Search results for: use case specification
10955 A Case of Generalized Anxiety Disorder (GAD)
Authors: Muhammad Zeeshan
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This case study is about a 54 years man named Mr. U, referred to Capital Hospital, Islamabad, with the presenting complaints of Generalized Anxiety Disorder (GAD). Contrary to his complaints, the client reported psychological symptoms such as restlessness, low mood and fear of darkness and fear from closed places from the last 30 days. He also had a fear of death and his existence in the grave. His sleep was also disturbed due to excessive urination due to diabetes. He was also suffering from semantic symptoms such as headache, numbness of feet and pain in the chest and blockage of the nose. A complete history was taken and informal assessment (clinical interview and MSE) and formal testing (BAI) was applied that showed the clear diagnosis of Generalized Anxiety Disorder. CBT, relaxation techniques, prayer chart and behavioural techniques were applied for the treatment purposes.Keywords: generalized anxiety disorder, presenting complaints, formal and informal assessment, diagnosis
Procedia PDF Downloads 28510954 Teleconsultations and The Need of Onsite Additional Medical Services
Authors: Cristina Hotoleanu
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Introduction: The recent Covid-19 pandemic accelerated the development of e-health, including telemedicine, smartphone applications, and medical wearable devices. Providing remote teleconsultations supposes challenges which may require further face-to-face medical interactions. The aim of this study was to assess the correlation between the types of teleconsultations and the need of onsite medical services (investigations and medical visits) for the diagnosis and treatment. Methods: a retrospective study including all the teleconsultations using the platform offered by a telehealth provider in Romania (Telios Care SA) between May 1, 2021- April 30, 2022, was performed. Binary data were analysed using the chi-square test with a significance level of p < 0.05. Results: out of 7163 consultations, 3961 were phone calls, 1981 were online messages, and 1221 were video calls. Onsite medical services were indicated in 3327 (46.44%) cases; the onsite investigations or the onsite visits were recommended for 2908 patients as follows: 2326 in case of phone calls, 582 in case of online messages, none in case of video calls. Both onsite investigations and visits were indicated for 419 patients. The need for onsite additional medical services was significantly higher in the case of phone calls than in the other 2 types of teleconsultations (Chi square= 1207.06, p= 0.00001). The indication for onsite services was done mainly after teleconsultations covering medical specialties (87.34%), significantly higher than the other specialties (Chi square=914.59, p=0.00001). Teleconsultations in surgical specialties and other fields (pharmacy, dentistry, psychology, wellbeing- nutrition, fitness) resulted in 12.13%, respective less than 1%, indication for onsite investigations or visits, explained by using of video calls in most of the cases. Conclusion: a further onsite medical service was necessary in less than a half of the teleconsultations. This indication was done mainly after phone calls and teleconsultations in medical specialties. Video calls were used mostly in psychology, nutrition, and fitness teleconsultations and did not require a further onsite medical service. Other studies are necessary to assess better the types of teleconsultations and the specialties bringing the biggest benefit for the patients.Keywords: onsite medical services, phone calls, teleconsultations, telemedicine
Procedia PDF Downloads 10110953 Guidelines for Proper Internal Control of Internet Payment: A Case Study of Internet Payment Gateway, Thailand
Authors: Pichamon Chansuchai
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The objective of this research were to investigate electronic payment system on the internet and offer the guidelines for proper internal control of the payment system based on international standard security control (ISO/IEC 17799:2005),in a case study of payment of the internet, Thailand. The guidelines covered five important areas: (1) business requirement for access control, (2) information systems acquisition, development and maintenance, (3) information security incident management, (4) business continuity management, and (5) compliance with legal requirement. The findings from this qualitative study revealed the guidelines for proper internet control that were more reliable and allow the same line of business to implement the same system of control.Keywords: audit, best practice, internet, payment
Procedia PDF Downloads 49910952 Analyzing the Economic Impact and Stakeholder Perception of Destination Promotion: A Case Study of the First City on the Mississippi as 'True North'
Authors: Kelly La Venture
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Destination promotion has become increasingly important to economic development in the United States. Key stakeholders of the First City on the Mississippi recognizes the importance of the visitor economy and decided to invest in destination promotion of the city as ‘True North’. The purpose of the study was to analyze the economic impact and stakeholder perceptions of destination promotion of the First City on the Mississippi as ‘True North’ using the case study method. Using a semi-structured guide consisting of 8 questions and additional probing questions, investigators engaged in 30-90 minute interviews with 20 key stakeholders. Data captured was then subjected to thematic analysis and interpretation. Through a review of literature and interview analysis, data indicate(1) there is increasing value in the visitor economy of the First City on the Mississippi,(2) the visitor economy warrants investments in destination promotion,(3) economic development can be more effective through coordination of destination promotion of as ‘True North’ and,(4) destination promotion fuels development across the entire economic spectrum. As a result, the First City on the Mississippi should prioritize marketing efforts of as ‘True North’ and coordinate these efforts with economic development initiatives. The destination promotion of the First City on the Mississippi as ‘True North’ may raise the communities profile and open doors to increased tourism, business relocation, business expansion, and entrepreneurs ready to start up a new organization.Keywords: case study method, destination promotion, economic development, leisure and business travel
