Search results for: environmental cases
10350 Ocular Biometry: Common Etiologies of Difference More Than 0.33mm between Axial Lengths of the 2 Eyes
Authors: Ghandehari Motlagh, Mohammad
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Purpose: We tried to find the most common etiologies for anisometropia in pre-op cataract cases: axial or refractive. Methods: In this cross-sectional study ,41 pre-op cataract eyes with more than 0.33 difference between axial lengths of 2 eyes were enrolled.Considered for each 1mm difference between axial lengths in long eyes( AXL more than 25):1.75-2.00 D of anisometropia, for normal eyes(AXL: 22- 25):2.50D and for short eyes (AXL less than 22):3.50-3.75 D as axial anisometropia. If there are more or lesser anisometropia, we recorded as refractive anisometropia. Results: Average of anisometropia :4.24 D, prevalence of PK or LK :1 (2.38%), kc:1(2.38%), glaucoma surgery: 1(2.38%), and pseudophakic status of the opposite eye 8(19.04%). Prevalence of axial anisometropia:21 (52.4%) and refractive anisometropia 20(47.6%).Then on basis of this study we can rely on the patient’s refraction exactly before phaco for evaluation of axial length differences between the 2 eyes, because most of the anisometropias are axial. Conclusion: In most cases, cataract does not induce significant change in refractive error (secondary myopia) and AXL difference between the 2 eyes are correlated with anisometropia.so it can be used for cataract patient’s ocular biometry evaluation. Pre-cataract refraction is a valuable variable should be measured and recorded in routin eye examination.Keywords: ocular axial length, anisometropia, cataract, ophthalmology and optometry
Procedia PDF Downloads 38110349 Lateral Retroperitoneal Transpsoas Approach: A Practical Minimal Invasive Surgery Option for Treating Pyogenic Spondylitis of the Lumbar Vertebra
Authors: Sundaresan Soundararajan, Chor Ngee Tan
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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF
Procedia PDF Downloads 17710348 The Use of Regional Blocks Versus IV Opioid Analgesics for Acute Traumatic Pain Management in the Emergency Department
Authors: Lajeesh Jabbar, Shibu T. Varghese
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Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures
Procedia PDF Downloads 42010347 Place of Radiotherapy in the Treatment of Intracranial Meningiomas: Experience of the Cancer Center Emir Abdelkader of Oran Algeria
Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.
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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.Keywords: diagnosis, meningioma, surgery, radiotherapy, survival
Procedia PDF Downloads 10110346 The Effect of Simultaneous Application of Laser Beam and Magnet in Treatment of Intervertebral Disc Herniation
Authors: Alireza Moghtaderi, Negin Khakpour
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Disc Herniation is a common complication in the society and it is one of the main reasons for referring to physical medicine and rehabilitation clinics. Despite of various methods proposed for treatingthis disease, still there is disagreement on success of these methods especially in non-surgical methods, and thus current study aims at determining effect of laser beam and magnet on treatment of Intervertebral Disc Herniation. During a clinical trial study, 80 patients with Intervertebral Disc Herniation underwent a combined package of treatment including magnet, laser beam, PRP and Prolotherapy during 6 months. Average age of patients was 51.25 ± 10.7 with range of 25 – 71 years. 30 men (37.5%) and 50 women (62.5%) took part in the study. average weight of patients was 64.3 ± 7.2 with range of 49 – 79 kg. highest level of Disc Herniation was L5 – S1 with frequency of 17 cases (21.3%). Disc Herniation was severe in 30 cases before treatment, but it reduced to 3 casesafter treatment. This study indicates effect of combined treatment using non-invasive laser beam and magnet therapy on disco genic diseases and mechanical pains of spine is highly effective.Keywords: hallux, valgus, botulinum toxin a, pain
Procedia PDF Downloads 9210345 The Influence of Applying Mechanical Chest Compression Systems on the Effectiveness of Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest
Authors: Slawomir Pilip, Michal Wasilewski, Daniel Celinski, Leszek Szpakowski, Grzegorz Michalak
