson technique to create an air pocket with finger dissection. The patient's preoperative, perioperative, and postoperative findings are reported. Results: A total of 10 patients were included in the study. The median number of operations before laparoscopy was three. The most common site for the first trocar entry was Palmer's point (40%). No mortality or morbidity was observed amongst any patients. The average number of adhesions detected by USG and observed on laparoscopy were significantly positively correlated. Conclusion: In children with a history of multiple abdominal surgeries, abdominal wall ultrasonography for visualization of adhesions and finger dissection for the formation of an air pocket appears to be a safe method for the first trocar insertion.

Keywords: abdominal wall, child, laparoscopy, ultrasonography

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Authors: Simiso Fisokuhle Nyandeni

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The environment is one of the major components of intergenerational equity under sustainability; however, this component has been facing a lot of issues/crises, which include those that are caused by natural systems due to the actions of humans. Although some of those environmental issues may occur from natural causes, however, climate change effects have shown to increase rapidly due to human behavior, which led to the increase in greenhouse emissions and the over-exploitation of natural resources that maintain an ecological balance in our environment. Based on the recent projections, the growing population tends to outstrip the environmental resources, and as a result, the rapid depletion of natural resources that maintain ecological balance within the environment has resulted in such environmental issues. This paper has adopted desktop analysis to address the main objective, which seeks to address the effects of population dynamics on environmental issues and what needs to be done to maintain the ecological balance between the growing population and the limited resources that are available; thus, the collective data sources were used to justify the literature in order to get adequate results to influence the potential findings. The major findings postulate that there is an ecological imbalance between limited resources available and the growing population; as a result, the environment is taking action against humanity through climate change impacts. Hence findings further outline that in order to prevent such impacts, there should be drastic interventions by the governments (all stakeholders should be involved in decision-making; Governmental or non-governmental institutions, scientists, researchers, etc.) around the world to maintain this ecological balance and also to prioritize the adaptation measures. Therefore, this paper seeks to examine the implications of population dynamics on the environmental issues and what needs to be done in order to maintain this ecological balance between the growing population and environmental resources; hence, this review will be based on the climate change context.

Keywords: population dynamics, climate change, environment, sustainability

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Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

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During the recent years, demand for healthcare services has dramatically increased. As the demand for healthcare services increases, so does the necessity of constructing new healthcare buildings and redesigning and renovating existing ones. Increasing demands necessitate the use of optimization techniques to improve the overall service efficiency in healthcare settings. However, high complexity of care processes remains the major challenge to accomplish this goal. This study proposes a method based on process mining results to address the high complexity of care processes and to find the optimal layout of the various medical centers in an emergency department. ProM framework is used to discover clinical pathway patterns and relationship between activities. Sequence clustering plug-in is used to remove infrequent events and to derive the process model in the form of Markov chain. The process mining results served as an input for the next phase which consists of the development of the optimization model. Comparison of the current ED design with the one obtained from the proposed method indicated that a carefully designed layout can significantly decrease the distances that patients must travel.

Keywords: Mixed Integer programming, Facility layout problem, Process Mining, Healthcare Operation Management

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Authors: Tugce Duygu Koksal

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In recent years, given the fact that the acts of terrorism and the threat of the latter are taking place without any border and distinction, it has led the states to deal with the terrorism as a priority issue. More recently, as seen in different countries during state of emergency, the adoption of anti-terrorism measures motivated by the sole need of the prevention of terrorism targets directly the fundamental rights of individuals. Therefore, a contribution to the understanding of the value of the principle of legality is becoming more and more important nowadays. This paper aims to reflect the probable effects of the adoption of anti-terrorism measures regardless of the principle of legality, on the fundamental rights. In this respect, this paper will first discuss the margin of appreciation of the national authorities by countering terrorism, and then, the importance of the respect of the legality of the anti-terrorism measures will be examined in the light of actual examples. Indeed, one of the major findings of this study is the fact that the anti-terrorism laws and measures were taken in this framework must be subject to close scrutiny in democracies, which adopted the principle of the rule of law and respect human rights. Although the state's margin of appreciation in the field of counter-terrorism is broad, these measures which are based on the legitimate aim of a democracies’ legitimate right to protect itself against the activities of terrorist organizations should have the legal basis and be strictly required by the exigencies of the fight against terrorism. While combating terrorism, the legal basis shall only be achieved if the legal consequences of an individuals’ actions related to terrorism shall be clear and foreseeable by the individuals of a society. On the other hand, particularly during the state of emergency, the ambiguity of the law might be used to include a wide range of actions under acts of terrorism. This is becoming more dangerous where freedom of expression, freedom of the press, freedom of association and the right to information is in the substance of these actions. Disregarding the principle of legality is susceptible to create a chilling effect on the exercise of human rights, and therefore, the fight against terrorism can be transformed into a repressive regime on opponents. As a result, the efforts to counter terrorism of the national authorities irrespective of the principle of legality are susceptible to cause a transformation of the rule of law to a state of law which cannot be appreciated in a democratic society.