Procedia PDF Downloads 29510951 Satisfaction Evaluation on the Fundamental Public Services for a Large-Scale Indemnificatory Residential Community: A Case Study of Nanjing
Authors: Dezhi Li, Peng Cui, Bo Zhang, Tengyuan Chang
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In order to solve the housing problem for the low-income families, the construction of affordable housing is booming in China. However, due to various reasons, the service facilities and systems in the indemnificatory residential community meet many problems. This article established a Satisfaction Evaluation System of the Fundamental Public Services for Large-scale Indemnificatory Residential Community based on the national standards and local criteria and developed evaluation methods and processes. At last, in the case of Huagang project in Nanjing, the satisfaction of basic public service is calculated according to a survey of local residents.Keywords: indemnificatory residential community, public services, satisfaction evaluation, structural equation modeling
Procedia PDF Downloads 36210950 The Light-Effect in Cylindrical Quantum Wire with an Infinite Potential for the Case of Electrons: Optical Phonon Scattering
Authors: Hoang Van Ngoc, Nguyen Vu Nhan, Nguyen Quang Bau
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The light-effect in cylindrical quantum wire with an infinite potential for the case of electrons, optical phonon scattering, is studied based on the quantum kinetic equation. The density of the direct current in a cylindrical quantum wire by a linearly polarized electromagnetic wave, a DC electric field, and an intense laser field is calculated. Analytic expressions for the density of the direct current are studied as a function of the frequency of the laser radiation field, the frequency of the linearly polarized electromagnetic wave, the temperature of system, and the size of quantum wire. The density of the direct current in cylindrical quantum wire with an infinite potential for the case of electrons – optical phonon scattering is nonlinearly dependent on the frequency of the linearly polarized electromagnetic wave. The analytic expressions are numerically evaluated and plotted for a specific quantum wire, GaAs/GaAsAl.Keywords: the light–effect, cylindrical quantum wire with an infinite potential, the density of the direct current, electrons-optical phonon scattering
Procedia PDF Downloads 34010949 Optimal Number of Reconfigurable Robots in a Transport System
Authors: Mari Chaikovskaia, Jean-Philippe Gayon, Alain Quilliot
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We consider a fleet of elementary robots that can be connected in different ways to transport loads of different types. For instance, a single robot can transport a small load, and the association of two robots can either transport a large load or two small loads. We seek to determine the optimal number of robots to transport a set of loads in a given time interval, with or without reconfiguration. We show that the problem with reconfiguration is strongly NP-hard by a reduction to the bin-packing problem. Then, we study a special case with unit capacities and derive simple formulas for the minimum number of robots, up to 3 types of loads. For this special case, we compare the minimum number of robots with or without reconfiguration and show that the gain is limited in absolute value but may be significant for small fleets.Keywords: fleet sizing, reconfigurability, robots, transportation
Procedia PDF Downloads 8610948 A Levelized Cost Analysis for Solar Energy Powered Sea Water Desalination in the Arabian Gulf Region
Authors: Abdullah Kaya, Muammer Koc
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A levelized cost analysis of solar energy powered seawater desalination in The Emirate of Abu Dhabi is conducted to show that clean and renewable desalination is economically viable. The Emirate heavily relies on seawater desalination for its freshwater needs due to limited freshwater resources available. This trend is expected to increase further due to growing population and economic activity, rapid decline in limited freshwater reserves, and aggravating effects of climate change. Seawater desalination in Abu Dhabi is currently done through thermal desalination technologies such as multi-stage flash (MSF) and multi-effect distillation (MED) which are coupled with thermal power plants known as co-generation. Our analysis indicates that these thermal desalination methods are inefficient regarding energy consumption and harmful to the environment due to CO₂ emissions and other dangerous byproducts. Therefore, utilization of clean and renewable desalination options has become a must for The Emirate for the transition to a sustainable future. The rapid decline in the cost of solar PV system for energy production and RO technology for desalination makes the combination of these two an ideal option for a future of sustainable desalination in the Emirate of Abu Dhabi. A Levelized cost analysis for water produced