Search results for: road signs

Authors: Aniruddha Kulkarni

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In very few cases of external hernias we require imaging modalities as on most occasions clinical examination tests are good enough. Ultrasound will help in chronic abdominal or groin pain, equivocal clinical results & complicated hernias. Ultrasound is useful in assessment of cause of raised intrabdominal pressure. In certain cases will comment about etiology, complications and chronicicty of lesion. Screening of rest of abdominal organs too is important advantage being real time modality. Cost effectiveness, no radiation allows modality be used repeatedly in indicated cases. Sonography is better accepted by patients too as it is cost effective. Best advanced tissue harmonic equipment and increasing expertise making it popular. Ultrasound can define surgical anatomy, rent size, contents, etiological /recurrence factors in great detail and with authority hence accidental findings in a planned surgical procedure can be easily avoided. Clinical dynamic valselva and reducibility test can better documented by real time ultrasound study. In case of recurrence, Sonography will help in assessing the hernia details better as being dynamic real time investigation. Ultrasound signs in case of internal hernias are well comparable with CT findings.

Keywords: laparoscopic repair, Hernia, CT findings, chronic pain

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Authors: Jacklynn Walters, Amanda A. Alblas, Linda M. Greyling

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Cervical carcinoma is the second most common cancer found in women. Diagnosis of skeletal metastases is uncommon in cervical cancer patients. The aim of this study was to determine the prevalence of skeletal metastases in in a Western Cape skeletal population. Skeletal samples (n=14) from the Kirsten Skeletal Collection at Stellenbosch University, diagnosed pre-mortem with cervical cancer, were examined. Macroscopic analysis was done using low magnification to examine each skeletal element for signs of disease. Skeletons were also x-rayed using the Lodox® Statscan® Imaging system and the scans evaluated by a musculoskeletal radiologist. Three (21%) of the skeletons showed metastases, with the os coxae and lower vertebral column affected in all three cases. Furthermore, metastases occurred in the scapulae and ribs in two of the cases and in one case the skull, mandible, and long bones were affected. Additionally, three skeletons without evidence of skeletal metastases presented with a periosteal reaction on the os coxae in response to the diseased adjacent soft tissue. Previous studies observed that skeletal metastases are more common than what is diagnosed pre-mortem with the vertebral spine most commonly affected. The findings of this study agree with previous reports and illustrate the effectiveness of the Lodox® scanner in diagnoses of metastases in skeletal material.

Keywords: cancer, cervix, radiology, skeletal metastases

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Authors: Hamid Alalwany, Nabeel A. Koshak, Mohammad K. Ibrahim

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Both knowledge economy and sustainable development are considered key dimensions in the policy action lines of many developed and developing countries. In this context, universities and other higher education institutes have a vital role in developing and sustaining wellbeing communities. In this paper, the authors’ aim is to address the links between the concepts of innovation and entrepreneurial capacity and knowledge economy, and to utilize the approach of intellectual capital development in building a sustainable knowledge economy. The paper will contribute to two discourses: (1) Developing a common understanding of the intersection aspects between the three concepts: Knowledge economy, Innovation and entrepreneurial system, and sustainable development; (2) Paving the road towards developing an integrated multidimensional framework for sustainable knowledge economy.

Keywords: innovation and entrepreneurial capacity, intellectual capital development, sustainable development, sustainable knowledge economy.

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Authors: Aarif Rasheed, Joseph Bulbulia

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Western democracies exhibit signs of distinctive anti-Muslim prejudice, but little is known about its causes and effects on Muslim minorities. Here, drawing on nine years of responses from a nationally representative longitudinal sample of New Zealanders (New Zealand Attitudes and Values Study, N > 31,000), we systematically investigate the demographic and ideological predictors of factors that predict both positive and negative change in Muslim attitudes. First, we find that that education, moderate and liberal political ideology, and positive views about religion predict greater Muslim acceptance. Second, we find a there though there is a general trend for increasing acceptance over nine years, we find evidence of increasing extremism at the margins. Third, focusing on the Muslim sub-sample and comparing it to other religious sub-groups, we find substantially higher reports of perceived anti-religious prejudice. Collectively, these results point to serious challenges to the health of New Zealand as a democracy where people can worship freely without discrimination. Finally, we find consistency in our responses with the reported experiences of victims of the Christchurch attacks, in terms of harassment, assault, slurs, and other hostile behaviour both before and after the attacks.

Keywords: democracy, longitudinal, Muslim, panel data, prejudice

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Authors: Henry Acurio, Alvaro Corral, Juan Fonseca