Keywords: anti-terrorism measures, chilling effect, predictability, the principle of legality, state of emergency

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Authors: Ziying Wu, Danfeng Yan

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Multi-Access Edge Computing (MEC) is one of the key technologies of the future 5G network. By deploying edge computing centers at the edge of wireless access network, the computation tasks can be offloaded to edge servers rather than the remote cloud server to meet the requirements of 5G low-latency and high-reliability application scenarios. Meanwhile, with the development of IOV (Internet of Vehicles) technology, various delay-sensitive and compute-intensive in-vehicle applications continue to appear. Compared with traditional internet business, these computation tasks have higher processing priority and lower delay requirements. In this paper, we design a 5G-based Vehicle-Aware Multi-Access Edge Computing Network (VAMECN) and propose a joint optimization problem of minimizing total system cost. In view of the problem, a deep reinforcement learning-based joint computation offloading and task migration optimization (JCOTM) algorithm is proposed, considering the influences of multiple factors such as concurrent multiple computation tasks, system computing resources distribution, and network communication bandwidth. And, the mixed integer nonlinear programming problem is described as a Markov Decision Process. Experiments show that our proposed algorithm can effectively reduce task processing delay and equipment energy consumption, optimize computing offloading and resource allocation schemes, and improve system resource utilization, compared with other computing offloading policies.

Keywords: multi-access edge computing, computation offloading, 5th generation, vehicle-aware, deep reinforcement learning, deep q-network

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Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

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Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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Authors: Sina Mahdavi

Abstract:

Background and Objective: Multiple sclerosis (MS) is an inflammatory autoimmune disease of the CNS that affects the myelination process in the central nervous system (CNS). Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially Human Herpesvirus 6 (HHV-6), and MS is one potential cause that is not well understood. In this study, we aim to summarize the available data on HHV-6 infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis", " Human Herpesvirus 6 ", and "central nervous system" in the databases PubMed and Google Scholar between 2017 and 2022 were searched, and 12 articles were chosen, studied, and analyzed. Results: HHV 6 tends towards TCD 4+ lymphocytes and enters the CNS due to the weakening of the blood-brain barrier due to inflammatory damage. Following the observation that the HHV-6 U24 protein has a seven amino acid sequence with myelin basic protein, which is one of the main components of the myelin sheath, it could cause a molecular mimicry mechanism followed by cross-reactivity. Reactivation of HHV-6 in the CNS can cause the release of proinflammatory cytokines, including TNF-α, leading to immune-mediated demyelination in patients with MS. Conclusion: There is a high expression of endogenous retroviruses during the course of MS, which indicates the relationship between HHV-6 and MS, and that this virus can play a role in the development of MS by creating an inflammatory state. Therefore, measures to modulate the expression of HHV-6 may be effective in reducing inflammatory processes in demyelinated areas of MS patients.