by solar PV + RO system indicates that Abu Dhabi is well positioned to utilize this technological combination for cheap and clean desalination for the coming years. It has been shown that cap-ex cost of solar PV powered RO system has potential to go as low as to 101 million US $ (1111 $/m³) at best case considering the recent technological developments. The levelized cost of water (LCW) values fluctuate between 0.34 $/m³ for the baseline case and 0.27 $/m³ for the best case. Even the highly conservative case yields LCW cheaper than 100% from all thermal desalination methods currently employed in the Emirate. Exponential cost decreases in both solar PV and RO sectors along with increasing economic scale globally signal the fact that a cheap and clean desalination can be achieved by the combination of these technologies.Keywords: solar PV, RO desalination, sustainable desalination, levelized cost of analysis, Emirate of Abu Dhabi
Procedia PDF Downloads 16310947 Surgical Management of Cystic Lesions in the Sellar and Suprasellar Region
Authors: Hakim Derradji, Abdelkader Yahi, Abdelmalek Sabrou, Nacer Tabet
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Introduction: Cystic lesions located in the sellar and suprasellar region cause a diagnostic and therapeutic problem, given their location and their impact on neighboring structures. The patient's symptomatology varies from a simple headache to serious visual and endocrine disorders, involving the functional prognosis, sometimes even the vital prognosis. Surgery in this region remains a therapeutic challenge, and several surgical techniques have been described and used. Material and Methods: We treated 15 patients during the period from 2015 to 2022, whose clinical, biological, radiological, and therapeutic characteristics will be presented in detail in this work, and in whom the surgical technique differs from one case to another. Conclusion: We will discuss in this work the different techniques used to treat these lesions and the different objectives to be achieved for each case, as well as the complications and our conduct to be taken per and post-operative.Keywords: cystic lesions, adenomas, sellar and suprasellar region, neuroendoscopy
Procedia PDF Downloads 10810946 Case Study of Child Labour in Pakistan
Authors: Ahmad Ali Ansari, Hassan Arshad, Basharat Hussani, Adnan Raza, Ahmad Ali Khan
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Child labor is a kind of an issue which was found all over the world, but now the first world countries like countries in Europe and America (USA) got hold of it up to a large extent but Underdeveloped or the developing countries including Pakistan are still a victim of this issue. The following attempt has been made in this research article to figure out the main reasons of child labor in underdeveloped countries especially in Pakistan and also some of the issues are discussed which are hindering the solution of child labor in Pakistan. In this research we interviewed 70 working children in the area of Rawalpindi, Islamabad, Taxila and Hatar who belonged to the different parts of the country and figured out the basic causes of the child labor in Pakistan, what are its bad effects on the young one who is a victim of it and we also put a light on what the government of Pakistan is doing in this context and what the government still have to do.Keywords: child labour, Pakistan, case study, underdeveloped countries
Procedia PDF Downloads 66310945 Two Cases of VACTERL Association in Pregnancy with Lymphocyte Therapy
Authors: Seyed Mazyar Mortazavi, Masod Memari, Hasan Ali Ahmadi, Zhaleh Abed
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Introduction: VACTERL association is a rare disorder with various congenital malformations. The aetiology remains unknown. Combination of at least three congenital anomalies of the following criteria is required for diagnosis: vertebral defects, anal atresia, cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and limb defects. Case presentation: The first case was 1-day old male neonate with multiple congenital anomalies was bore from 28 years old mother. The mother had history of pregnancy with lymphocyte therapy. His anomalies included: defects in thoracic and lumbar vertebral, anal atresia, bilateral hydronephrosis, atrial septal defect, and lower limb abnormality. Other anomalies were cryptorchidism and nasal canal narrowing. The second case was born with 32 weeks gestational age from mother with history of pregnancy with lymphocyte therapy. He had thoracic vertebral defect, cardiac anomalies and renal defect. Conclusion: diagnosis based on clinical finding is VACTERL association. Early diagnosis is very important to investigation and treatment of other coexistence anomalies. VACTERL association in mothers with history of pregnancy with lymphocyte therapy has suggested possibly of relationship between VACTERL association and this method of pregnancy.Keywords: anal atresia, tracheo-esophageal fistula, atrial septal defect, lymphocyte therapy
Procedia PDF Downloads 45310944 Occupational Attainment of Second Generation of Ethnic Minority Immigrants in the UK
Authors: Rukhsana Kausar, Issam Malki