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In Ecuador, subventions on fossil fuels for the road transportation sector have always been part of its economy throughout time, mainly because of demagogy and populism from political leaders. It is clearly seen that the government cannot maintain the subsidies anymore due to its commercial balance and its general state budget; subsidies are a key barrier to implementing the use of cleaner technologies. However, during the last few months, the elimination of subsidies has been done gradually with the purpose of reaching international prices. It is expected that with this measure, the population will opt for other means of transportation, and in a certain way, it will promote the use of private electric vehicles and public, e.g., taxis and buses (urban transport). Considering the three main elements of sustainable development, an analysis of the social, economic, and environmental impacts of eliminating subsidies will be generated at the country level. To achieve this, four scenarios will be developed in order to determine how the subsidies will contribute to the promotion of electro-mobility: 1) A Business as Usual (BAU) scenario; 2) the introduction of 10 000 electric vehicles by 2025; 3) the introduction of 100 000 electric vehicles by 2030; 4) the introduction of 750 000 electric vehicles by 2040 (for all the scenarios, buses, taxis, lightweight duty vehicles, and private vehicles will be introduced, as it is established in the National Electro Mobility Strategy for Ecuador). The Low Emissions Analysis Platform (LEAP) will be used, and it will be suitable to determine the cost for the government in terms of importing derivatives for fossil fuels and the cost of electricity to power the electric fleet that can be changed. The elimination of subventions generates fiscal resources for the state that can be used to develop other kinds of projects that will benefit Ecuadorian society. It will definitely change the energy matrix, and it will provide energy security for the country; it will be an opportunity for the government to incentivize a greater introduction of renewable energies, e.g., solar, wind, and geothermal. At the same time, it will also reduce greenhouse gas emissions (GHG) from the transportation sector, considering its mitigation potential, which as a result, will ameliorate the inhabitant quality of life by improving the quality of air, therefore reducing respiratory diseases associated with exhaust emissions, consequently, achieving sustainability, the Sustainable Development Goals (SDGs), and complying with the agreements established in the Paris Agreement COP 21 in 2015. Electro-mobility in Latin America and the Caribbean can only be achieved by the implementation of the right policies by the central government, which need to be accompanied by a National Urban Mobility Policy (NUMP), and can encompass a greater vision to develop holistic, sustainable transport systems at local governments.

Keywords: electro mobility, energy, policy, sustainable transportation

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Authors: Ahuja Ashish, Nain Prabhdeep Singh

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Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

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Authors: Oktavia Eka Puspita

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The possibility of using Solid Lipid Nanoparticles (SLN) for topical use is an interesting feature concerning this system has occlusive properties on the skin surface therefore enhance the penetration of drugs through the stratum corneum by increased hydration. This advantage can be used to enhance the drug penetration of topical delivery such as Diclofenac sodium for the relief of signs and symptoms of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. The purpose of this study was focused on the preparation and physical characterization of Diclofenac sodium loaded SLN (D-SLN). D loaded SLN were prepared by hot homogenization followed by ultrasonication technique. Since the occlusion factor of SLN is related to its particle size the formulation of D-SLN in present study two formulations different in its surfactant contents were prepared to investigate the difference of the particle size resulted. Surfactants selected for preparation of formulation A (FA) were lecithin soya and Tween 80 whereas formulation B (FB) were lecithin soya, Tween 80, and Sodium Lauryl Sulphate. D-SLN were characterized for particle size and distribution, polydispersity index (PI), zeta potential using Beckman-Coulter Delsa™ Nano. Overall, the particle size obtained from FA was larger than FB. FA has 90% of the particles were above 1000 nm, while FB has 90% were below 100 nm.

Keywords: solid lipid nanoparticles, hot homogenization technique, particle size analysis, topical administration

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Authors: H. J. T. Kevin Mozes, Dyah Purnamasari

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Background: Lung cancer accounted for the fourth most common cancer in Indonesia. 85% of all lung cancer cases are the Non-Small Cell Lung Cancer (NSCLC). The indistinct signs and symptoms of NSCLC sometimes lead to misdiagnosis. The gold standard assessment for the diagnosis of NSCLC is the histopathological biopsy, which is invasive. Cyfra 21-1 is a tumor marker, which can be found in the intermediate protein structure in the epitel. The accuracy of Cyfra 21-1 in diagnosing NSCLC is not yet known, so this report is made to seek the answer for the question above. Methods: Literature searching is done using online databases. Proquest and Pubmed are online databases being used in this report. Then, literature selection is done by excluding and including based on inclusion criterias and exclusion criterias. The selected literature is then being appraised using the criteria of validity, importance, and validity. Results: From six journals appraised, five of them are valid. Sensitivity value acquired from all five literature is ranging from 50-84.5 %, meanwhile the specificity is 87.8 %-94.4 %. Likelihood the ratio of all appraised literature is ranging from 5.09 -10.54, which categorized to Intermediate High. Conclusion: Serum Cyfra 21-1 is a sensitive and very specific tumor marker for diagnosis of non-small cell lung cancer (NSCLC).