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The aim of the study was to evaluate the effectiveness of cardiopulmonary resuscitation taken by Medical Emergency Teams (MET) at the place of an accident including the usage of mechanical chest compression systems. In the period of January-May 2017, there were 137 cases of a sudden cardiac arrest in a chosen region of Eastern Poland with 360.000 inhabitants. Medical records and questionnaires filled by METs were analysed to prove the effectiveness of cardiopulmonary resuscitations that were considered to be effective when an early indication of spontaneous circulation was provided and the patient was taken to hospital. A chest compression system used by METs was applied in 60 cases (Lucas3 - 34 patients; Auto Pulse - 24 patients). The effectiveness of cardiopulmonary resuscitation among patients who were employed a chest compression system was much higher (43,3%) than the manual cardiac massage (36,4%). Thus, the usage of Lucas3 chest compression system resulted in 47% while Auto Pulse was 33,3%. The average ambulance arrival time could have had a significant impact on the subsequent effectiveness of cardiopulmonary resuscitation in these cases. Ambulances equipped with Lucas3 reached the destination within 8 minutes, and those with Auto Pulse needed 12,1 minutes. Moreover, taking effective basic life support (BLS) by bystanders before the ambulance arrival was much more frequent for ambulances with Lucas3 than Auto Pulse. Therefore, the percentage of BLS among the group of patients who were employed Lucas3 by METs was 26,5%, and 20,8% for Auto Pulse. The total percentage of taking BLS by bystanders before the ambulance arrival resulted in 25% of patients who were later applied a chest compression system by METs. Not only was shockable cardiac rhythm obtained in 47% of these cases, but an early indication of spontaneous circulation was also provided in all these patients. Both Lucas3 and Auto Pulse were evaluated to be significantly useful in improving the effectiveness of cardiopulmonary resuscitation by 97% of Medical Emergency Teams. Therefore, implementation of chest compression systems essentially makes the cardiopulmonary resuscitation even more effective. The ambulance arrival time, taking successful BLS by bystanders before the ambulance arrival and the presence of shockable cardiac rhythm determine an early indication of spontaneous circulation among patients after a sudden cardiac arrest.Keywords: cardiac arrest, effectiveness, mechanical chest compression systems, resuscitation
Procedia PDF Downloads 25010344 Ozone Therapy for Disc Herniation: A Non-surgical Option
Authors: Shahzad Karim Bhatti
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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.Keywords: pain, prolapse, Ozone, backpain
Procedia PDF Downloads 3010343 Evaluation of the Architect-Friendliness of LCA-Based Environmental Impact Assessment Tools
Authors: Elke Meex, Elke Knapen, Griet Verbeeck
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The focus of sustainable building is gradually shifting from energy efficiency towards the more global environmental impact of building design during all life-cycle stages. In this context, many tools have been developed that use a LCA-approach to assess the environmental impact on a whole building level. Since the building design strongly influences the final environmental performance and the architect plays a key role in the design process, it is important that these tools are adapted to his work method and support the decision making from the early design phase on. Therefore, a comparative evaluation of the degree of architect-friendliness of some LCA tools on building level is made, based on an evaluation framework specifically developed for the architect’s viewpoint. In order to allow comparison of the results, a reference building has been designed, documented for different design phases and entered in all software tools. The evaluation according to the framework shows that the existing tools are not very architect-friendly. Suggestions for improvement are formulated.Keywords: architect-friendliness, design supportive value, evaluation framework, tool comparison
Procedia PDF Downloads 54210342 The Agri-Environmental Instruments in Agricultural Policy to Reduce Nitrogen Pollution
Authors: Flavio Gazzani
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Nitrogen is an important agricultural input that is critical for the production. However, the introduction of large amounts of nitrogen into the environment has a number of undesirable impacts such as: the loss of biodiversity, eutrophication of waters and soils, drinking water pollution, acidification, greenhouse gas emissions, human health risks. It is a challenge to sustain or increase food production and at the same time reduce losses of reactive nitrogen to the environment, but there are many potential benefits associated with improving nitrogen use efficiency. Reducing nutrient losses from agriculture is crucial to the successful implementation of agricultural policy. Traditional regulatory instruments applied to implement environmental policies to reduce environmental impacts from nitrogen fertilizers, despite some successes, failed to address many environmental challenges and imposed high costs on the society to achieve environmental quality objectives. As a result, economic instruments started to be recognized for their flexibility and cost-effectiveness. The objective of the research project is to analyze the potential for increased use of market-based instruments in nitrogen control policy. The report reviews existing knowledge, bringing different studies together to assess the global nitrogen situation and the most relevant environmental management policy that aims to reduce pollution in a sustainable way without affect negatively agriculture production and food price. This analysis provides some guidance on how different market based instruments might be orchestrated in an overall policy framework to the development and assessment of sustainable nitrogen management from the economics, environmental and food security point of view.Keywords: nitrogen emissions, chemical fertilizers, eutrophication, non-point of source pollution, dairy farm