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The integration and assimilation of ethnic minority immigrants (EMIs) and their subsequent generations remains a serious unsettled issue in most of the host countries. This study conducts the labour market gender analysis to investigate specifically whether second generation of ethnic minority immigrants in the UK is gaining access to professional and managerial employment and advantaged occupational positions on par with their native counterparts. The data used to examine the labour market achievements of EMIs is taken from Labour Force Survey (LFS) for the period 2014-2018. We apply a multivalued treatment under ignorability as proposed by Cattaneo (2010), which refers to treatment effects under the assumptions of (i) selection – on – observables and (ii) common support. We report estimates of Average Treatment Effect (ATE), Average Treatment Effect on the Treated (ATET), and Potential Outcomes Means (POM) using three estimators, including the Regression Adjustment (RA), Augmented Inverse Probability Weighting (AIPW) and Inverse Probability Weighting- Regression Adjustment (IPWRA). We consider two cases: the case with four categories where the first-generation natives are the base category, the second case combine all natives as a base group. Our findings suggest the following. Under Case 1, the estimated probabilities and differences across groups are consistently similar and highly significant. As expected, first generation natives have the highest probability for higher career attainment among both men and women. The findings also suggest that first generation immigrants perform better than the remaining two groups, including the second-generation natives and immigrants. Furthermore, second generation immigrants have higher probability to attain higher professional career, while this is lower for a managerial career. Similar conclusions are reached under Case 2. That is to say that both first – generation and second – generation immigrants have a lower probability for higher career and managerial attainment. First – generation immigrants are found to perform better than second – generation immigrants.Keywords: immigrnats, second generation, occupational attainment, ethnicity
Procedia PDF Downloads 10610943 Study of Seismic Behavior of an Earth Dam with Sealing Walls: The Case of Kef Eddir’s Dam, Tipaza, Algeria
Authors: M. Boumaiza, S. Mohamadi, B. Moussai
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In this article the study of the seismic response of an earth dam with sealing walls has been made by introducing the effect of the change of position and depth of the sealing wall and the effect of non-linear behavior of soil of the foundation by taking into account the variation of the viscous damping and shear modulus in each layer of soil on the seismic response of the dam. As a case study, we take the Algerian dam Kef-Eddir which lies in the far west of the territory of the Wilaya of Tipaza (wadi Eddamous), classified according to the RPA 2003 as a high seismicity zone (zone III). With a height of 71m above the foundation and a width of 478m. The seismic event applied to the rock, is the earthquake of Chenoua (29 October, 1989), with a magnitude Mw=6 that hit the region.Keywords: earth dam, earthquake, sealing walls, viscous damping
Procedia PDF Downloads 60710942 Observing Vocabulary Teaching Strategies in English Classrooms in Saudi Schools
Authors: Mohammed Hassan Alshaikhi
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Teaching vocabulary is a fundamental step in helping students to develop a good grasp of language. Exploring new strategies is an essential part of improving the teaching of vocabulary. The study aimed to explore the teaching vocabulary strategies in Saudi primary classrooms (aged 11 and 12 years old) in Jeddah, Saudi Arabia. The study was based on qualitative data collected from a large-scale case study, which utilised observations at eight male state and private primary schools during the academic year 2016-2017. The observations were transcribed, coded and entered into Nvivo software to be organised and analysed. Varying teaching vocabulary strategies were explored, and then they were circulated to many English teachers to be used in their classes.Keywords: case study, English language, Saudi teachers, teaching vocabulary strategies
Procedia PDF Downloads 37310941 Challenges of Management of Subaortic Membrane in a Young Adult Patient: A Case Review and Literature Review
Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran
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This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure
Procedia PDF Downloads 10010940 Organizational Innovativeness: Motivation in Employee’s Innovative Work Behaviors
Authors: P. T. Ngan
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Purpose: The study aims to answer the question what are motivational conditions that have great influences on employees’ innovative work behaviors by investigating the case of SATAMANKULMA/ Anya Productions Ky in Kuopio, Finland. Design/methodology: The main methodology utilized was the qualitative single case study research, analysis was conducted with an adapted thematic content analysis procedure, created from empirical material that was collected through interviews, observation and document review. Findings: The paper highlights the significance of combining relevant synergistic extrinsic and intrinsic motivations into the organizational motivation system. The findings show that intrinsic drives are essential for the initiation phases while extrinsic drives are more important for the implementation phases of innovative work behaviors. The study also offers the IDEA motivation model-interpersonal relationships & networks, development opportunities, economic constituent and application supports as an ideal tool to optimize business performance. Practical limitations/ implications: The research was only conducted from the perspective of SATAMANKULMA/Anya Productions Ky, with five interviews, a few observations and with several reviewed documents. However, further research is required to include other stakeholders, such as the customers, partner companies etc. Also the study does not offer statistical validity of the findings; an extensive case study or a qualitative multiple case study is suggested to compare the findings and provide information as to whether IDEA model relevant in other types of firms. Originality/value: Neither the innovation nor the human resource management field provides a detailed overview of specific motivational conditions might use to stimulate innovative work behaviors of individual employees. This paper fills that void.Keywords: employee innovative work behaviors, extrinsic motivation, intrinsic motivation, organizational innovativeness