Keywords: cyfra 21-1, diagnosis, nonsmall cell lung cancer, NSCLC, tumor marker

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Authors: Ganga Brahma

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Boro employs verbs hooked up with morphemes which lead verbs to adjust with their arguments and hence, affecting the whole of sentence structures. This paper is based on few such syntactic parameters which are usually considered as argument decreasing parameters in linguistic works. Passivizing of few transitive clauses which are usually construed from the verbs occurring with certain morphemes and representation in middle constructions are few of such strategies which lead to conceptualizing of decreasing of syntactic arguments from a sentence. This paper focuses on the mentioned linguistic strategies and attempts to describe the linguistic processes as for how these parameters work in languages especially by concentrating on a particular Tibeto-Burman language i.e. Boro. Boro is a Tibeto-Burman language widely spoken in parts of the north-eastern regions of India. It has an agglutinative nature in forming words as well as clauses. There is a morpheme ‘za’ which means ‘to happen, become’ in Boro whose appearances with verb roots denotes an idea of the subject being passivized. Passivization, usually has notions that it is a reversed representation of its active sentence forms in the terms of argument placements. (However, it is not accountably true as passives and actives have some distinct features of their own and independent of one and the other.) This particular work will concentrate on the semantics of passivization at the same time along with its syntactic reality. The verb khɑo meaning ‘to steal’ offers a sense of passivization with the appearance of the morpheme zɑ which means ‘to happen, become’ (e.g Zunu-ɑ lama-ɑo phɯisɑ khɑo-zɑ-bɑi; Junu-NOM road-LOC money steal-PASS-PRES: Junu got her money stolen on the road). The focus, here, is more on the argument placed at the subject position (i.e. Zunu) and the event taken place. The semantics of such construction asks for the agent because without an agent the event could not have taken place. However, the syntactic elements fill the slots of relegated or temporarily deleted agent which, infact, is the actual subject cum agent in its active representation. Due to the event marker ‘zɑ’ in this presentation it affords to reduce one participant from such a situation which in actual is made up of three participants. Hence, the structure of di-transitive construction here reduces to mono-transitive structure. Unlike passivization, middle construction does not allow relegation of the agents. It permanently deletes agents. However, it also focuses on the fore-grounded subject and highlighting on the changed states on the subjects which happens to be the underlying objects of their respective transitive structures (with agents). This work intends to describe how these two parameters which are different at their semantic realization can meet together at a syntactic level in order to create a linguistic parameter that decreases participants from their actual structures which are with more than one participant.

Keywords: argument-decrease, middle-construction, passivization, transitivity-intransitivity

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Authors: Hideo Suzuki, Yuya Kiyonobu, Kotaro Matsushita, Masaki Hanada, Rie Suzuki, Noriko Niijima, Noriko Uosaki, Tadao Nakamura

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People often worry about their elderly family members who are living by themselves or staying alone somewhere. An intelligent watch-over system for such elderly people, using a Raspberry Pi IoT device, has been newly developed to monitor those who live or stay separately from their families and alert them if a problem occurs. The system consists of motion sensors and temperature-humidity combined sensors that are located at seven points within an elderly person's home. The intelligent algorithms of the system detect signs and the possibility of unhealthy situations arising for the elderly relative; e.g., an unusually long bathing time, or a visit to a restroom, too high a room temperature, etc., by using data cached by the sensors above, at seven points within their house. The system gives more consideration to the elderly person's privacy, by using the sensors above, instead of using cameras and microphones placed around the house. The system invented and described here, can send a Twitter direct message to designated family members when an elderly relative is possibly in an unhealthy condition. Thus the system helps decrease family members' anxieties regarding their elderly relatives and increases their sense of security.

Keywords: elderly person, IoT device, Raspberry Pi, watch-over system

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Authors: Dilek Ozturk, Narin Ozturk, Zeliha Pala Kara, Engin Kaptan, Serap Sancar Bas, Nurten Ozsoy, Alper Okyar

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Most physiological processes oscillate in a rhythmic manner in mammals including metabolism and energy homeostasis, locomotor activity, hormone secretion, immune and endocrine system functions. Endocrine body rhythms are tightly regulated by the circadian timing system. The hypothalamic-pituitary-thyroid (HPT) axis is under circadian control at multiple levels from hypothalamus to thyroid gland. Since circadian timing system controls a variety of biological functions in mammals, circadian rhythms of biological functions may modify the drug tolerability/toxicity depending on the dosing time. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer agent that is active against many cancers. It was also found to be active in medullary thyroid cancer. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus on the thyroid gland and hormones in mice. Healthy C57BL/6J mice were synchronized with 12h:12h Light-Dark cycle (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding to Light onset). Everolimus was administered to male (5 mg/kg/day) and female mice (15 mg/kg/day) orally at ZT1-rest period- and ZT13-activity period- for 4 weeks; body weight loss, clinical signs and possible changes in serum thyroid hormone levels (TSH and free T4) were examined. Histological alterations in the thyroid gland were evaluated according to the following criteria: follicular size, colloid density and viscidity, height of the follicular epithelium and the presence of necrotic cells. The statistical significance between differences was analyzed with ANOVA. Study findings included everolimus-related diarrhea, decreased activity, decreased body weight gains, alterations in serum TSH levels, and histopathological changes in thyroid gland. Decreases in mean body weight gains were more evident in mice treated at ZT1 as compared to ZT13 (p < 0.001, for both sexes). Control tissue sections of thyroid glands exhibited well-organized histoarchitecture when compared to everolimus-treated groups. Everolimus caused histopathological alterations in thyroid glands in male (5 mg/kg, slightly) and female mice (15 mg/kg; p < 0.01 for both ZT as compared to their controls) irrespective of dosing-time. TSH levels were slightly decreased upon everolimus treatment at ZT13 in both males and females. Conversely, increases in TSH levels were observed when everolimus treated at ZT1 in both males (5 mg/kg; p < 0.05) and females (15 mg/kg; slightly). No statistically significant alterations in serum free T4 levels were observed. TSH and free T4 is clinically important thyroid hormones since a number of disease states have been linked to alterations in these hormones. Serum free T4 levels within the normal ranges in the presence of abnormal serum TSH levels in everolimus treated mice may suggest subclinical thyroid disease which may have repercussions on the cardiovascular system, as well as on other organs and systems. Our study has revealed the histological damage on thyroid gland induced by subacute everolimus administration, this effect was irrespective of dosing time. However, based on the body weight changes and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13 in both male and females. Yet, effects of everolimus on thyroid functions may deserve further studies regarding their clinical importance and chronotoxicity.