Procedia PDF Downloads 32910341 Oncological and Antiresorptive Treatment of Breast Cancer: Dental Assessment and Risk of MRONJ Development
Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell
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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ
Procedia PDF Downloads 8910340 The Silent Tuberculosis: A Case Study to Highlight Awareness of a Global Health Disease and Difficulties in Diagnosis
Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das
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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge
Procedia PDF Downloads 19410339 The Environmental Impact Assessment of Land Use Planning (Case Study: Tannery Industry in Al-Garma District)
Authors: Husam Abdulmuttaleb Hashim
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The environmental pollution problems represent a great challenge to the world, threatening to destroy all the evolution that mankind has reached, the organizations and associations that cares about environment are trying to warn the world from the forthcoming danger resulted from excessive use of nature resources and consuming it without looking to the damage happened as a result of unfair use of it. Most of the urban centers suffers from the environmental pollution problems and health, economic, and social dangers resulted from this pollution, and while the land use planning is responsible for distributing different uses in urban centers and controlling the interactions between these uses to reach a homogeneous and perfect state for the different activities in cities, the occurrence of environmental problems in the shade of existing land use planning operation refers to the disorder or insufficiency in this operation which leads to presence of such problems, and this disorder lays in lack of sufficient importance to the environmental considerations during the land use planning operations and setting up the master plan, so the research start to study this problem and finding solutions for it, the research assumes that using accurate and scientific methods in early stages of land use planning operation will prevent occurring of environmental pollution problems in the future, the research aims to study and show the importance of the environmental impact assessment method (EIA) as an important planning tool to investigate and predict the pollution ranges of the land use that has a polluting pattern in land use planning operation. This research encompasses the concept of environmental assessment and its kinds and clarifies environmental impact assessment and its contents, the research also dealt with urban planning concept and land use planning, it also dealt with the current situation of the case study (Al-Garma district) and the land use planning in it and explain the most polluting use on the environment which is the industrial land use represented in the tannery industries and then there was a stating of current situation of this land use and explaining its contents and environmental impacts resulted from it, and then we analyzed the tests applied by the researcher for water and soil, and perform environmental evaluation through applying environmental impact assessment matrix using the direct method to reveal the pollution ranges on the ambient environment of industrial land use, and we also applied the environmental and site limits and standards by using (GIS) and (AUTOCAD) to select the site of the best alternative of the industrial region in Al-Garma district after the research approved the unsuitability of its current site location for the environmental and site limitations, the research conducted some conclusions and recommendations regard clarifying the concluded facts and to set the proper solutions.Keywords: EIA, pollution, tannery industry, land use planning
Procedia PDF Downloads 45010338 Perceived Environmental Effects of Charcoal Production among Rural Dwellers in Rainforest and Guinea Savannah Agro-Ecological Zones of Nigeria
Authors: P. O. Eniola, S. O. Odebode