Procedia PDF Downloads 26710939 The Great Mimicker: A Case of Disseminated Tuberculosis
Authors: W. Ling, Mohamed Saufi Bin Awang
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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis
Procedia PDF Downloads 18910938 Academic Freedom Policy: A Case Study
Authors: Marlin Killen
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The American Association of University Professors (AAUP) describes academic freedom as essential to the purposes of research and teaching. The importance of academic freedom as a bedrock foundation that supports the work of the professoriate cannot be overstated, and there have been innumerable challenges that have attempted to curtail it. These challenges come from a variety of sources that span legal, ethical, cultural, institutional, and professional perspective and are amplified by social media, traditional media, and political action efforts. Because of these challenges, the development of a comprehensive institutional policy on academic freedom that addresses the principles, practices, and appropriate responses to modern challenges can be a daunting task. This presentation will focus on a case study of a university’s effort to develop an updated, evolving policy on academic freedom that provides a framework and remedies for contemporary challenges to this critical function in higher education.Keywords: academic freedom, academic freedom policy, higher education policy
Procedia PDF Downloads 19910937 Case Study of Ground Improvement Solution for a Power Plant
Authors: Eleonora Di Mario
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This paper describes the application of ground improvement to replace a typical piled foundation scheme in a power plant in Singapore. Several buildings within the plant were founded on vibro-compacted sand, including a turbine unit which had extremely stringent requirements on the allowable settlement. The achieved savings in terms of cost and schedule are presented. The monitoring data collected during the operation of the turbine are compared to the design predictions to validate the design approach, and the quality of the ground improvement works. In addition, the calculated carbon footprint of the ground improvement works are compared to the piled solution, showing that the vibro-compaction has a significantly lower carbon footprint.Keywords: ground improvement, vibro-compaction, case study, sustainability, carbon footprint
Procedia PDF Downloads 10910936 Improving Operational Excellence Adopting TPM Practices in an Indian Automobile Industry: A Case Study
Authors: Pardeep Gupta
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The purpose of this paper is to present a case study on TPM implementation methodology and to highlight the benefits achieved after TPM in an engineering industry XYZ Ltd. (name changed) situated in Mohali, Punjab. The improvements in key performance indicators (PQCDSM) after implementing the TPM proved that its implementation helped the company significantly to achieve higher productivity, customer satisfaction, morale, and profits. The manufacturing cost reduced by 30%, overall equipment efficiency increased from 63% in 2010 to 84% after three years and productivity improved by 67%. The Company has won the TPM Excellence Award, Category-A in 2013 and after that continued implementing second phase of TPM. The findings of the study govern that the strategic TPM implementation can significantly contribute for the realization of operational excellence in almost all types of industry.Keywords: total productive maintenance, overall equipment efficiency, continuous improvement, manufacturing excellence, availability, TPM initiatives, productivity
Procedia PDF Downloads 39810935 Embodied Carbon Footprint of Existing Malaysian Green Homes
Authors: Fahanim Abdul Rashid, Muhammad Azzam Ismail
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Part and parcel of building green homes (GHs) with favorable thermal comfort (TC) is to design and build with reduced carbon footprint (CF) from embodied energy in the building envelope and reduced operational CF overall. Together, the environmental impact of GHs can be reduced significantly. Nevertheless, there is still a need to identify the base CF value for Malaysian GHs and this can be done by assessing existing ones which can then be compared to conventional and vernacular houses which are built differently with different building materials. This paper underlines the research design and introduces the case studies. For now, the operational CF of the case studies is beyond the scope of this study. Findings from this research could identify the best building material and construction technique combination to build GHs depending on the available skills, financial constraints and the condition of the immediate environment.Keywords: embodied carbon footprint, Malaysian green homes
Procedia PDF Downloads 34410934 Post-Operative Pain Management in Ehlers-Danlos Hypermobile-Type Syndrome Following Wisdom Teeth Extraction: A Case Report and Literature Review
Authors: Aikaterini Amanatidou