Keywords: circadian rhythm, chronotoxicity, everolimus, thyroid gland, thyroid hormones

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Authors: Narin Ozturk, Xiao-Mei Li, Sylvie Giachetti, Francis Levi, Alper Okyar

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P-glycoprotein (P-gp, MDR1, ABCB1) is a transmembrane protein acting as an ATP-dependent efflux pump and functions as a biological barrier by extruding drugs and xenobiotics out of cells in healthy tissues especially in intestines, liver and brain as well as in tumor cells. The circadian timing system controls a variety of biological functions in mammals including xenobiotic metabolism and detoxification, proliferation and cell cycle events, and may affect pharmacokinetics, toxicity and efficacy of drugs. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer drug that is active against many cancers, and its pharmacokinetics depend on P-gp. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus with respect to the intestinal P-gp expression rhythms in mdr1a::Luc mice using Real Time-Biolumicorder (RT-BIO) System. Mdr1a::Luc male mice were synchronized with 12 h of Light and 12 h of Dark (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding Light onset). After 1-week baseline recordings, everolimus (5 mg/kg/day x 14 days) was administered orally at ZT1-resting period- and ZT13-activity period- to mdr1a::Luc mice singly housed in an innovative monitoring device, Real Time-Biolumicorder units which let us monitor real-time and long-term gene expression in freely moving mice. D-luciferin (1.5 mg/mL) was dissolved in drinking water. Mouse intestinal mdr1a::Luc oscillation profile reflecting P-gp gene expression and locomotor activity pattern were recorded every minute with the photomultiplier tube and infrared sensor respectively. General behavior and clinical signs were monitored, and body weight was measured every day as an index of toxicity. Drug-induced body weight change was expressed relative to body weight on the initial treatment day. Statistical significance of differences between groups was validated with ANOVA. Circadian rhythms were validated with Cosinor Analysis. Everolimus toxicity changed as a function of drug timing, which was least following dosing at ZT13, near the onset of the activity span in male mice. Mean body weight loss was nearly twice as large in mice treated with 5 mg/kg everolimus at ZT1 as compared to ZT13 (8.9% vs. 5.4%; ANOVA, p < 0.001). Based on the body weight loss and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13. Both rest-activity and mdr1a::Luc expression displayed stable 24-h periodic rhythms before everolimus and in both vehicle-treated controls. Real-time bioluminescence pattern of mdr1a revealed a circadian rhythm with a 24-h period with an acrophase at ZT16 (Cosinor, p < 0.001). Mdr1a expression remained rhythmic in everolimus-treated mice, whereas down-regulation was observed in P-gp expression in 2 of 4 mice. The study identified the circadian pattern of intestinal P-gp expression with an unprecedented precision. The circadian timing depending on the P-gp expression rhythms may play a crucial role in the tolerability/toxicity of everolimus. The circadian changes in mdr1a genes deserve further studies regarding their relevance for in vitro and in vivo chronotolerance of mdr1a-transported anticancer drugs. Chronotherapy with P-gp-effluxed anticancer drugs could then be applied according to their rhythmic patterns in host and tumor to jointly maximize treatment efficacy and minimize toxicity.

Keywords: circadian rhythm, chronotoxicity, everolimus, mdr1a::Luc mice, p-glycoprotein

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Authors: Wan Aminah Hasbullah

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The knowledge of medicine in Malay society stemmed out from the need to remedy disease process. Such knowledge came from observations by looking at the signs on the plants which signify it uses, the doctrine of signature, and also observing what kind of animal and its parts that can be used to treat the disease. Prayers (jampi and doa’) play a very important role in the therapeutic processes addressing the ethereal part of the body. In Malay medicine, prayers were said in the heart of the Malay bomoh (medicine man) when they are first approaching the diseased person, seeking the help of Allah in accurately directing his mind into making the right diagnosis and subsequently the right choice of treatment. In the making of medicine, similar rituals were religiously followed, starting from gathering the materia medica to the final concoction of the medicine. Thus, all the materia medica and the prayers in Malay medicine were gathered and documented in the medical manuscript known as MSS 2999 Kitab Tibb. For this study, a collection of vegetative materia medica which is specialized for the women illness from this manuscript will be gathered and analysed. A medical and cultural interpretation will be highlighted to see the relationship between efficacy in traditional Malay medicine as practiced in the past and the recent practice of the modern medicine.