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Charcoal production constitutes serious environmental problems to most developing countries of the world. Hence, the study assessed perceived environmental effects of charcoal production (CP) among the rural dwellers in rainforest and guinea savannah (GS) zones of Nigeria. Multi-stage sampling procedure was used to select 83 and 85 charcoal producers in GS and rainforest zones respectively. Eighteen statements on perceived environmental effects of charcoal production were collected. Data was collected through the use of structured interview schedule and analysed using both descriptive and inferential statistics. Descriptive analysis showed that the mean age was 43 years, 90.5% males, 90.6% married and 35.3% of respondents had no formal education. The majority (80.0%) of the respondents make use of earth mound method of CP and 52.9% of respondents produced between 32-32000kg of charcoal per annum. Respondents (62.7%) perceived that charcoal production could lead to erosion, 62.4% reduce the available trees for future use (62.4%) and reduce available air in the environment (54.1%). A significant difference existed in the perceived environmental effects of charcoal production between rainforest and guinea savannah agro-ecological zones (F=14.62). There is a need for the government to quickly work on other available and affordable alternative household energy sources.Keywords: deforestation, energy, earth mound method, environment
Procedia PDF Downloads 39610337 A Novel Multi-Attribute Green Decision Making Model for Environmental Supply Chain Sustainability
Authors: Amirhossein Mahlouji
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In current business market, the concept of integrating environmental sustainability into long-term as well as routine operations is becoming a prevailing trend. Therefore, several stimuli are helping organization to move toward environmental sustainability. The concept of green supply chain management can help provide a strategic framework to develop a customized sustainability roadmap for each organization. In this regard, this paper is mainly focused on presenting a strategic decision making framework that will assist top level decision-making issues. This decision-making tool is based on literature and practice in the area of environmentally conscious business practices. The goal of this paper will be on the components and parameters of green supply chain management and how they serve as a baseline for the decision framework. Later, the applicability of a multi-input multi-output decision model (MIMO), will be analyzed as the analytical network process, within the green supply chain.Keywords: Multi-attribute, Green Supply Chain, Environmental, Sustainability
Procedia PDF Downloads 15210336 Computational Study of Passive Scalar Diffusion of a Counterflowing round Jet
Authors: Amani Amamou, Sabra Habli, Nejla Mahjoub Saïd, Georges Le Palec
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Round jets have been widely studied due to their important application in industry. Many configurations of round jet were encountered in literature as free jet, co-flow jet, couterflowing jet and cross flow jet. In this paper, we are concerned with turbulent round jet in uniform counterflow stream which is known to enhance mixing and dispersion efficiency owing to flow reversal. This type of flow configuration is a typical application in environmental engineering such as the disposal of wastewater into seas or rivers. A computational study of a turbulent circular jet discharging into a uniform counterflow is conducted in order to investigate the characteristics of the diffusion field of the jet effluent. The investigation is carried out for three different cases of jet-to-current velocity ratios; low, medium and high velocity ratios. The Reynolds Stress Model (RSM) is used in the comparison with available experimental measurements. The decay of the center line velocity and the dynamic proprieties of the flow together with the centerline dilution of the passive scalar and the other characteristics of the concentration field are computationally analyzed in this paper.Keywords: Counterflow stream, jet, velocity, concentration
Procedia PDF Downloads 38510335 Clostridium Glycolicum Abdominal Infection in a Patient with Small Bowel Obstruction
Authors: Benedikt Munzar, Jagraj Singh, Alice Mei, David Musheyev, Sandeep Gandhi
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Clostridium glycolicum is a gram-positive, anaerobic, spore-forming rod that is not commonly identified as a primary human pathogen. Here is presented a case of a 60-year-old patient with a history of opioid use disorder who underwent a number of abdominal surgeries for small bowel obstruction. His hospital course was complicated by Clostridium glycolicum infection, resulting in an acute abdomen. The patient clinically improved with antibiotic therapy. A thorough review of the National Institute of Health database revealed that only a small number of cases have been reported since 2007, with the last postsurgical cases documented in 2009 and the last clinical case documented in 2012. Clostridium glycolicum infections have been noted in patients with immunosuppressive conditions or those undergoing medical treatments that compromise immune function. This case was unusual due to the patient being immunocompetent. We suggest that a case of an acute abdomen should consider this organism as an etiological agent.Keywords: acute abdomen, bacterial infection, clostridium glycolicum, Meckel’s diverticulum, pneumoperitoneum, small bowel obstruction