Keywords: multiple sclerosis, human herpesvirus 6, central nervous system, autoimmunity

Procedia PDF Downloads 107

Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

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According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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Authors: Darma Putra Sitepu, Dewi Larasati, Yohanes Wolter Hendrik George

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Sepsis is a life-threatening medical emergency frequently observed in intensive care unit (ICU). Surviving Sepsis Campaign in 2018 has recommended the administration of early vasopressor in the first hour of sepsis or septic shock but has not yet included de-resuscitation protocol. De-resuscitation in acute management of septic shock is where patient received active removal of accumulated fluid. It has been proposed by some studies and ongoing clinical trials. Here we present a case with early vasopressor and de-resuscitation. Male, 27 years old presenting to the emergency room with shortness of breath, altered mental status, and widespread blisters on his body and lips started a few hours prior, after receiving non-steroidal anti-inflammatory drug through intravenous injection. Patient was hypotensive, tachycardic, and tachypneic at admission, diagnosed with Steven Johnson Syndrome with Septic Shock. Patient received fluid resuscitation, early vasopressor, and diuresis agent aimed to actively remove fluid after the initial phase of resuscitation. Patient was admitted to ICU and progressively recovering. At day-10, patient was stabilized and was transferred to general ward. Early vasopressor and de-resuscitation are beneficial for the patient.

Keywords: sepsis, shock, de-resuscitation, vasopressor, fluid, case report

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Authors: Nuhi Arslani, Aleks Brumec

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Adhesive small bowel obstruction (ASBO) accounts for 20% of emergency surgical procedures and intraabdominal adhesions account for 65% of such cases. In a 10-year post-operative period of abdominal surgery patients, around 35% of them will be readmitted because of ASBO. The first step in approaching ASBOs is using the Bologna guidelines, which include a thorough initial evaluation to diagnose or rule out an ASBO and then proceed with either further imaging studies or emergency surgery, which can be either open or laparoscopic. The contraindications for a laparoscopic approach include hemodynamic instability of the patient and infections in the peritoneum or port sites. Studies have shown that a laparoscopic approach to adhesiolysis is linked with a significantly smaller risk of readmissions and reoperations as well as with faster recovery time and fewer postoperative infections, but has a higher risk of bowel injuries, so a careful selection of patients is required. Although studies favor a laparoscopic approach, many countries still prefer a laparotomy, often because a laparoscopic approach requires surgeons to be highly skilled in the procedure. In the US and UK, between 50 and 60% of surgeons would approach an ASBO with laparoscopy, while in Italy, this number is around 15% and it is most likely similar in Slovenia. We believe that in the right cases and in the right patients, a laparoscopic approach can be equally feasible for treating ASBOs and is associated with fewer intraoperative and postoperative complications.

Keywords: adhesive small bowel obstruction, laparoscopy, adhesions, adhesiolysis

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Authors: Tareq AlNuaim, Mubashir Alam, Abdulrazaq Aldowesh

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The usage of micro-Unmanned Ariel Vehicles (UAVs) has witnessed an enormous increase recently. Detection of such drones became a necessity nowadays to prevent any harmful activities. Typically, such targets have low velocity and low Radar Cross Section (RCS), making them indistinguishable from clutter and phase noise. Multiple-Input Multiple-Output (MIMO) Radars have many potentials; it increases the degrees of freedom on both transmit and receive ends. Such architecture allows for flexibility in operation, through utilizing the direct access to every element in the transmit/ receive array. MIMO systems allow for several array processing techniques, permitting the system to stare at targets for longer times, which improves the Doppler resolution. In this paper, a 2×2 MIMO radar prototype is developed using Software Defined Radio (SDR) technology, and its performance is evaluated against a slow-moving low radar cross section micro-UAV used by hobbyists. Radar cross section simulations were carried out using FEKO simulator, achieving an average of -14.42 dBsm at S-band. The developed prototype was experimentally evaluated achieving more than 300 meters of detection range for a DJI Mavic pro-drone