Keywords: vegetative, materia medica, woman illness, Malay medical manuscript

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Djamel–Eddine Yassine Boutiba

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In this present memory, we present the various impacts deflectometer leading to the sizing by strengthening of existing roadways. It reminds that the road network in Algeria plays a major role with regard to drainage in major strategic areas and especially in the fringe northern Algeria. Heavy traffic passing through the northern fringe (between 25% and 30% heavy vehicles) causes substantial degradations at both the surface layer and base layer. The work on site by means within the laboratory CTTP such as deflectographe Lacroix, allowed us to record a large number of deflection localized bending on RN19A (Carrefour CW73-Ain- Merane), whose analysis of the results led us to opt for a building throughout the band's project . By the recorder against HWD (Heavy Weight déflectometer) allowed us to learn about the behavior of the pavement on the banks. In addition, the Software Alize III has been essential in the verification of the increase in the thickness dimensioned.

Keywords: capacity, deflection, deflectograph lacroix, degradation, hwd

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Authors: Sahar Heidary, Ramin Ghasemi Shayan

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By the development of new coronavirus (2019-nCoV) pneumonia, chest high-resolution computed tomography (HRCT) has been one of the main investigative implements. To realize timely and truthful diagnostics, defining the radiological features of the infection is of excessive value. The purpose of this impression was to consider the imaging demonstrations of early-stage coronavirus disease 2019 (COVID-19) and to run an imaging base for a primary finding of supposed cases and stratified interference. The right prophetic rate of HRCT was 85%, sensitivity was 73% for all patients. Total accuracy was 68%. There was no important change in these values for symptomatic and asymptomatic persons. These consequences were besides free of the period of X-ray from the beginning of signs or interaction. Therefore, we suggest that HRCT is a brilliant attachment for early identification of COVID-19 pneumonia in both symptomatic and asymptomatic individuals in adding to the role of predictive gauge for COVID-19 pneumonia. Patients experienced non-contrast HRCT chest checkups and images were restored in a thin 1.25 mm lung window. Images were estimated for the existence of lung scratches & a CT severity notch was allocated separately for each patient based on the number of lung lobes convoluted.

Keywords: COVID-19, radiology, respiratory diseases, HRCT

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Authors: Mas Pertiwi I. G. AG Istri, Sri Kristinayanti Wayan, Oka Aryawan I. Gede Made

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Ability of government to meet the needs of infrastructure investment constrained by the size of the budget commitments for other sectors. Another barrier is the complexity of the process of land acquisition. Public Private Partnership can help bridge the investment gap by including the amount of funding from the private sector, shifted the responsibility of financing, construction of the asset, and the operation and post-project design and care to them. In principle, a construction project implementation always requires the investor as a party to provide resources in the form of funding which it must be contained in a successor agreement in the form of a contract. In general, construction contracts consist of contracts which passed in Indonesia and contract International. One source of funding used in the implementation of construction projects comes from funding that comes from the collaboration between the government and the private sector, for example with the system: BLT (Build Lease Transfer), BOT (Build Operate Transfer), BTO (Build Transfer Operate) and BOO (Build Operate Own). And form of payment under a construction contract can be distinguished several ways: monthly payment, payments based on progress and payment after completed projects (Turn Key). One of the tools used to analyze the feasibility of the investment is to use financial models. The financial model describes the relationship between different variables and assumptions used. From a financial model will be known how the cash flow structure of the project, which includes revenues, expenses, liabilities to creditors and the payment of taxes to the government. Net cash flow generated from the project will be used as a basis for analyzing the feasibility of investment source of project financing Public Private Partnership could come from equity or debt. The proportion of funding according to its source is a comparison of a number of investment funds originating from each source of financing for a total investment cost during the construction period by selected the contract system and several alternative financing percentage ratio determined according to sources will generate cash flow structure that is different. Of the various possibilities for the structure of the cash flow generated will be analyzed by software is to test T Paired to compared the contract system used by various alternatives comparison of financing to determine the effect of the contract system and the comparison of such financing for the feasibility of investment toll road construction project for the economic life of 20 (twenty) years. In this use case studies of toll road contruction project Bali Mandara. And in this analysis only covered two systems contracts, namely Build Operate Transfer and Turn Key. Based on the results obtained by analysis of the variable investment feasibility of the NPV, BCR and IRR between the contract system Build Operate Transfer and contract system Turn Key on the interest rate of 9%, 12% and 15%.

Keywords: contract system, financing, internal rate of return, net present value

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Authors: Amic G. Ho

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Language usage and typography in Hong Kong are unique, as can be seen clearly on the streets of the city. In contrast to many other parts of the world, where there is only one language, in Hong Kong many signs and billboards display two languages: Chinese and English. The language usage on signage, fonts and types used, and the designs in magazines and advertisements all demonstrate the unique features of Hong Kong typographic design, which reflect the multicultural nature of Hong Kong society. This study is the first step in investigating the nature and development of Hong Kong typography. The preliminary research explored how the historical development of Hong Kong is reflected in its unique typography. Following a review of historical development, a quantitative study was designed: Local Hong Kong participants were invited to provide input on what makes the Hong Kong typographic style unique. Their input was collected and analyzed. This provided us with information about the characteristic criteria and features of Hong Kong typography, as recognized by the local people. The most significant typographic designs in Hong Kong were then investigated and the influence of Chinese and other cultures on Hong Kong typography was assessed. The research results provide an indication to local designers on how they can strengthen local design outcomes and promote the values and culture of their mother town.

