Search results for: English for academic and specific purposes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12433

Search results for: English for academic and specific purposes

3823 A Study of the Replacement of Natural Coarse Aggregate by Spherically-Shaped and Crushed Waste Cathode Ray Tube Glass in Concrete

Authors: N. N. M. Pauzi, M. R. Karim, M. Jamil, R. Hamid, M. F. M. Zain

Abstract:

The aim of this study is to conduct an experimental investigation on the influence of complete replacement of natural coarse aggregate with spherically-shape and crushed waste cathode ray tube (CRT) glass to the aspect of workability, density, and compressive strength of the concrete. After characterizing the glass, a group of concrete mixes was prepared to contain a 40% spherical CRT glass and 60% crushed CRT glass as a complete (100%) replacement of natural coarse aggregates. From a total of 16 types of concrete mixes, the optimum proportion was selected based on its best performance. The test results showed that the use of spherical and crushed glass that possesses a smooth surface, rounded, irregular and elongated shape, and low water absorption affects the workability of concrete. Due to a higher specific gravity of crushed glass, concrete mixes containing CRT glass had a higher density compared to ordinary concrete. Despite the spherical and crushed CRT glass being stronger than gravel, the results revealed a reduction in compressive strength of the concrete. However, using a lower water to binder (w/b) ratio and a higher superplasticizer (SP) dosage, it is found to enhance the compressive strength of 60.97 MPa at 28 days that is lower by 13% than the control specimen. These findings indicate that waste CRT glass in the form of spherical and crushed could be used as an alternative of coarse aggregate that may pave the way for the disposal of hazardous e-waste.

Keywords: cathode ray tube, glass, coarse aggregate, compressive strength

Procedia PDF Downloads 156
3822 Understanding Awareness, Agency and Autonomy of Mothers and Potential of Digital Technology in Expanding Maternal Health Information Access: A Survey of Mothers in Urban India

Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

Abstract:

Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

Procedia PDF Downloads 132
3821 Storage Method for Parts from End of Life Vehicles' Dismantling Process According to Sustainable Development Requirements: Polish Case Study

Authors: M. Kosacka, I. Kudelska

Abstract:

Vehicle is one of the most influential and complex product worldwide, which affects people’s life, state of the environment and condition of the economy (all aspects of sustainable development concept) during each stage of lifecycle. With the increase of vehicles’ number, there is growing potential for management of End of Life Vehicle (ELV), which is hazardous waste. From one point of view, the ELV should be managed to ensure risk elimination, but from another point, it should be treated as a source of valuable materials and spare parts. In order to obtain materials and spare parts, there are established recycling networks, which are an example of sustainable policy realization at the national level. The basic object in the polish recycling network is dismantling facility. The output material streams in dismantling stations include waste, which very often generate costs and spare parts, that have the biggest potential for revenues creation. Both outputs are stored into warehouses, according to the law. In accordance to the revenue creation and sustainability potential, it has been placed a strong emphasis on storage process. We present the concept of storage method, which takes into account the specific of the dismantling facility in order to support decision-making process with regard to the principles of sustainable development. The method was developed on the basis of case study of one of the greatest dismantling facility in Poland.

Keywords: dismantling, end of life vehicles, sustainability, storage

Procedia PDF Downloads 266
3820 The Impact of Universal Design for Learning Implementation on Teaching Practices for Students with Intellectual Disabilities in the Kingdom of Saudi Arabia

Authors: Adnan Alhazmi

Abstract:

Background: UDL can be understood as a framework that holds the potential to elaborate the alternatives and platforms for the students with intellectual disabilities within general education settings and aims at offering flexible pathways that can support all the students in gaining a mastering over the goals of learning. This system of learning addresses the problem of the variability of the learner by delineating the diverse ways in which the individuals can understand, conceive, express and deal with the information. Goal: The aim of the proposed research is to examine the impact of the implementation of UDL in teaching practices for the students with intellectual disabilities in Saudi Arabian schools. Method: This research has used a combination of quantitative and qualitative designs. Survey questionnaires were used to gather the data for under this analytical descriptive method. The application of the qualitative interpretive approach was applied with the help of the interview to gather a detailed understanding on the aim of the research. For this purpose, the semi-structured interviews were conducted. Thus, the primary data will be gathered with the help of survey and interview to examine the impact of universal design learning implementation on teaching practices for intellectually disabled students in Saudi Arabian schools. The survey was conducted to examine the prevailing teaching practices for the students with intellectual disabilities in Saudi Arabia and evaluate if the teaching experience influences the current practices or not. The surveys were distributed to 50 teachers who teach the students with intellectual disabilities. However, the interviews were conducted to explore barriers of implementing UDL in Saudi Arabia and provide suggested guideline for the implementation of UDL in Saudi Arabia. The interviews, therefore, were with 10 teachers teaching the same subject. Findings: A key findings highlighted in this study revealed that the UDL framework serves as a crucial guide for teachers within inclusive settings to undertake meaningful planning for the individuals with intellectual disabilities so that they are able to access, participate, and grow within the general education curriculum. Other findings of the study highlighted the need to prepare the educators and all faculty members to understand the purpose and need for inclusion, the UDL framework so that better information about academic and social expectations for individuals with intellectual disabilities can be delivered. Conclusion: On the basis of the preliminary study undertaken on the subject of research, it could be suggested that UDL can serve to be an effective support for undertaking a meaningful inclusion of students with intellectual disability (ID) in general educational settings. It holds the potential role of working as an institutional design framework that could be used for designing curriculum for students with intellectual disabilities.

Keywords: intellectual disability, inclusion, universal design for learning, teaching practice

Procedia PDF Downloads 131
3819 Factors Associated with Hand Functional Disability in People with Rheumatoid Arthritis: A Systematic Review and Best-Evidence Synthesis

Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

Abstract:

Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

Procedia PDF Downloads 140
3818 The Nexus between Country Risk and Exchange Rate Regimes: A Global Investigation

Authors: Jie Liu, Wei Wei, Chun-Ping Chang

Abstract:

Using a sample of 110 countries over the period 1984-2013, this paper examines the impacts of country risks on choosing a specific exchange rate regime (first by utilizing the Levy-Yeyati and Sturzenegger de facto classification and then robusting it by the IMF de jure measurement) relative to other regimes via the panel multinomial logit approach. Empirical findings are as follows. First, in the full samples case we provide evidence that government is more likely to implement a flexible regime, but less likely to adopt a fixed regime, under a low level of composite and financial risk. Second, we find that Eurozone countries are more likely to choose a fixed exchange rate regime with a decrease in the level of country risk and favor a flexible regime in response to a shock from an increase of risk, which is opposite to non-Eurozone countries. Third, we note that high-risk countries are more likely to choose a fixed regime with a low level of composite and political risk in the government, but do not adjust the exchange rate regime as a shock absorber when facing economic and financial risks. It is interesting to see that those countries with relatively low risk display almost opposite results versus high-risk economies. Overall, we believe that it is critically important to account for political economy variables in a government’s exchange rate policy decisions, especially for country risks. All results are robust to the panel ordered probit model.

Keywords: country risk, political economy, exchange rate regimes, shock absorber

Procedia PDF Downloads 296
3817 Case Study of Migrants, Cultures and Environmental Crisis

Authors: Christina Y. P. Ting

Abstract:

Migration is a global phenomenon with movements of migrants from developed and developing countries to the host societies. Migrants have changed the host countries’ demography – its population structure and also its ethnic cultural diversity. Acculturation of migrants in terms of their adoption of the host culture is seen as important to ensure that they ‘fit into’ their adopted country so as to participate in everyday public life. However, this research found that the increase of the China-born migrants’ post-migration consumption level had impact on Australia’s environment reflected not only because of their adoption of elements of the host culture, but also retention of aspects of Chinese culture – indicating that the influence of bi-culturalism was in operation. This research, which was based on the face-to-face interview with 61 China-born migrants in the suburb of Box Hill, Melbourne, investigated the pattern of change in the migrants’ consumption upon their settlement in Australia. Using an ecological footprint calculator, their post-migration footprints were found to be larger than pre-migration footprint. The uniquely-derived CALD (Culturally and Linguistically Diverse) Index was used to measure individuals’ strength of connectedness to ethnic culture. Multi-variant analysis was carried out to understand which independent factors that influence consumption best explain the change in footprint (which is the difference between pre-and post-migration footprints, as a dependent factor). These independent factors ranged from socio-economic and demographics to the cultural context, that is, the CALD Index and indicators of acculturation. The major findings from the analysis were: Chinese culture (as measured by the CALD Index) and indicators of acculturation such as length of residency and using English in communications besides the traditional factors such as age, income and education level made significant contributions to the large increase in the China-born group’s post-migration consumption level. This paper as part of a larger study found that younger migrants’ large change in their footprint were related to high income and low level of education. This group of migrants also practiced bi-cultural consumption in retaining ethnic culture and adopting the host culture. These findings have importantly highlighted that for a host society to tackle environmental crisis, governments need not only to understand the relationship between age and consumption behaviour, but also to understand and embrace the migrants’ ethnic cultures, which may act as bridges and/or fences in relationships. In conclusion, for governments to deal with national issues such as environmental crisis within a cultural diverse population, it necessitates an understanding of age and aspects of ethnic culture that may act as bridges and fences. This understanding can aid in putting in place policies that enable the co-existence of a hybrid of the ethnic and host cultures in order to create and maintain a harmonious and secured living environment for population groups.