Procedia PDF Downloads 3310334 A Study of Environmental Test Sequences for Electrical Units
Authors: Jung Ho Yang, Yong Soo Kim
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Electrical units are operated by electrical and electronic components. An environmental test sequence is useful for testing electrical units to reduce reliability issues. This study introduces test sequence guidelines based on relevant principles and considerations for electronic testing according to international standard IEC-60068-1 and the United States military standard MIL-STD-810G. Then, test sequences were proposed based on the descriptions for each test. Finally, General Motors (GM) specification GMW3172 was interpreted and compared to IEC-60068-1 and MIL-STD-810G.Keywords: reliability, environmental test sequence, electrical units, IEC 60068-1, MIL-STD-810G
Procedia PDF Downloads 50510333 Effective Urban Design on Environmental Quality Improvement of Historical Textures: A Case Study on Khajeh Khezr Neighborhood in Kerman City
Authors: Saman Sobhani
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Historical neighborhoods have special values inside them, and, in addition to inducing a sense of collective memories, they have to have some criteria in respect of achieving desirable environmental quality in order for citizens to live. From the perspective of urban planners and designers, a neighborhood as an urban space has to satisfy various needs of citizens in terms of activities as well as their spiritual requirements. In the research based on the component of environmental quality in one of the neighborhoods with historical value resulting from the theoretical model presented (functional-structural, physical-spatial, and substantive), integrated analysis has been performed on the Khajeh Khezr neighborhood in Kerman. Then, after studying the weaknesses and strengths points of it based on the AIDA model, some mechanisms have been presented to promote environmental quality based on neighborhood organization, and related urban design projects have been defined accordingly. Analyzing the findings shows that inhabitants in the Khajeh Khezr neighborhood are not much satisfied with the quality of the urban environment of the neighborhood. In the research, the descriptive-analytical method and review of texts have been used in the form of library studies, and case study has been applied as well as observation and questionnaire in the form of field studies.Keywords: environmental quality, Kerman, Khajeh Khezr, neighborhood
Procedia PDF Downloads 8510332 Air Flow Characteristics and Pressure Distributions for Staggered Wing Shaped Tubes Bundle
Authors: Sayed A. Elsayed, Emad Z. Ibrahim, Osama M. Mesalhy, Mohamed A. Abdelatief
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An experimental and numerical study has been conducted to clarify fluid flow characteristics and pressure drop distributions of a cross-flow heat exchanger employing staggered wing-shaped tubes at different angels of attack. The water-side Rew and the air-side Rea were at 5 x 102 and at from 1.8 x 103 to 9.7 x 103, respectively. Three cases of the tubes arrangements with various angles of attack, row angles of attack and 90° cone angles were employed at the considered Rea range. Correlation of pressure drop coefficient Pdc in terms of Rea, design parameters for the studied cases were presented. The flow pattern around the staggered wing-shaped tubes bundle were predicted by using commercial CFD FLUENT 6.3.26 software package. Results indicated that the values of Pdc were increased by increasing the angle of attack from 0° to 45°, while the opposite was true for angles of attack from 135° to 180°. Comparisons between the experimental and numerical results of the present study and those, previously, obtained for similar available studies showed good agreements.Keywords: wing-shaped tubes, cross-flow cooling, staggered arrangement, CFD
Procedia PDF Downloads 37810331 The Predictive Value of Micro Rna 451 on the Outcome of Imatinib Treatment in Chronic Myeloid Leukemia Patients
Authors: Nehal Adel Khalil, Amel Foad Ketat, Fairouz Elsayed Mohamed Ali, Nahla Abdelmoneim Hamid, Hazem Farag Manaa