Keywords: digital beamforming, drone detection, micro-UAV, MIMO, phased array

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Authors: Jun Hong Lee

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Background: Many dementia patients complain insomnia and depressive mood, and hypnotics and antidepressants are being prescribed. As prevalence of dementia is increasing, insomnia and depressive mood are becoming more important. Objective: We evaluated insomnia and depression in outpatients of dementia center. Patients and Methods/Material and Methods: We reviewed medical records of the patients who visited outpatients clinic of NHIS Ilsan Hospital Dementia Center during 2016. Results: Total 716 patients are included; Subjective Memory Impairment (SMI) : 143 patients (20%), non-amnestic Mild Cognitive Impairment (MCI): single domain 70 (10%), multiple domain 34 (5%), amnestic MCI: single domain 74 (10%), multiple domain 159 (22%), Early onset Alzheimer´s disease (AD): 9 (1%), AD 121 (17%), Vascular dementia: 62 (9%), Mixed dementia 44 (6%). Hypnotics and antidepressants are prescribed as follows; SMI : hypnotics 14 patients (10%), antidepressants 27 (19%), non-amnestic MCI: single domain hypnotics 9 (13%), antidepressants 12 (17%), multiple domain hypnotics 4 (12%), antidepressants 6 (18%), amnestic MCI: single domain hypnotics 10 (14%), antidepressants 16 (22%), multiple domain hypnotics 22 (14%), antidepressants 24 (15%), Early onset Alzheimer´s disease (AD): hypnotics 1 (11%), antidepressants 2 (22%), AD: hypnotics 10 (8%), antidepressants 36 (30%), Vascular dementia: hypnotics 8 (13%), antidepressants 20 (32%), Mixed dementia: hypnotics 4 (9%), antidepressants 17 (39%). Conclusion: Among the outpatients of Dementia Center, MCI and SMI are majorities, and the number of MCI patients are almost half. Depression is more prevalent in AD, and Vascular dementia than MCI and SMI, and about 22% of patients are being prescribed by antidepressants and 11% by hypnotics.

Keywords: insomnia, depression, dementia, antidepressants, hypnotics

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Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: developing country, local resources, nutrition program, urban fringe

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Authors: Rafi Ullah, Shah Muhammad Emaduddin, Taha Jilani

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Vehicle Adhoc Networks (VANET) belongs to a special class of Mobile Adhoc Network (MANET) with high mobility. Network is created by road side vehicles equipped with communication devices like GPS and Wifi etc. Since the environment is highly dynamic due to difference in speed and high mobility of vehicles and weak stability of the network connection, it is a challenging task to design an efficient routing protocol for such an unstable environment. Our proposed algorithm uses heuristic for the calculation of optimal path for routing the packet efficiently in collaboration with several other parameters like geographical location, speed, priority, the distance among the vehicles, communication range, and networks congestion. We have incorporated probabilistic, heuristic and machine learning based approach inconsistency with the relay function of the memory buffer to keep the packet moving towards the destination. These parameters when used in collaboration provide us a very strong and admissible heuristics. We have mathematically proved that the proposed technique is efficient for the routing of packets, especially in a medical emergency situation. These networks can be used for medical emergency, security, entertainment and routing purposes.

Keywords: heuristics routing, intelligent routing, VANET, route optimization

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Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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Authors: C. L. Huang, J. J. Sia

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The interest-based social networks, also known as social bookmark sharing systems, are useful platforms for people to conveniently read and collect internet resources. These platforms also providing function of social networks, and users can share and explore internet resources from the social networks. Providing personalized internet resources to users is an important issue on these platforms. This study uses two types of relationship on the social networks—following and follower and proposes a collaborative recommender system, consisting of two main steps. First, this study calculates the relationship strength between the target user and the target user's followings and followers to find top-N similar neighbors. Second, from the top-N similar neighbors, the articles (internet resources) that may interest the target user are recommended to the target user. In this system, users can efficiently obtain recent, related and diverse internet resources (knowledge) from the interest-based social network. This study collected the experimental dataset from Diigo, which is a famous bookmark sharing system. The experimental results show that the proposed recommendation model is more accurate than two traditional baseline recommendation models but slightly lower than the cosine model in accuracy. However, in the metrics of the diversity and executing time, our proposed model outperforms the cosine model.

Keywords: recommender systems, social networks, tagging, bookmark sharing systems, collaborative recommender systems, knowledge management

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Authors: Morsy Ahmed Morsy Ismail

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In this paper, the structure of a coherent homodyne receiver for the Binary Phase Shift Keying (BPSK) Optical Code Division Multiple Access (OCDMA) network is introduced based on the Multi-Length Weighted Modified Prime Code (ML-WMPC) for multimedia applications. The Bit Error Rate (BER) of this homodyne detection is evaluated as a function of the number of active users and the signal to noise ratio for different code lengths according to the multimedia application such as audio, voice, and video. Besides, the Mach-Zehnder interferometer is used as an external phase modulator in homodyne detection. Furthermore, the Multiple Access Interference (MAI) and the receiver noise in a shot-noise limited regime are taken into consideration in the BER calculations.