Keywords: typography, Hong Kong, historical developments, multiple cultures

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Authors: Barenten Suciu

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In this work, by replacing the traditional solid spokes with colloidal spokes, a vehicle wheel with a built-in suspension structure is proposed. Following the background and description of the wheel system, firstly, a vibration model of the wheel equipped with colloidal spokes is proposed, and based on such model the equivalent damping coefficients and spring constants are identified. Then, a modified model of a quarter-vehicle moving on a rough pavement is proposed in order to estimate the transmissibility of vibration from the road roughness to vehicle body. In the end, the optimal design of the colloidal spokes and the optimum number of colloidal spokes are decided in order to minimize the transmissibility of vibration, i.e., to maximize the ride comfort of the vehicle.

Keywords: built-in suspension, colloidal spoke, intrinsic spring, vibration analysis, wheel

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Authors: Sukhpreet Singh, Kishan Bhojrath, Vijay, Avinash Kumar, Mandlesh Mishra

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The project uses an Arduino and ESP8266 to construct an alcohol detection system with an engine locking mechanism, offering a distinct way to fight drunk driving. An alcohol sensor module is used by the system to determine the amount of alcohol present in the ambient air. When the system detects alcohol levels beyond a certain threshold that is deemed hazardous for driving, it activates a relay module that is linked to the engine of the car, so rendering it inoperable. By preventing people from operating a vehicle while intoxicated, this preventive measure seeks to improve road safety. Adding an ESP8266 module also allows for remote monitoring and notifications, giving users access to real-time status updates on their system. By using an integrated strategy, the initiative provides a workable and efficient way to lessen the dangers related to driving while intoxicated.

Keywords: MQ3 sensor, ESP 8266, arduino, IoT

Procedia PDF Downloads 43

Authors: G. Meccariello, L. Della Ragione

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The exposure to outdoor air pollution causes lung cancer and increases the risk of bladder cancer. Because air pollution in urban areas is mainly caused by transportation, it is necessary to evaluate pollutant exhaust emissions from vehicles during their real-world use. Nevertheless their evaluation and reduction is a key problem, especially in the cities, that account for more than 50% of world population. A particular attention was given to the slope variability along the streets during each journey performed by the instrumented vehicle. In this paper we dealt with the problem of describing a quantitatively approach for the reconstruction of GPS coordinates and altitude, in the context of correlation study between driving cycles / emission / geographical location, during an experimental campaign realized with some instrumented cars. Finally the slope analysis can be correlated to the emission and consumption values in a specific road position, and it could be evaluated its influence on their behaviour.

Keywords: air pollution, driving cycles, GPS signal, slope, emission factor, fuel consumption

Procedia PDF Downloads 373

Authors: Patricia Abigail B. Miranda, Imelda A. Luna

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Introduction: COVID-19 infection is a novel viral illness that began as a local epidemic in December 2019 in Wuhan, China which quickly emerged into a pandemic by February 2020. The virus causes a spectrum of signs and symptoms, ranging from mild upper respiratory symptoms to acute respiratory distress syndrome, which may lead to death. Among children and neonates, those afflicted with the disease may present asymptomatically or with mild symptoms. To date, there has been limited local data that describes the outcomes of the growing number of COVID-19 cases, specifically in neonates. Methods: A cross-sectional study was conducted to determine the outcomes of neonates born to COVID-19 Positive Mothers from March 2020 until June 2022. The prevalence of COVID-19 among these neonates was also determined. Results: COVID-positive prevalence after 24 hours of life is at 8%, while prevalence after 48 hours among those who still underwent testing was at 13.51%. Moreover, among those COVID-19-negative neonates who had symptoms, they mostly presented with tachypnea (5.7%). The prevalence of complications among COVID-19-negative neonates delivered to COVID-19-positive mothers is 22.7%. Conclusion: Neonates born to COVID-19-positive mothers who yielded positive COVID-19 results are generally asymptomatic. Moreover, there are no associated mortalities among those who yielded positive results.

Keywords: COVID-19, neonates, outcomes, clinical profile

Procedia PDF Downloads 60

Authors: Espen Gronlie

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This paper will suggest that Ezra Pound and James Joyce are paradigmatic for two different approaches to literature and visual arts. Both authors are infamous for being difficult, but this does not mean that their works are similar. Pound famously promoted Joyce’s Ulysses and was instrumental in getting the work published in literary reviews. However, Pound did not appreciate Joyce’s artistic development in his so-called Work in Progress, which was published in 1939 under the title Finnegans Wake. Pound and Joyce will be read as representing two different approaches to literature and other forms of art. Pound can be seen as essentially influenced by cubism and modernist techniques such as collage and montage. While many critics have used these notions to describe The Cantos, this paper will suggest reading Pound’s opus magnum in relation to Finnegans Wake. The latter work shows how Joyce remained tied to an idea of the literary work as sound, as something which may – or perhaps even should – be read aloud. In contrast, Pound’s The Cantos show clear signs of being influenced by experiments in the visual arts. The paper will argue that Pound intended to develop his work in order to bring literature 'up to date' with the development in visual arts, while Joyce stuck to a more classical understanding of the literary work as composed for oral presentation.