Keywords: bicultural consumer, CALD index, consumption, ethnic culture, migrants

Procedia PDF Downloads 239
3816 The Use of Phototherapy with Unusual Case Studies in Counselling

Authors: Briar Schulz

Abstract:

The use of phototherapy within the counselling room offers significant advantages in extending far beyond typical "talk therapy" avenues. The benefits of using this approach are numerous and include: efficiency in recalling pertinent information in addition to utilizing a visual lens that often captures opulent detail that can be eluded in traditional dialogue. The goal of this presentation is to provide conference attendees with an opportunity to understand the therapeutic benefits and creative possibilities of incorporating photography into the clinical counselling process. This includes practical strategies for using in specific case studies, where studies of phototherapy have previously been limited. Ethical considerations and limitations to the process will also be addressed. Attendees will observe the benefits of using phototherapy with six longitudinal case studies including: a 30 year old female, with anorexia nervosa; a 22 year old self-harming individual with obsessive compulsive disorder; a 24 year old client with developmental delays, and bipolar disorder; a 14 year old client with Autism; and two clients with rare medical conditions struggling with depression and anxiety, one 21 years old and the other 16 years old. Aspects of each case will be linked to various theoretical modalities to highlight the efficiency and benefits of phototherapy in drawing important clinical conclusions. Furthermore, the use of phototherapy within these clinical areas remains a relatively unexplored area of the literature, and possibilities for future research will be highlighted. Finally, conference attendees will have the opportunity to try various phototherapy strategies within the interactive portion of this presentation. .

Keywords: Atypical, Case studies, Phototherapy, Photovoice

Procedia PDF Downloads 141
3815 Outcomes of Live Renal Donors with a History of Nephrolithiasis

Authors: Bin Mohamed Ebrahim, Aminesh Singla, Henry Pleass

Abstract:

Aim: There is an ongoing gap in renal transplantation between organs available for donation and recipients on the waiting list. Live donors with pre-existing or a history of renal calculi were thought to be a relative contraindication due to safety concerns for donors. We aim to review current literature assessing outcomes of donors who were found to have a history of renal calculi. Methods: Ovid and Embase were searched between 1960 to 2021 using key terms and Medical Subject Headings (MeSH) – nephrolithiasis, renal stones, renal transplantation and renal graft. Articles included conference proceedings and journal articles and were not excluded based on patient numbers. Studies were excluded if the specific organ was not identified, duplicated reports found or if post-transplant outcomes were not recorded. Outcomes were donor’s renal function or renal calculi recurrence postoperatively. Results: Upon reviewing 344 articles, 14 manuscripts met inclusion criteria. A total of 152 live donors were identified as having pre-existing or with a history of renal calculi at pre-operative workup. The mean stone size was 2.6 4mm (1 – 16) with a mean follow-up duration of 31.8 months (1 – 96). Seven studies had both outcomes. None showed renal complications or stone recurrence. The remaining studies contained 2 out of 84 patients having recurrent nephrolithiasis. Conclusion: Data suggests minimal morbidity involved for live renal donors with a history of nephrolithiasis. This should encourage surgeons to continue recruiting such donors for kidney transplantation.