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We describe the case of a 20-year-old female patient diagnosed with Ehlers-Danlos Syndrome (EDS) who was scheduled to undergo a wisdom teeth extraction in outpatient surgery. EDS is a hereditary connective tissue disorder characterized by joint hypermobility, skin hyper-extensibility, and vascular and soft tissue fragility. There are six subtypes of Ehlers-Danlos, and in our case, the patient had EDS hyper-mobility (HT) type disorder. One important clinical feature of this syndrome is chronic pain, which is often poorly understood and treated. Our patient had a long history of articular and lumbar pain when she was diagnosed. She was prescribed analgesic treatment for acute and neuropathic pain and had multiple sessions of psychotherapy and physiotherapy to ease the pain. Unfortunately, her extensive medical history was underrated by our anesthetic team, and no further measures were taken for the operation. Despite an uneventful intra-operative phase, the patient experienced several episodes of hyperalgesia during the immediate post-operative care. Management of pain was challenging for the anesthetic team: initial opioid treatment had only a temporary effect and a paradoxical reaction after a while. Final pain relief was eventually obtained with psycho-physiologic treatment, high doses of ketamine, and patient-controlled analgesia infusion of morphine-ketamine-dehydrobenzperidol. We suspected an episode of Opioid-Induced hyperalgesia. This case report supports the hypothesis that anti-hyperalgesics such as ketamine as well as lidocaine, and dexmedetomidine should be considered intra-operatively to avoid opioid-induced hyperalgesia and may be an alternative solution to manage complex chronic pain like others in neuropathic pain syndromes.Keywords: Ehlers-Danlos, post-operative management, hyperalgesia, opioid-induced hyperalgesia, rare disease
Procedia PDF Downloads 9510933 Reverse Twin Block with Expansion Screw for Treatment of Skeletal Class III Malocclusion in Growing Patient: Case Report
Authors: Alfrina Marwan, Erna Sulistyawati
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Class III malocclusion shows both skeletal and dentoalveolar component. Sketal Class III malocclusion can have variants in different region, maxilla or mandibular. Skeletal Class III malocclusion during growth period is considered to treat to prevent its severity in adulthood. Orthopedics treatment of skeletal Class III malocclusion in growing patient can be treated by using reverse twin block with expansion screw to modify the growth pattern. The objective of this case report was to describe the functional correction of skeletal Class III maloclussion using reverse twin block with expansion screw in growing patient. A patient with concave profile came with a chief complaint of aesthetic problems. The cephalometric analysis showed that patient had skeletal Class III malocclusion (ANB -50, SNA 75º, Wits appraisal -3 mm) with anterior cross bite and deep bite (overjet -3 mm, overbite 6 mm). In this case report, the patient was treated with reverse twin block appliance with expansion screw. After three months of treatment, the skeletal problems have been corrected (ANB -1°), overjet, overbite and aesthetic were improved. Reverse twin block appliance with expansion screw can be used as orthopedics treatment for skeletal Class III malocclusion in growing patient and can improve the aesthetic with great satisfaction which was the main complaint in this patient.Keywords: maxilla retrognatism, reverse twin block, skeletal class III malocclusion, growing patient
Procedia PDF Downloads 19710932 Design and Implementation of Agricultural Machinery Equipment Scheduling Platform Based On Case-Based Reasoning
Authors: Wen Li, Zhengyu Bai, Qi Zhang
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The demand for smart scheduling platform in agriculture, particularly in the scheduling process of machinery equipment, is high. With the continuous development of agricultural machinery equipment technology, a large number of agricultural machinery equipment and agricultural machinery cooperative service organizations continue to appear in China. The large area of cultivated land and a large number of agricultural activities in the central and western regions of China have made the demand for smart and efficient agricultural machinery equipment scheduling platforms more intense. In this study, we design and implement a platform for agricultural machinery equipment scheduling to allocate agricultural machinery equipment resources reasonably. With agricultural machinery equipment scheduling platform taken as the research object, we discuss its research significance and value, use the service blueprint technology to analyze and characterize the agricultural machinery equipment schedule workflow, the network analytic method to obtain the demand platform function requirements, and divide the platform functions through the platform function division diagram. Simultaneously, based on the case-based reasoning (CBR) algorithm, the equipment scheduling module of the agricultural machinery equipment scheduling platform is realized; finally, a design scheme of the agricultural machinery equipment scheduling platform architecture is provided, and the visualization interface of the platform is established via VB programming language. It provides design ideas and theoretical support for the construction of a modern agricultural equipment information scheduling platform.Keywords: case-based reasoning, service blueprint, system design, ANP, VB programming language
Procedia PDF Downloads 17510931 Estimation of Fragility Curves Using Proposed Ground Motion Selection and Scaling Procedure
Authors: Esra Zengin, Sinan Akkar