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Background: Chronic myeloid leukemia (CML) represents 15% of adult leukemias. Imatinib Mesylate (IM) is the gold standard treatment for new cases of CML. Treatment with IM results in improvement of the majority of cases. However, about 25% of cases may develop resistance. Sensitive and specific early predictors of IM resistance in CML patients have not been established to date. Aim: To investigate the value of miR-451 in CML as an early predictor for IM resistance in Egyptian CML patients. Methods: The study employed Real time Polymerase Reaction (qPCR) technique to investigate the leucocytic expression of miR-451 in fifteen newly diagnosed CML patients (group I), fifteen IM responder CML patients (group II), fifteen IM resistant CML patients (group III) and fifteen healthy subjects of matched age and sex as a control group (group IV). The response to IM was defined as < 10% BCR-ABL transcript level after 3 months of therapy. The following parameters were assessed in subjects of all the studied groups: 1- Complete blood count (CBC). 2- Measurement of plasma level of miRNA 451 using real-time Polymerase Chain Reaction (qPCR). 3- Detection of BCR-ABL gene mutation in CML using qPCR. Results: The present study revealed that miR-451 was significantly down-regulated in leucocytes of newly diagnosed CML patients as compared to healthy subjects. IM responder CML patients showed an up-regulation of miR- 451 compared with IM resistant CML patients. Conclusion: According to the data from the present study, it can be concluded that leucocytic miR- 451 expression is a useful additional follow-up marker for the response to IM and a promising prognostic biomarker for CML.Keywords: chronic myeloid leukemia, imatinib resistance, microRNA 451, Polymerase Chain Reaction
Procedia PDF Downloads 29510330 Joubert Syndrome in Children as Multicentric Screening in Ten Different Places in World
Authors: Bajraktarevic Adnan, Djukic Branka, Sporisevic Lutvo, Krdzalic Zecevic Belma, Uzicanin Sajra, Hadzimuratovic Admir, Hadzimuratovic Hadzipasic Emina, Abduzaimovic Alisa, Kustric Amer, Suljevic Ismet, Serafi Ismail, Tahmiscija Indira, Khatib Hakam, Semic Jusufagic Aida, Haas Helmut, Vladicic Aleksandra, Aplenc Richard, Kadic Deovic Aida
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Introduction: Joubert syndrome has an autosomal recessive pattern of inheritance. It is referred as the brain malfunctioning and caused due to the underdevelopment of the cerebellar vermis. Associated conditions involving the eye, the kidney, and ocular disease are well described. Aims: Research helps us better understand this diseases, Joubert syndrome and can lead to advances in diagnosis and treatment. Methods: Different several conditions have been described in which the molar tooth sign and characteristics of Joubert syndrome in ten different places in the world. Carrier testing and diagnosis are available if one of these gene mutations has been identified in an affected family member. Results: Authors have described eleven cases during twenty years of Joubert syndrome. It is a clinically and genetically heterogeneous group of disorders characterized by hypoplasia of the cerebellar vermis with the characteristic neuroradiologic molar tooth sign, and accompanying neurologic symptoms, including dysregulation of breathing pattern and developmental delay. We made confirmation of diagnosis in twin sisters with Joubert syndrome with renal anomalies. Ocular symptoms have existed in seven cases (63.64%) from total eleven. Eleven cases were different sex, five boys (45.45%) and six girls (54.44%). Conclusions: Joubert syndrome is inherited as an autosomal recessive genetic disorder with several features of the disease.Keywords: Joubert syndrome, cerebellooculorenal syndrome, autosomal recessive genetic disorder (ARGD), children
Procedia PDF Downloads 27910329 Anatomical and Pathological Evaluation of Anomaly Cases Presented to the Department of Pathology at the Kafkas University Faculty of Veterinary Medicine, between 2017 and 2019
Authors: Gülseren Kırbaş Doğan, Emin Karakurt, Mushap Kuru, Hilmi Nuhoğlu
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Developmental anomalies can be caused by defects in bone tissue, cartilage tissue, or primitive mesenchymal tissue. Genetic-, environmental-, teratogenic-, faulty breeding selection–, or feeding-related anomalies can be observed either locally or systemically. This study aimed to evaluate in detail the various anomalies in six calves according to pathological and anatomical investigations. Six calves were delivered to the Department of Pathology at the Kafkas University Faculty of Veterinary Medicine between 2017 and 2019. These calves comprised one with anencephaly, one with the diencephalic syndrome, one with Schistosoma reflexum, two with anasarca, and one with nasal and calvarium openings. After necropsy, samples were taken from the organs, foreseen, and routine pathological examinations were performed. Following these procedures, the calves were brought to the anatomy laboratory and anatomically examined. As a result, various anomalies in 6 calves were evaluated according to pathological and anatomical investigations. These findings are believed to contribute to the literature.Keywords: anatomy, anomaly, calf, pathology
Procedia PDF Downloads 18310328 Characteristics of Clinical and Diagnostic Aspects of Benign Diseases of Cervi̇x in Women
Authors: Gurbanova J., Majidova N., Ali-Zade S., Hasanova A., Mikailzade P.