Keywords: collage, conceptualism, montage, literature and visual arts

Procedia PDF Downloads 177

Authors: Tallal Abdel Karim Bouzir, Nourdinne Zemmouri, Djihed Berkouk

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In this research, a quantitative assessment of the urban sound environment of the city of Biskra, Algeria, was conducted. To determine the quality of the soundscape based on in-situ measurement, using a Landtek SL5868P sound level meter in 47 points, which have been identified to represent the whole city. The result shows that the urban noise level varies from 55.3 dB to 75.8 dB during the weekdays and from 51.7 dB to 74.3 dB during the weekend. On the other hand, we can also note that 70.20% of the results of the weekday measurements and 55.30% of the results of the weekend measurements have levels of sound intensity that exceed the levels allowed by Algerian law and the recommendations of the World Health Organization. These very high urban noise levels affect the quality of life, the acoustic comfort and may even pose multiple risks to people's health.

Keywords: road traffic, noise pollution, sound intensity, public health

Procedia PDF Downloads 245

Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

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Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

Procedia PDF Downloads 425

Authors: Boukhris Lahouari, Bouchetara Mostefa

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The active safety of a vehicle is mainly influenced by the properties of the installed braking system. With the increase in road traffic density and travel speeds, increasingly stringent requirements are placed on the vehicle's behaviour during braking. The achievable decelerations are limited by the physical aspect characterized by the coefficient of friction between the tires and the ground. As a result, it follows that an optimized distribution of braking forces becomes necessary for a better use of friction coefficients. This objective could only be achieved if sufficient knowledge is available on the theory of vehicle dynamics during braking and on current standards for the approval of braking systems. These will facilitate the development of a braking force calculation algorithm that will enable an optimized distribution of braking forces to be achieved. Operating safety is conditioned by the requirements of efficiency, progressiveness, regularity or fidelity of a braking system without obviously neglecting the recommendations imposed by the legislator.

Keywords: brake force distribution, distribution diagram, friction coefficient, brake by wire

Procedia PDF Downloads 65

Authors: Henry Gonzalo Acurio Flores, Alvaro Nicolas Corral Naveda, Juan Francisco Fonseca Palacios

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In Ecuador, subventions on fossil fuels for the road transportation sector have always been part of its economy throughout time, mainly because of demagogy and populism from political leaders. It is clearly seen that the government cannot maintain the subsidies anymore due to its commercial balance and its general state budget; subsidies are a key barrier to implementing the use of cleaner technologies. However, during the last few months, the elimination of subsidies has been done gradually with the purpose of reaching international prices. It is expected that with this measure, the population will opt for other means of transportation, and in a certain way, it will promote the use of private electric vehicles and public, e.g., taxis and buses (urban transport). Considering the three main elements of sustainable development, an analysis of the social, economic, and environmental impacts of eliminating subsidies will be generated at the country level. To achieve this, four scenarios will be developed in order to determine how the subsidies will contribute to the promotion of electro-mobility. 1) A Business as Usual BAU scenario; 2) the introduction of 10 000 electric vehicles by 2025; 3) the introduction of 100 000 electric vehicles by 2030; 4) the introduction of 750 000 electric vehicles by 2040 (for all the scenarios buses, taxis, lightweight duty vehicles, and private vehicles will be introduced, as it is established in the National Electro Mobility Strategy for Ecuador). The Low Emissions Analysis Platform (LEAP) will be used, and it will be suitable to determine the cost for the government in terms of importing derivatives for fossil fuels and the cost of electricity to power the electric fleet that can be changed. The elimination of subventions generates fiscal resources for the state that can be used to develop other kinds of projects that will benefit Ecuadorian society. It will definitely change the energy matrix, and it will provide energy security for the country; it will be an opportunity for the government to incentivize a greater introduction of renewable energies, e.g., solar, wind, and geothermal. At the same time, it will also reduce greenhouse gas emissions (GHG) from the transportation sector, considering its mitigation potential, which as a result, will ameliorate the inhabitant quality of life by improving the quality of air, therefore reducing respiratory diseases associated with exhaust emissions, consequently, achieving sustainability, the Sustainable Development Goals (SDGs), and complying with the agreements established in the Paris Agreement COP 21 in 2015. Electro mobility in Latin America and the Caribbean can only be achieved by the implementation of the right policies at the central government, which need to be accompanied by a National Urban Mobility Policy (NUMP) and can encompass a greater vision to develop holistic, sustainable transport systems at local governments.