Keywords: renal transplantation, renal graft, nephrolithiasis, renal calculi, live donor

Procedia PDF Downloads 177
3814 Teacher Professional Development in Saudi Arabia through the Implementation of Universal Design for Learning

Authors: Majed A. Alsalem

Abstract:

Universal Design for Learning (UDL) is common theme in education across the US and an influential model and framework that enables students in general and particularly students who are deaf and hard of hearing (DHH) to access the general education curriculum. UDL helps teachers determine how information will be presented to students and how to keep students engaged. Moreover, UDL helps students to express their understanding and knowledge to others. UDL relies on technology to promote students' interaction with content and their communication of knowledge. This study included 120 DHH students who received daily instruction based on UDL principles. This study presents the results of the study and discusses its implications for the integration of UDL in day-to-day practice as well as in the country's education policy. UDL is a Western concept that began and grew in the US, and it has just begun to transfer to other countries such as Saudi Arabia. It will be very important to researchers, practitioners, and educators to see how UDL is being implemented in a new place with a different culture. UDL is a framework that is built to provide multiple means of engagement, representation, and action and expression that should be part of curricula and lessons for all students. The purpose of this study is to investigate the variables associated with the implementation of UDL in Saudi Arabian schools and identify the barriers that could prevent the implementation of UDL. Therefore, this study used a mixed methods design that use both quantitative and qualitative methods. More insights will be gained by including both quantitative and qualitative rather than using a single method. By having methods that different concepts and approaches, the databases will be enriched. This study uses levels of collecting date through two stages in order to insure that the data comes from multiple ways to mitigate validity threats and establishing trustworthiness in the findings. The rationale and significance of this study is that it will be the first known research that targets UDL in Saudi Arabia. Furthermore, it will deal with UDL in depth to set the path for further studies in the Middle East. From a perspective of content, this study considers teachers’ implementation knowledge, skills, and concerns of implementation. This study deals with effective instructional designs that have not been presented in any conferences, workshops, teacher preparation and professional development programs in Saudi Arabia. Specifically, Saudi Arabian schools are challenged to design inclusive schools and practices as well as to support all students’ academic skills development. The total participants in stage one were 336 teachers of DHH students. The results of the intervention indicated significant differences among teachers before and after taking the training sessions associated with their understanding and level of concern. Teachers have indicated interest in knowing more about UDL and adopting it into their practices; they reported that UDL has benefits that will enhance their performance for supporting student learning.

Keywords: deaf and hard of hearing, professional development, Saudi Arabia, universal design for learning

Procedia PDF Downloads 426
3813 Toxicities associated with EBRT and Brachytherapy for Intermediate and High Risk Prostate Cancer, Correlated with Intra-operative Dosing

Authors: Rebecca Dunne, Cormac Small, Geraldine O'Boyle, Nazir Ibrahim, Anisha

Abstract:

Prostate cancer is the most common cancer among men, excluding non-melanoma skin cancers. It is estimated that approximately 12% of men will develop prostate cancer during their lifetime. Patients with intermediate, high risk, and very-high risk prostate cancer often undergo a combination of radiation treatments. These treatments include external beam radiotherapy with a low-dose rate or high-dose rate brachytherapy boost, often with concomitant androgen deprivation therapy. The literature on follow-up of patients that receive brachytherapy is scarce, particularly follow-up of patients that undergo high-dose rate brachytherapy. This retrospective study aims to investigate the biochemical failure and toxicities associated with triple therapy and external beam radiotherapy given in combination with brachytherapy. Reported toxicities and prostate specific antigen (PSA) were retrospectively evaluated in eighty patients that previously underwent external beam radiotherapy with a low-dose rate or high dose-rate brachytherapy boost. The severity of toxicities were correlated with intra-operative dosing during brachytherapy on ultrasound and CT scan. The results of this study will provide further information for clinicians and patients when considering treatment options.

Keywords: toxicities, combination, brachytherapy, intra-operative dosing, biochemical failure

Procedia PDF Downloads 228
3812 The History of the Residential Care Environments for the Elderly in Iran

Authors: Saeed Haghnia

Abstract:

This paper traces the back history of environments in which the elderly who could not stay in private dwellings were accommodated and taken care of in Iran in the 19th century. It investigates the factors impacting on the establishment of the first nursing homes in Iran in 1973. Today in 2020, the nursing home is the only available model of residential care environment for the elderly who cannot stay in private dwellings in Iran. Understanding the evolution of these environments from a socio-political perspective is crucial before studying nursing homes’ response to the elderly and society in Iran and seeking any alternative model specific to the context. However, no study on the evolution of these environments in Iran was found. Thus, this paper, by going through primary and secondary resources and from a socio-political perspective, investigates how the elderly who could not stay in private dwellings were accommodated and taken care of in Iran in the 19th century. Maristan, in the early 19th century in Egypt as a part of Islamic territory, is an example of such spaces in which homeless elderly were kept and taken care of. This study suggests that in the 19th century in Iran in lack of significant governmental influence over people’s social affairs, any potential environments accommodating and taking care of the elderly who could not stay in private dwellings (mainly homeless) in Iran were probably regulated or supported by local figures, specifically clergies, as a response to the need for taking care of the vulnerable members of society.