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Currently, the problem of oncogynecological diseases is widespread and remains relevant in terms of quantitative growth. It is known that due to the increase in the number of benign diseases of the cervix, the development of precancerous conditions occurs. Benign diseases of the cervix represent the most common gynecological problem, which are often precursors of malignant neoplasms, especially cervical cancer. According to statistics, benign diseases of the cervix cover 25-45% of all gynecological diseases. Among women's oncogynecological diseases, cervical cancer ranks second in the world after breast cancer and ranks first in the mortality rate among oncological diseases in economically underdeveloped countries. We performed a comprehensive clinical and laboratory examination of 130 women aged 18 to 73 with benign cervical diseases. 59 (38.5%) women of reproductive age, as well as 39 (30%) premenopausal and 41 (31.5%) menopausal patients, participated in the study. Detailed anamnesis was collected from all patients, objective and gynecological examination was performed, laboratory and instrumental examinations (USM, IPV DNA, smear microscopy, and PCR bacteriological examination of sexually transmitted infections), simple and extended colposcopy, liquid-based РАР-smear smear and РАР-classic smear examinations were conducted. As a result of the research, the following nosological forms were found in women with benign diseases of the cervix: non-specific vaginitis in 10 (7.7%) cases; ectopia, endocervicitis - 60(46.2%); cervical ectropion - 7(5.4%); cervical polyp - 9(6.9%); cervical leukoplakia - 15(11.5%); atrophic vaginitis - 7(5.4%); condyloma - 12(9.2%); cervical stenosis - 2(1.5%); endometriosis of the cervix - was noted in 8 (6.2%) cases (p<0.001), respectively. Characteristics of the menstrual cycle among the examined women: normal cycle in 97 (74.6%) cases; oligomenorrhea – 23 (17.7%); polymenorrhea – 4(3.1%); algomenorrhea – noted in 6 (4.6%) cases (p<0.001). Cytological examination showed that: the specificity of liquid-based cytology was 76.2%, and the traditional PAP test was set at 70.6%. The overall diagnostic value was calculated to be 86% in liquid-based cytology and 78.5% in conventional PAP tests. Treatment of women with benign diseases of the cervix was carried out by diathermocoagulation method and "FOTEK EA 141M" device. It should be noted that 6 months after the treatment, after treatment with the "FOTEK EA 141M" device, there was no relapse in any patient. Recurrence was found in 23.7% of patients after diathermoelectrocoagulation. Thus, it is clear from the above that the study of cervical pathologies, the determination of optimal examinations, and effective treatment methods is one of the urgent problems facing obstetrics and gynecology.Keywords: cervical cancer, cytological examination, PAP-smear, non-specific vaginitis
Procedia PDF Downloads 12210327 Estimation of Synchronous Machine Synchronizing and Damping Torque Coefficients
Authors: Khaled M. EL-Naggar
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Synchronizing and damping torque coefficients of a synchronous machine can give a quite clear picture for machine behavior during transients. These coefficients are used as a power system transient stability measurement. In this paper, a crow search optimization algorithm is presented and implemented to study the power system stability during transients. The algorithm makes use of the machine responses to perform the stability study in time domain. The problem is formulated as a dynamic estimation problem. An objective function that minimizes the error square in the estimated coefficients is designed. The method is tested using practical system with different study cases. Results are reported and a thorough discussion is presented. The study illustrates that the proposed method can estimate the stability coefficients for the critical stable cases where other methods may fail. The tests proved that the proposed tool is an accurate and reliable tool for estimating the machine coefficients for assessment of power system stability.Keywords: optimization, estimation, synchronous, machine, crow search
Procedia PDF Downloads 14010326 Factors That Promote Bystander Intervention in Cases of Sexual Violence
Authors: Avigail Moor
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Sexual violence against women occurs at alarmingly high rates, which have remained steady irrespective of the increased societal awareness of this problem, affecting an upward of 20% of women. It appears that all the public discourse on this topic, including research, prevention programs, and public campaigns have not made a noticeable dent in this prevalence. This calls for new course of action. Raising awareness regarding the preventive role of bystanders might be it. To that end, the present study sought to establish what promotes bystander intervention and what hinders it. Three hundred and twenty-four men and women, ranging in age from 20-40, participated in this study, completing self-report questionnaires on the topics under investigation. Results indicated that the proclivity to intervene as a bystander is impacted by various factors. The most consequential among them is gender, with twice as many women as men, 70% vs 38% respectively, being positively inclined to take action in such cases. Other significant factors included belief in rape myths and having empathy towards perpetrators, which reduced the likelihood of bystander intervention. Holding the attitude that it is possible to freely consent to sex while intoxicated had a similar impact. The discussion addresses various preventive implications.Keywords: bystander intervention, sexual assault, rape prevention, rape myths
Procedia PDF Downloads 13110325 Governance and Local Planning for Sustainability: Need for Change - Implications of Legislation on Local Planning
Authors: Rahaf Suleiman Altallaa