Keywords: electro mobility, energy, policy, sustainable transportation

Procedia PDF Downloads 61

Authors: Kibret Berhanu Getinet

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Off-farm income diversification by farm rural households has gained the attention of researchers and policymakers due to the fact that agriculture failed to meet the needs of people in developing countries like Ethiopia. The objective of this study was to investigate income diversification strategies into off-farm activities among rural households in Hawassa Zuria Woreda, Sidama National Regional State, Ethiopia. The study used primary and secondary data sources for the primary data collection questionnaire employed as a data collection instrument. A multistage sampling technique was used to collect data from a total of 197 sample households from four kebeles of the study area. Descriptive statistics, as well as econometrics methods of data analysis, were employed. The descriptive statistics result indicates that the majority of sample rural households (68.53 %) have engaged in off-farm income diversification activities while the remaining 31.47% of households did not participate in the diversification in the study area. The choice of participants among the strategies indicates that 6.60% of respondents participated in off-farm wage employment, 30.46% participated in off-farm self-employment, and about 31.47% of them participated in both off-farm wage employment. The study revealed that the share of off-farm income in total annual earnings of households was about 48.457%, and thus, the off-farm diversification significantly contributes to the rural household income. Moreover, binary and multinomial logistic regression models were employed to identify factors that affect the participation and the choices of the off-farm income diversification strategies, respectively. The binary logit model result indicated that agro-ecological zone, education status of the households, available technical skills of the household, household saving, total livestock owned by the households, access to electricity, road access and being married of household head were significant and positively affected the chance of diversification in off-farm activities while the on-farm income of households is negatively affected the chance of diversification. Similarly, the multinomial logistic regression model estimate revealed that agroecological zone, on-farm income, available technical skills, household savings, and access to electricity are positively related and significantly influenced the household’s choice of employment into off-farm wage employment. The off-farm self-employment diversification choice is significantly influenced by on-farm income, available technical skills, household savings, total livestock owned, and access to electricity. Moreover, the result showed that the factors that affect the choice of farm households to engage in both off-farm wage and self-employment are ecological zone, education status, on-farm income, available technical skills, household own saving, market access, total livestock owned, access to electricity and road access. Thus, due attention should be given to addressing the demographic, socio-economic, and institutional constraints to strengthen off-farm income diversification strategies to improve the income of rural households.

Keywords: off-farm, incoem, diversification, logit model

Procedia PDF Downloads 37

Authors: Vaidehi Raipat

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A city is an expression of coexistence between its users and built environment. The way in which its spaces are animated signify the quality of this coexistence. Urban sustainability is the ability of a city to respond efficiently towards its people, culture, environment, visual image, history, visions and identity. The quality of built environment determines the quality of our lifestyles, but poor ability of the built environment to adapt and sustain itself through the changes leads to degradation of cities. Ranchi was created in November 2000, as the capital of the newly formed state Jharkhand, located on eastern side of India. Before this Ranchi was known as summer capital of Bihar and was a little larger than a town in terms of development. But since then it has been vigorously expanding in size, infrastructure as well as population. This sudden expansion has created a stress on existing built environment. The large forest covers, agricultural land, diverse culture and pleasant climatic conditions have degraded and decreased to a large extent. Narrow roads and old buildings are unable to bear the load of the changing requirements, fast improving technology and growing population. The built environment has hence been rendered unsustainable and unadaptable through fastidious changes of present era. Some of the common hazards that can be easily spotted in the built environment are half-finished built forms, pedestrians and vehicles moving on the same part of the road. Unpaved areas on street edges. Over-sized, bright and randomly placed hoardings. Negligible trees or green spaces. The old buildings have been poorly maintained and the new ones are being constructed over them. Roads are too narrow to cater to the increasing traffic, both pedestrian and vehicular. The streets have a large variety of activities taking place on them, but haphazardly. Trees are being cut down for road widening and new constructions. There is no space for greenery in the commercial as well as old residential areas. The old infrastructure is deteriorating because of poor maintenance and the economic limitations. Pseudo understanding of functionality as well as aesthetics drive the new infrastructure. It is hence necessary to evaluate the extent of sustainability of existing built environment of the city and create or regenerate the existing built environment into a more sustainable and adaptable one. For this purpose, research titled “Sustainability of the Built Environment of Ranchi District” has been carried out. In this research the condition of the built environment of Ranchi are explored so as to figure out the problems and shortcomings existing in the city and provide for design strategies that can make the existing built-environment sustainable. The built environment of Ranchi that include its outdoor spaces like streets, parks, other open areas, its built forms as well as its users, has been analyzed in terms of various urban design parameters. Based on which strategies have been suggested to make the city environmentally, socially, culturally and economically sustainable.

Keywords: adaptable, built-environment, sustainability, urban

Procedia PDF Downloads 218

Authors: Heather Clark, Jon Kelly

Abstract:

Burnout among healthcare professionals has been elevated to a high level of concern. The descriptions of the healthcare workplace often include language such as, stressful, long hours, rotating shifts, weekends and holidays, and exhausting. New graduate healthcare professionals are being sent into the workplace with little to no coping skills, knowledge of signs and symptoms of burnout, or resources that are available. The authors of this study created a university course entitled 'coping in your profession' that enrolled registered nurses, licensed practical nurses, EMTs, nurse assistants, and medical assistants. The course addresses burnout, self-analysis, incivility, coping mechanisms, and organizational responsibilities for employee well-being. The students were surveyed using QualtricsXM that included a pre-course and post-course analysis. Pre-course results showed high levels of individual experiences with burnout and limited knowledge of resources to combat burnout. Post-course results included personal growth and that students’ perception of burnout can be prevented at both the individual and the organization levels. Students also indicated that few to no resources to combat burnout existed at their place of employment. Addressing burnout at the educational level helps prepare graduates with the knowledge and tools to combat burnout at the individual and organization level.

Keywords: burnout, coping, healthcare workers, incivility, resilience

Procedia PDF Downloads 115