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Reliable and accurate prediction of nonlinear structural response requires specification of appropriate earthquake ground motions to be used in nonlinear time history analysis. The current research has mainly focused on selection and manipulation of real earthquake records that can be seen as the most critical step in the performance based seismic design and assessment of the structures. Utilizing amplitude scaled ground motions that matches with the target spectra is commonly used technique for the estimation of nonlinear structural response. Representative ground motion ensembles are selected to match target spectrum such as scenario-based spectrum derived from ground motion prediction equations, Uniform Hazard Spectrum (UHS), Conditional Mean Spectrum (CMS) or Conditional Spectrum (CS). Different sets of criteria exist among those developed methodologies to select and scale ground motions with the objective of obtaining robust estimation of the structural performance. This study presents ground motion selection and scaling procedure that considers the spectral variability at target demand with the level of ground motion dispersion. The proposed methodology provides a set of ground motions whose response spectra match target median and corresponding variance within a specified period interval. The efficient and simple algorithm is used to assemble the ground motion sets. The scaling stage is based on the minimization of the error between scaled median and the target spectra where the dispersion of the earthquake shaking is preserved along the period interval. The impact of the spectral variability on nonlinear response distribution is investigated at the level of inelastic single degree of freedom systems. In order to see the effect of different selection and scaling methodologies on fragility curve estimations, results are compared with those obtained by CMS-based scaling methodology. The variability in fragility curves due to the consideration of dispersion in ground motion selection process is also examined.Keywords: ground motion selection, scaling, uncertainty, fragility curve
Procedia PDF Downloads 58310930 Smart Growth Through Innovation Programs: Challenges and Opportunities
Authors: Hanadi Mubarak Al-Mubaraki, Michael Busler
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Innovation is the powerful tools for economic growth and diversification, which lead to smart growth. The objective of this paper is to identify the opportunities and challenges of innovation programs discuss and analyse the implementation of the innovation program in the United States (US) and United Kingdom (UK). To achieve the objectives, the research used a mixed methods approach, quantitative (survey), and qualitative (multi-case study) to examine innovation best practices in developed countries. In addition, the selection of 4 interview case studies of innovation organisations based on the best practices and successful implementation worldwide. The research findings indicated the two challenges such as 1) innovation required business ecosystem support to deliver innovation outcomes such as new product and new services, and 2) foster the climate of innovation &entrepreneurship for economic growth and diversification. Although the two opportunities such as 1) sustainability of the innovation events which lead smart growth, and 2) establish the for fostering the artificial intelligence hub entrepreneurship networking at multi-levels. The research adds value to academicians and practitioners such as government, funded organizations, institutions, and policymakers. The authors aim to conduct future research a comparative study of innovation case studies between developed and developing countries for policy implications worldwide. The Originality of This study contributes to current literature about the innovation best practice in developed and developing countries.Keywords: economic development, technology transfer, entrepreneurship, innovation program
Procedia PDF Downloads 14510929 Preparation and Characterization of Supported Metal Nanocrystal Using Simple Heating Method for Renewable Diesel Synthesis from Nyamplung Oil (Calophyllum inophyllum Oil)
Authors: Aida Safiera, Andika Dwi Rubyantoro, Muhammad Bagus Prakasa
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Indonesia’s needs of diesel oil each year are increasing and getting urge. However, that problems are not supported by the amount of oil production that still low and also influenced by the fact of oil reserve is reduced. Because of that, the government prefers to import from other countries than fulfill the needs of diesel. To anticipate that problem, development of fuel based on renewable diesel is started. Renewable diesel is renewable alternative fuel that is hydrocarbon derivative from decarbonylation of non-edible oil. Indonesia is rich with natural resources, including nyamplung oil (Calophyllum inophyllum oil) and zeolite. Nyamplung oil (Calophyllum inophyllum oil) has many stearic acids which are useful on renewable diesel synthesis meanwhile zeolite is cheap. Zeolite is many used on high temperature reaction and cracking process on oil industry. Zeolite also has advantages which are a high crystallization, surface area and pores. In this research, the main focus that becomes our attention is on preparation and characterization of metal nanocrystal. Active site that used in this research is Nickel Molybdenum (NiMo). The advantage of nanocrystal with nano scale is having larger surface area. The synthesis of metal nanocrystal will be done with conventional preparation modification method that is called simple heating. Simple heating method is a metal nanocrystal synthesis method using continuous media which is polymer liquid. This method is a simple method and produces a small particles size in a short time. Influence of metal nanocrystal growth on this method is the heating profile. On the synthesis of nanocrystal, the manipulated variables are temperature and calcination time. Results to achieve from this research are diameter size on nano scale (< 100 nm) and uniform size without any agglomeration. Besides that, the conversion of synthesis of renewable diesel is high and has an equal specification with petroleum diesel. Catalyst activities are tested by FT-IR and GC-TCD on decarbonylation process with a pressure 15 bar and temperature 375 °C. The highest conversion from this reaction is 35% with selectivity around 43%.Keywords: renewable diesel, simple heating, metal nanocrystal, NiMo, zeolite