Keywords: nursing home, ageing, Iran, middle east, Qajar, Pahlavi

Procedia PDF Downloads 86
3811 Stressful Events and Serious Mood Disorders

Authors: Horesh Reinman Netta

Abstract:

Objectives: To examine the relationship between stressful life events and recurrent major depressive disorders Methods: Three groups of 50 subjects were assessed. One group had a recurrent major depressive disorder with melancholic features; the second group met the criteria for borderline personality disorder, and the third consisted of healthy controls. The Structured Clinical Interview for AXIS I DSM-IV Disorders sand the Structured Clinical Interview for AXIS II DSM-IV Disorders were used for diagnosis. The Israel Psychiatric Epidemiology Research Interview (IPERI) Life Event Scale and the Coddington Life Events Schedule (CLES) were used to measure life events which were confirmed with a confirmatory semi-structured interview. The Beck Depression Inventory and the Satisfaction from Life scales were also administered. Results : The total number of loss-related events in childhood and in the year preceding the first episode was significantly higher in the affective disorder group than in the two control groups. Total number of LE, uncontrolled and independent events were also more common in the depressed patients in the year preceding the first episode. No category of SLE was differentiated among any of the three groups during any period of time following the first depressive episode. Conclusions: SLE play an important role in the onset of affective disorders. There appear to be specific kinds of SLE occurring in childhood and in the year preceding a first episode that have particular significance. SLE may have a lesser role in the maintenance of this illness.

Keywords: modd dosorders, recurrent depression, stress, life events

Procedia PDF Downloads 101
3810 Development of a Combustible Gas Detector with Two Sensor Modules to Enable Measuring Range of Low Concentration

Authors: Young Gyu Kim, Sangguk Ahn, Gyoutae Park, Hiesik Kim

Abstract:

In the gas industrial fields, there are many problems to detect extremely small amounts of combustible gas (CH₄) if a conventional semiconductor is used. Those reasons are that measuring is difficult at the low concentration level, the stabilization time is long, and an initial response time is slow. In this study, we propose a method to solve these issues using two specific sensors to overcome the circumstances of temperature and humidity. This idea is to combine a catalytic and a semiconductor type sensor and to utilize every advantage from every sensor’s characteristic. In order to achieve the goal, we reduced fluctuations of a gas sensor for temperature and humidity by applying designed circuits for sensing temperature and humidity. And we induced the best calibration line of gas sensors through adjusting a weight value corresponding to changeable patterns of temperature and humidity after their data are previously acquired and stored. We proposed and developed the gas leak detector using two sensor modules, which is first operated by a semiconductor sensor for measuring small gas quantities and second a catalytic type sensor is detected if measuring range of the first sensor is beyond. We conclusively verified characteristics of sharp sensitivity and fast response time against even at lower gas concentration level through experiments other than a conventional gas sensor. We think that our proposed idea is very useful if another gas leak is developed to enable measuring extremely small quantities of toxic and flammable gases.

Keywords: gas sensor, leak detector, lower concentration, and calibration

Procedia PDF Downloads 235
3809 Climate Change Impact on Water Resources above the Territory of Georgia

Authors: T. Davitashvili

Abstract:

At present impact of global climate change on the territory of Georgia is evident at least on the background of the Caucasus glaciers melting which during the last century have decreased to half their size. Glaciers are early indicators of ongoing global and regional climate change. Knowledge of the Caucasus glaciers fluctuation (melting) is an extremely necessary tool for planning hydro-electric stations and water reservoir, for development tourism and agriculture, for provision of population with drinking water and for prediction of water supplies in more arid regions of Georgia. Otherwise, the activity of anthropogenic factors has resulted in decreasing of the mowing, arable, unused lands, water resources, shrubs and forests, owing to increasing the production and building. Transformation of one type structural unit into another one has resulted in local climate change and its directly or indirectly impacts on different components of water resources on the territory of Georgia. In the present paper, some hydrological specifications of Georgian water resources and its potential pollutants on the background of regional climate change are presented. Some results of Georgian’s glaciers pollution and its melting process are given. The possibility of surface and subsurface water pollution owing to accidents at oil pipelines or railway routes are discussed. The specific properties of regional climate warming process in the eastern Georgia are studied by statistical methods. The effect of the eastern Georgian climate change upon water resources is investigated.