Keywords: OCDMA networks, bit error rate, multiple access interference, binary phase-shift keying, multimedia

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Authors: Bill Wang, Paul Childerhouse, Yuanfei Kang

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Purpose: The research is to extend resource orchestration theory (ROT) into supply chain management (SCM) area to investigate the dyadic relationships at both individual and organizational levels in supply chain integration (SCI). Also, we try to explore the interaction mechanism between inter-personal relationships (IPRs) and inter-organizational (IORs) during the whole SCI process. Methodology/approach: The research employed an exploratory multiple case study approach of four New Zealand companies. The data was collected via semi-structured interviews with top, middle, and lower level managers and operators from different departments of both suppliers and customers triangulated with company archival data. Findings: The research highlights the important role of both IPRs and IORs in the whole SCI process. Both IPRs and IORs are valuable, inimitable resources but IORs are formal and exterior while IPRs are informal and subordinated. In the initial stage of SCI process, IPRs are seen as key resources antecedents to IOR building while three IPRs dimensions work differently: personal credibility acts as an icebreaker to strengthen the confidence forming IORs, and personal affection acts as a gatekeeper, whilst personal communication expedites the IORs process. In the maintenance and development stage, IORs and IPRs interact each other continuously: good interaction between IPRs and IORs can facilitate SCI process while the bad interaction between IPRs can damage the SCI process. On the other hand, during the life-cycle of SCI process, IPRs can facilitate the formation, development of IORs while IORs development can cultivate the ties of IPRs. Out of the three dimensions of IPRs, Personal communication plays a more important role to develop IORs than personal credibility and personal affection. Originality/value: This research contributes to ROT in supply chain management literature by highlighting the interaction of IPRs and IORs in SCI. The intangible resources and capabilities of three dimensions of IPRs need to be orchestrated and nurtured to achieve efficient and effective IORs in SCI. Also, IPRs and IORs need to be orchestrated in terms of breadth, depth, and life-cycle of whole SCI process. Our study provides further insight into the rarely explored inter-personal level of SCI. Managerial implications: Our research provides top management with further evidence of the significance roles of IPRs at different levels when working with trading partners. This highlights the need to actively manage and develop these soft IPRs skills as an intangible competitive resource. Further, the research identifies when staff with specific skills and connections should be utilized during the different stages of building and maintaining inter-organizational ties. More importantly, top management needs to orchestrate and balance the resources of IPRs and IORs.

Keywords: case study, inter-organizational relationships, inter-personal relationships, resource orchestration, supply chain integration

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Authors: Ntandoyenkosi Moyo

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Majority of rural Eastern Cape villages of South Africa households do not have access to safe water supply. Due to changes in climatic conditions for example higher temperatures, these sources become not reliable in supplying adequate and safe water to the population. These rural populations due to the drying up of water resources have to find other alternative ways to get water. Climate change has an impact on the reliability of water resources and this has an impact on rural communities. This study seeks to establish what alternative ways do people use when affected by unfavorable conditions like less rainfall and increased temperatures. The study also seeks to investigate any local and provincial intervention in the provision of water to the village. Interventions can be in the form of programmes or initiatives that involve water supply strategies. The community should participate fully in making sure that their place is serviced. The study will identify households with improved sources (JOJO tanks) and those with unimproved sources (rivers) and investigate what alternatives they resort to when their sources dry up. The study also investigates community views on whether they have any challenges of water supply (reliability and adequacy) as required by section 27(1) (b) of the constitution which states that everyone should have access to safe and clean water.

Keywords: rural water resources, temperature, improved sources, unimproved sources