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City planning involves making plans, organizing and dealing with the cities urban areas. It attempts to organize socio-spatial relationships at exceptional ranges of governance Urban planning offers the social, monetary and environmental effects of defining spatial obstacles and the influence on the spatial distribution of resources. The dreams and methods of reaching such dissemination vary extensively traditionally and geographically and are often challenged through traditional strategies that expose the political nature of application interventions and the bounds of technical know-how claims. Space, network, argument, and postcolonial debates address how present-day socio-spatial organization is formed, what needs to or should not trade, and the way it underscores whether or not a good plan will contribute to a given situation. Inside the absence of an agreed-upon technical justification for the planning exercise, the planning idea has a tendency to focus on normative processes, positioning making plans as an area for participatory democracy.Keywords: environmental governance, environmental planning, environmental management, sustainable competitiveness, sustainability
Procedia PDF Downloads 12310324 The Per Capita Income, Energy production and Environmental Degradation: A Comprehensive Assessment of the existence of the Environmental Kuznets Curve Hypothesis in Bangladesh
Authors: Ashique Mahmud, MD. Ataul Gani Osmani, Shoria Sharmin
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In the first quarter of the twenty-first century, the most substantial global concern is environmental contamination, and it has gained the prioritization of both the national and international community. Keeping in mind this crucial fact, this study conducted different statistical and econometrical methods to identify whether the gross national income of the country has a significant impact on electricity production from nonrenewable sources and different air pollutants like carbon dioxide, nitrous oxide, and methane emissions. Besides, the primary objective of this research was to analyze whether the environmental Kuznets curve hypothesis holds for the examined variables. After analyzing different statistical properties of the variables, this study came to the conclusion that the environmental Kuznets curve hypothesis holds for gross national income and carbon dioxide emission in Bangladesh in the short run as well as the long run. This study comes to this conclusion based on the findings of ordinary least square estimations, ARDL bound tests, short-run causality analysis, the Error Correction Model, and other pre-diagnostic and post-diagnostic tests that have been employed in the structural model. Moreover, this study wants to demonstrate that the outline of gross national income and carbon dioxide emissions is in its initial stage of development and will increase up to the optimal peak. The compositional effect will then force the emission to decrease, and the environmental quality will be restored in the long run.Keywords: environmental Kuznets curve hypothesis, carbon dioxide emission in Bangladesh, gross national income in Bangladesh, autoregressive distributed lag model, granger causality, error correction model
Procedia PDF Downloads 15010323 The Effect of a New Reimbursement Policy for Discharge Planning Service
Authors: Chueh Chi-An, Chan Hui-Ya
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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate
Procedia PDF Downloads 17510322 Bio-Based Processes for Circular Economy in the Textile Industry
Authors: Nazanin Forouz
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The textile industry faces increasing criticism due to its resource-intensive nature and the negative environmental and societal impacts associated with the manufacturing, use, and disposal of clothes. To address these concerns, there is a growing desire to transition towards a circular economy for textiles, implementing recycling concepts and technologies to protect resources, the environment, and people. While existing recycling processes have focused on chemical and mechanical reuse of textile fibers, bio-based processes have received limited attention beyond end-of-life composting. However, bio-based technologies hold great promise for circularizing the textile life cycle and reducing environmental impacts.Keywords: textile industry, circular economy, bio-based processes, recycling, environmental impacts
Procedia PDF Downloads 9510321 Environmental Degradation and Globalization with Special Reference to Developing Economics
Authors: Indira Sinha
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According to the Oxford Advanced Learner's English Dictionary of Current English, environment is the complex of physical, chemical and biotic factors that act upon an organism or an ecological community and ultimately determines its form and survival. It is defined as conditions and circumstances which are affecting people's lives. The meaning of environmental degradation is the degradation of the environment through depletion of resources such as air, water and soil and the destruction of ecosystems and extinction of wildlife. Globalization is a significant feature of recent world history. The aim of this phenomenon is to integrate societies, economies and cultures through a common link of trading policies, technology and communication. Undoubtedly it has opened up the world economy at a very high speed but at the same time it has an adverse impact on the environment. The purpose of the present study is to investigate the impact of globalization on the environmental conditions. An overview of what the forces of globalization have in store for the environment with constructing large number of industries and destroying large forests lands will be given in this paper. The forces of globalization have created many serious environmental problems like high temperature, extinction of many species of plant and animal and outlet of poisonous chemicals from industries. The revelation of this study is that in case of developing economics these problems are more critical. In developing countries like India many factories are built with less environmental regulations, while developed economies maintain positive environmental practices. The present study is a micro level study which aims to employ a combination of theoretical, descriptive, empirical and analytical approach in addition to the time tested case method.Keywords: globalization, trade policies, environmental degradation, developing economies, large industries
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