Keywords: climate, droughts, pollution, water resources

Procedia PDF Downloads 477
3808 Reconstructing Calvarial Bone Lesions Using PHBV Scaffolds and Cord Blood Mesenchymal Stem Cells in Rat

Authors: Hamed Hosseinkazemi, Esmaeil Biazar

Abstract:

For tissue engineering of bone, anatomical and operational reconstructions of damaged tissue seem to be vital. This is done via reconstruction of bone and appropriate biological joint with bone tissues of damaged areas. In this study the condition of biodegradable bed Nanofibrous PHBV and USSC cells were used to accelerate bone repair of damaged area. Hollow nanofabrication scaffold of damageable life was designed as PHBV by electrospinning and via determining the best factors such as the kind and amount of solvent, specific volume and rate. The separation of osseous tissue infiltration and evaluating its nature by flow cytometrocical analysis was done. Animal test including USSC as well as PHBV condition in the damaged bone was done in the rat. After 8 weeks the implanted area was analyzed using CT scan and was sent to histopathology ward. Finally, the rate and quality of reconstruction were determined after H and E coloring. Histomorphic analysis indicated a statistically significant difference between the experimental group of PHBV, USSC+PHBV and control group. Besides, the histopathologic analysis showed that bone reconstruction rate was high in the area containing USSC and PHBV, compared with area having PHBV and control group and consequently the reconstruction quality of bones and the relationship between the new bone tissues and surrounding bone tissues were high too. Using PHBR scaffold and USSC together could be useful in the amending of wide range of bone lesion.

Keywords: bone lesion, nanofibrous PHBV, stem cells, umbilical cord blood

Procedia PDF Downloads 313
3807 Complete Ensemble Empirical Mode Decomposition with Adaptive Noise Temporal Convolutional Network for Remaining Useful Life Prediction of Lithium Ion Batteries

Authors: Jing Zhao, Dayong Liu, Shihao Wang, Xinghua Zhu, Delong Li

Abstract:

Uhumanned Underwater Vehicles generally operate in the deep sea, which has its own unique working conditions. Lithium-ion power batteries should have the necessary stability and endurance for use as an underwater vehicle’s power source. Therefore, it is essential to accurately forecast how long lithium-ion batteries will last in order to maintain the system’s reliability and safety. In order to model and forecast lithium battery Remaining Useful Life (RUL), this research suggests a model based on Complete Ensemble Empirical Mode Decomposition with Adaptive noise-Temporal Convolutional Net (CEEMDAN-TCN). In this study, two datasets, NASA and CALCE, which have a specific gap in capacity data fluctuation, are used to verify the model and examine the experimental results in order to demonstrate the generalizability of the concept. The experiments demonstrate the network structure’s strong universality and ability to achieve good fitting outcomes on the test set for various battery dataset types. The evaluation metrics reveal that the CEEMDAN-TCN prediction performance of TCN is 25% to 35% better than that of a single neural network, proving that feature expansion and modal decomposition can both enhance the model’s generalizability and be extremely useful in industrial settings.

Keywords: lithium-ion battery, remaining useful life, complete EEMD with adaptive noise, temporal convolutional net

Procedia PDF Downloads 139
3806 Dissimilarity Measure for General Histogram Data and Its Application to Hierarchical Clustering

Authors: K. Umbleja, M. Ichino

Abstract:

Symbolic data mining has been developed to analyze data in very large datasets. It is also useful in cases when entry specific details should remain hidden. Symbolic data mining is quickly gaining popularity as datasets in need of analyzing are becoming ever larger. One type of such symbolic data is a histogram, which enables to save huge amounts of information into a single variable with high-level of granularity. Other types of symbolic data can also be described in histograms, therefore making histogram a very important and general symbolic data type - a method developed for histograms - can also be applied to other types of symbolic data. Due to its complex structure, analyzing histograms is complicated. This paper proposes a method, which allows to compare two histogram-valued variables and therefore find a dissimilarity between two histograms. Proposed method uses the Ichino-Yaguchi dissimilarity measure for mixed feature-type data analysis as a base and develops a dissimilarity measure specifically for histogram data, which allows to compare histograms with different number of bins and bin widths (so called general histogram). Proposed dissimilarity measure is then used as a measure for clustering. Furthermore, linkage method based on weighted averages is proposed with the concept of cluster compactness to measure the quality of clustering. The method is then validated with application on real datasets. As a result, the proposed dissimilarity measure is found producing adequate and comparable results with general histograms without the loss of detail or need to transform the data.