Procedia PDF Downloads 318

Authors: Yao Jiajia, Wu Guanlin, LIU Fang, Xue Junshuai, Zhang Jincheng, Hao Yue

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Resonant tunneling diodes (RTDs) based on GaN have been extensively studied. However, no results of multiple logic states achieved by RTDs were reported by the methods of epitaxy in the GaN materials. In this paper, the multiple negative-differential resistance regions by combining two discrete double-barrier RTDs in series have been first demonstrated. Plasma-assisted molecular beam epitaxy (PA-MBE) was used to grow structures consisting of two vertical RTDs. The substrate was a GaN-on-sapphire template. Each resonant tunneling structure was composed of a double barrier of AlN and a single well of GaN with undoped 4-nm space layers of GaN on each side. The AlN barriers were 1.5 nm thick, and the GaN well was 2 nm thick. The resonant tunneling structures were separated from each other by 30-nm thick n+ GaN layers. The bottom and top layers of the structures, grown neighboring to the spacer layers that consist of 200-nm-thick n+ GaN. These devices with two tunneling structures exhibited uniform peaks and valleys current and also had two negative differential resistance NDR regions equally spaced in bias voltage. The current-voltage (I-V) characteristics of resonant tunneling structures with diameters of 1 and 2 μm were analyzed in this study. These structures exhibit three stable operating points, which are investigated in detail. This research demonstrates that using molecular beam epitaxy MBE to vertically grow multiple resonant tunneling structures is a promising method for achieving multiple negative differential resistance regions and stable logic states. These findings have significant implications for the development of digital circuits capable of multi-value logic, which can be achieved with a small number of devices.

Keywords: GaN, AlN, RTDs, MBE, logic state

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Authors: Phalaunnnaphat Siriwongs

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The classroom of the 21st century is an ever changing forum for new and innovative thoughts and ideas. With increasing technology and opportunity, students have rapid access to information that only decades ago would have taken weeks to obtain. Unfortunately, new techniques and technology are not the cure for the fundamental problems that have plagued the classroom ever since education was established. Class size has been an issue long debated in academia. While it is difficult to pin point an exact number, it is clear that in this case more does not mean better. By looking into the success and pitfalls of classroom size the true advantages of smaller classes will become clear. Previously, one class was comprised of 50 students. Being seventeen and eighteen- year- old students, sometimes it was quite difficult for them to stay focused. To help them understand and gain much knowledge, a researcher introduced “The Theory of Multiple Intelligence” and this, in fact, enabled students to learn according to their own learning preferences no matter how they were being taught. In this lesson, the researcher designed a cycle of learning activities involving all intelligences so that everyone had equal opportunities to learn.

Keywords: multiple intelligences, role play, performance assessment, formative assessment

Procedia PDF Downloads 273

Authors: Michael J. Hahn

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Docker is a powerful tool used by many companies such as PayPal, MetLife, Expedia, Visa, and many others. Docker works by bundling multiple applications, binaries, and libraries together on top of an operating system image called a container. The container runs on a Docker engine that in turn runs on top of a standard operating system. This centralization saves a lot of system resources. In this paper, we will be demonstrating how to bypass Transport Layer Security and execute remote code within Docker containers built on a base image of Alpine Linux version 3.7.0 through the use of .apk files due to flaws in the Alpine Linux package management program. This exploit renders any applications built using Docker with a base image of Alpine Linux vulnerable to unwanted outside forces.

Keywords: cloud, cryptography, Docker, Linux, security

Procedia PDF Downloads 193

Authors: Katarzyna Piwowar-Sulej

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The functioning of a project-oriented organisation creates new and different, from the traditional ones, conditions for human resources management. In the analysed case HRM is primarily characterized by a double-track nature – on the one hand within the framework of permanent structures (departments) and, on the other, within the area of particular projects. The purpose of the article is to present the dilemmas associated with the development of selected HRM areas in project-oriented organisations. Theoretical discussion was supplemented by the results of empirical research.

Keywords: human resources management, tracks of HRM, project, project-oriented organisation

Procedia PDF Downloads 271

Authors: Mohammed Ali Faqeeh

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SCADA System Alarms Optimization Process has been introduced recently and applied accordingly in different implemented stages. First, MODBUS communication protocols between RTU/SCADA were improved at the level of I/O points scanning intervals. Then, some of the technical issues related to manufacturing limitations were resolved. Afterward, another approach was followed to take a decision on the configured alarms database. So, a couple of meetings and workshops were held among all system stakeholders, which resulted in an agreement of disabling unnecessary (Diagnostic) alarms. Moreover, a leap forward step was taken to segregate the SCADA Operator Graphics in a way to show only process-related alarms while some other graphics will ensure the availability of field alarms related to maintenance and engineering purposes. This overall system management and optimization have resulted in a huge effective impact on all operations, maintenance, and engineering. It has reduced unneeded open tickets for maintenance crews which led to reduce the driven mileages accordingly. Also, this practice has shown a good impression on the operation reactions and response to the emergency situations as the SCADA operators can be staying much vigilant on the real alarms rather than gets distracted by noisy ones. SCADA System Alarms Optimization process has been executed utilizing all applicable in-house resources among engineering, maintenance, and operations crews. The methodology of the entire enhanced scopes is performed through various stages.