Procedia PDF Downloads 23010928 Using the Countryside to Absorb Urban Political Youth: The Cultural Revolution, Ballet, and Discontent
Authors: Eva Chou
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This paper presents a case study of a historical moment in the city vs countryside relationship that is important in urban studies in China. Policies during the Cultural Revolution in China (1966-76) several times sent educated urban youths to the countryside. Initially, they were sent to “make revolution”: they were instructed to instigate powerful disruptions of established village relations. Later, they were “sent-down” to the countryside “to learn from the peasants.” Millions of urban youths “volunteered” to live as peasants did in the poverty of the countryside, thus resolving a political problem of urban unrest for the Party. Many had remained for decades before they were able to leave; others were never re-urbanized. Ballet troupes constituted a special case in both of these periods. This paper examines the differing experiences of individual “sent-down” ballet dancers on the one hand, and on the other hand, ballet troupes assigned to perform in the countryside.Keywords: cultural revolution, reurbanized, sent-down youths, ballet
Procedia PDF Downloads 28910927 The Extent of Proliferation, Apoptosis and Angiogenesis at the Site of Injury Determine the Course of Healing Either as Scar Free or as Scarred One in the Appendages of Lizard
Authors: Isha Ranadive, Sonam Patel, Suresh Balakrishnan
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It has been observed that in lizards wound can be healed by either a scar free mechanism or by scarring. The animal model used to study both these healing processes was Northern House Gecko. In lizard, the tail when amputated heals by scar free mechanism which allows it to regenerate, the same is not seen when the limb is amputated. Proliferation, apoptosis, and angiogenesis are the main events which succeed an injury. We observed that proliferation of the cells beneath the wound epidermis was much higher in case of wound healing in tail. This could be because after the wound gets covered by the epithelium, it enters in to a cross-talk with the underlying mesenchyme to recruit a pool of blastemal cells which proliferate and later differentiate to form the lost part through epimorphic regeneration. This was substantiated by mRNA expression levels of various FGFs which facilitate the cross-talk and also by PCNA which is a marker for proliferation. Western blot result reaffirms the same notion. However, in case of the limb, the rate of apoptosis was more than proliferation as there are a lot of debris that needs to be removed. We came to this conclusion as we observed that p53 the apoptotic gene was highly upregulated in case of the scarred tissue. Further, we confirmed this result by checking the anti-apoptotic gene bcl2 and found it to be significantly down-regulated. As we noticed heightened proliferation in the case of scar-free wound healing in tail, angiogenesis was targeted for the study. This is because, when the cells are proliferating they require constant supply of blood and hence neo-vascularization is inevitable. It was observed that the marker of angiogenesis, VEGF, was expressed more during wound healing as compared to the resting stage of tail. Moreover, a high up-regulation was seen in KDR, a receptor of VEGF. Thus, this study reveals how proliferation, apoptosis, and angiogenesis play a key role in the scar-free as well as scarred wound healing.Keywords: epimorphic regeneration, injury, northern house gecko, wound healing
Procedia PDF Downloads 24510926 Heat Loss Control in Stave Cooled Blast Furnace by Optimizing Gas Flow Pattern through Burden Distribution
Authors: Basant Kumar Singh, S. Subhachandhar, Vineet Ranjan Tripathi, Amit Kumar Singh, Uttam Singh, Santosh Kumar Lal
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Productivity of Blast Furnace is largely impacted by fuel efficiency and controlling heat loss is one of the enabling parameters for achieving lower fuel rate. 'I' Blast Furnace is the latest and largest Blast Furnace of Tata Steel Jamshedpur with working volume of 3230 m³ and with rated capacity of 3.055 million tons per annum. Optimizing heat losses in Belly and Bosh zone remained major challenge for blast furnace operators after its commissioning. 'I' Blast has installed Cast Iron & Copper Staves cooling members where copper staves are installed in Belly, Bosh & Lower Stack whereas cast iron staves are installed in upper stack area. Stave cooled Blast Furnaces are prone to higher heat losses in Belly and Bosh region with an increase in coal injection rate as Bosh gas volume increases. Under these conditions, managing gas flow pattern through proper burden distribution, casting techniques & by maintaining desired raw material qualities are of utmost importance for sustaining high injection rates. This study details, the burden distribution control by Ore & Coke ratio adjustment at wall and center of Blast Furnace as the coal injection rates increased from 140 kg/thm to 210 kg/thm. Control of blowing parameters, casting philosophy, specification for raw materials & devising operational practice for controlling heat losses is also elaborated with the model that is used to visualize heat loss pattern in different zones of Blast Furnace.Keywords: blast furnace, staves, gas flow pattern, belly/bosh heat losses, ore/coke ratio, blowing parameters, casting, operation practice
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