Keywords: dissimilarity measure, hierarchical clustering, histograms, symbolic data analysis

Procedia PDF Downloads 155
3805 The Dynamics of a 3D Vibrating and Rotating Disc Gyroscope

Authors: Getachew T. Sedebo, Stephan V. Joubert, Michael Y. Shatalov

Abstract:

Conventional configuration of the vibratory disc gyroscope is based on in-plane non-axisymmetric vibrations of the disc with a prescribed circumferential wave number. Due to the Bryan's effect, the vibrating pattern of the disc becomes sensitive to the axial component of inertial rotation of the disc. Rotation of the vibrating pattern relative to the disc is proportional to the inertial angular rate and is measured by sensors. In the present paper, the authors investigate a possibility of making a 3D sensor on the basis of both in-plane and bending vibrations of the disc resonator. We derive equations of motion for the disc vibratory gyroscope, where both in-plane and bending vibrations are considered. Hamiltonian variational principle is used in setting up equations of motion and the corresponding boundary conditions. The theory of thin shells with the linear elasticity principles is used in formulating the problem and also the disc is assumed to be isotropic and obeys Hooke's Law. The governing equation for a specific mode is converted to an ODE to determine the eigenfunction. The resulting ODE has exact solution as a linear combination of Bessel and Neumann functions. We demonstrate how to obtain an explicit solution and hence the eigenvalues and corresponding eigenfunctions for annular disc with fixed inner boundary and free outer boundary. Finally, the characteristics equations are obtained and the corresponding eigenvalues are calculated. The eigenvalues are used for the calculation of tuning conditions of the 3D disc vibratory gyroscope.

Keywords: Bryan’s effect, bending vibrations, disc gyroscope, eigenfunctions, eigenvalues, tuning conditions

Procedia PDF Downloads 315
3804 International Students into the Irish Higher Education System: Supporting the Transition

Authors: Tom Farrelly, Yvonne Kavanagh, Tony Murphy

Abstract:

The sharp rise in international students into Ireland has provided colleges with a number of opportunities but also a number of challenges, both at an institutional and individual lecturer level and of course for the incoming student. Previously, Ireland’s population, particularly its higher education student population was largely homogenous, largely drawn from its own shores and thus reflecting the ethnic, cultural and religious demographics of the day. However, over the twenty years Ireland witnessed considerable economic growth, downturn and subsequent growth all of which has resulted in an Ireland that has changed both culturally and demographically. Propelled by Ireland’s economic success up to the late 2000s, one of the defining features of this change was an unprecedented rise in the number of migrants, both academic and economic. In 2013, Ireland’s National Forum for the Enhancement for Teaching and Learning in Higher Education (hereafter the National Forum) invited proposals for inter-institutional collaborative projects aimed at different student groups’ transitioning in or out of higher education. Clearly, both as a country and a higher education sector we want incoming students to have a productive and enjoyable time in Ireland. One of the ways that will help the sector help the students make a successful transition is by developing strategies and polices that are well informed and student driven. This abstract outlines the research undertaken by the five colleges Institutes of Technology: Carlow; Cork; Tralee & Waterford and University College Cork) in Ireland that constitute the Southern cluster aimed at helping international students transition into the Irish higher education system. The aim of the southern clusters’ project was to develop a series of online learning units that can be accessed by prospective incoming international students prior to coming to Ireland and by Irish based lecturing staff. However, in order to make the units as relevant and informed as possible there was a strong research element to the project. As part of the southern cluster’s research strategy a large-scale online survey using SurveyMonkey was undertaken across the five colleges drawn from their respective international student communities. In total, there were 573 responses from students coming from over twenty different countries. The results from the survey have provided some interesting insights into the way that international students interact with and understand the Irish higher education system. The research and results will act as a model for consistent practice applicable across institutional clusters, thereby allowing institutions to minimise costs and focus on the unique aspects of transitioning international students into their institution.