Keywords: SCADA, RTU Communication, alarm management system, SCADA alarms, Modbus, DNP protocol

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Authors: Tekalign Gidi Kure

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This paper addresses a range of serious problems involving higher education in Ethiopia. In spite of increased enrollment in higher education, educational quality is deteriorating afterwards. Thus, this paper tried to assess the role of social infrastructure in education for economic development of the country and examined major critical problems in higher education of Ethiopia such as higher education finance, curriculum development, and instructor’s career development. Primarily the paper discusses the fundamental contributions of social infrastructure in higher education to economic development; namely development of human capital, improved health, life expectancy, increased productivity, and personal saving, then, the paper examines critically higher education in three regimes of Ethiopia (Emperor Regime, Derg Regime and EPDRF/current government). Thus, four main questions were raised during this research: "What are the antecedents of Ethiopia Higher Education System under three regimes?", " what are the current and emerging higher educational needs in Ethiopia economic development?", " what are the role of private sector in addressing the gaps in the higher education of the country and its adverse effect on quality issues? ", and "what improvements are needed in higher education system of Ethiopia?". Documents from Ministry of Education in Ethiopia, National Statistical Abstracts, and Reports from the World Bank and other recognized institutions were used in addition to recent empirical researches conducted in the country. In doing so, care had been taken to reduce prejudiced reports by involving different reports from multiple sources. The paper concludes that during emperor system higher education enrollment was among the very lowest in the world, therefore, the skilled human resource available to guide development were little, but the cost was very high. During the Derg regime where an ideological change in the system penetrated into higher education resulted with the lack of a large amount of resources to support higher education; the war inside and outside the country diverts resources from the sector. The main purpose of this paper is not only to discuss the problems and issues of higher education in the past, but it also investigates the influence that the current expansion of higher education has on the finance, staff, and other resources for the quality of education. The paper concludes that higher education in Ethiopia are financed by government, outdated curriculum and lagging behind the standard regarding qualified staff. Finally, it provided inevitable solutions if the country wants to gain well record in quality of education as well.

Keywords: social infrastructure, higher education, ethiopia, education quality

Procedia PDF Downloads 519

Authors: Tomasz Robert Kuczerski

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The high complexity of the algorithm of the autonomous tandem detonator system creates an optimization problem due to the parallel operation of several machine states of the system. Many years of experience and classic analyses have led to a partially optimized model. Limitations on the energy resources of this class of autonomous systems make it necessary to search for more effective methods of optimisation. The use of the Quantum Approximate Optimization Algorithm (QAOA) in these studies shows the most promising results. With the help of multiple evaluations of several qubit quantum circuits, proper results of variable parameter optimization were obtained. In addition, it was observed that the increase in the number of assessments does not result in further efficient growth due to the increasing complexity of optimising variables. The tests confirmed the effectiveness of the QAOA optimization method.

Keywords: algorithm analysis, autonomous system, quantum optimization, tandem detonator

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Authors: Clement Temaneh-Nyah, Josiah Makiche, Josephine Nujoma

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This paper considers the characterisation of a complex electromagnetic environment due to multiple sources of electromagnetic radiation as a five-dimensional surface which can be described by a set of several surface sections including: instant EM field intensity distribution maps at a given frequency and altitude, instantaneous spectrum at a given location in space and the time evolution of the electromagnetic field spectrum at a given point in space. This characterization if done over time can enable the exposure levels of Radio Frequency Radiation at every point in the analysis area to be determined and results interpreted based on comparison of the determined RFR exposure level with the safe guidelines for general public exposure given by recognised body such as the International commission on non-ionising radiation protection (ICNIRP), Institute of Electrical and Electronic Engineers (IEEE), the National Radiation Protection Authority (NRPA).

Keywords: complex electromagnetic environment, electric field strength, mathematical models, multiple sources

Procedia PDF Downloads 366