Keywords: digital, international, support, transitions

Procedia PDF Downloads 278
3803 Tuning of Kalman Filter Using Genetic Algorithm

Authors: Hesham Abdin, Mohamed Zakaria, Talaat Abd-Elmonaem, Alaa El-Din Sayed Hafez

Abstract:

Kalman filter algorithm is an estimator known as the workhorse of estimation. It has an important application in missile guidance, especially in lack of accurate data of the target due to noise or uncertainty. In this paper, a Kalman filter is used as a tracking filter in a simulated target-interceptor scenario with noise. It estimates the position, velocity, and acceleration of the target in the presence of noise. These estimations are needed for both proportional navigation and differential geometry guidance laws. A Kalman filter has a good performance at low noise, but a large noise causes considerable errors leads to performance degradation. Therefore, a new technique is required to overcome this defect using tuning factors to tune a Kalman filter to adapt increasing of noise. The values of the tuning factors are between 0.8 and 1.2, they have a specific value for the first half of range and a different value for the second half. they are multiplied by the estimated values. These factors have its optimum values and are altered with the change of the target heading. A genetic algorithm updates these selections to increase the maximum effective range which was previously reduced by noise. The results show that the selected factors have other benefits such as decreasing the minimum effective range that was increased earlier due to noise. In addition to, the selected factors decrease the miss distance for all ranges of this direction of the target, and expand the effective range which leads to increase probability of kill.

Keywords: proportional navigation, differential geometry, Kalman filter, genetic algorithm

Procedia PDF Downloads 503
3802 The Challenges Involved in Investigating and Prosecuting Hate Crime Online

Authors: Mark Williams

Abstract:

The digital revolution has radically transformed our social environment creating vast opportunities for interconnectivity and social interaction. This revolution, however, has also changed the reach and impact of hate crime, with social media providing a new platform to victimize and harass users in their homes. In this way, developments in the information and communication technologies have exacerbated and facilitated the commission of hate crime, increasing its prevalence and impact. Unfortunately, legislators, policymakers and criminal justice professionals have struggled to keep pace with these technological developments, reducing their ability to intervene in, regulate and govern the commission of hate crimes online. This work is further complicated by the global nature of this crime due to the tendency for offenders and victims to reside in multiple different jurisdictions, as well as the need for criminal justice professionals to obtain the cooperation of private companies to access information required for prosecution. Drawing on in-depth interviews with key criminal justice professionals and policymakers with detailed knowledge in this area, this paper examines the specific challenges the police and prosecution services face as they attempt to intervene in and prosecute the commission of hate crimes online. It is argued that any attempt to reduce online othering, such as the commission of hate crimes online, must be multifaceted, collaborative and involve both innovative technological solutions as well as internationally agreed ethical and legal frameworks.

Keywords: cybercrime, digital policing, hate crime, social media

Procedia PDF Downloads 215
3801 Implementation of International Standards in the Field of Higher Secondary Education in Kerala

Authors: Bernard Morais Joosa

Abstract:

Kerala, the southern state of India, is known for its accomplishments in universal education and enrollments. Through this mission, the Government proposes comprehensive educational reforms including 1000 Government schools into international standards during the first phase. The idea is not only to improve the infrastructural facilities but also to reform the teaching and learning process to the present day needs by introducing ICT enabled learning and providing smart classrooms. There will be focus on creating educational programmes which are useful for differently abled students. It is also meant to reinforce the teaching–learning process by providing ample opportunities to each student to construct their own knowledge using modern technology tools. The mission will redefine the existing classroom learning process, coordinate resource mobilization efforts and develop ‘Janakeeya Vidyabhyasa Mathruka.' Special packages to support schools which are in existence for over 100 years will also be attempted. The implementation will enlist full involvement and partnership of the Parent Teacher Association. Kerala was the first state in the country to attain 100 percent literacy more than two and a half decades ago. Since then the State has not rested on its laurels. It has moved forward in leaps and bounds conquering targets that no other State could achieve. Now the government of Kerala is taking off towards new goal of comprehensive educational reforms. And it focuses on Betterment of educational surroundings, use of technology in education, renewal of learning method and 1000 schools will be uplifted as Smart Schools. Need to upgrade 1000 schools into international standards and turning classrooms from standard 9 to 12 in high schools and higher secondary into high-tech classrooms and a special unique package for the renovation of schools, which have completed 50 and 100 years. The government intends to focus on developing standards first to eighth standards in tune with the times by engaging the teachers, parents, and alumni to recapture the relevance of public schools. English learning will be encouraged in schools. The idea is not only to improve the infrastructure facilities but also reform the curriculum to the present day needs. Keeping in view the differently-abled friendly approach of the government, there will be focus on creating educational program which is useful for differently abled students. The idea is to address the infrastructural deficiencies being faced by such schools. There will be special emphasis on ensuring internet connectivity to promote IT-friendly existence. A task-force and a full-time chief executive will be in charge of managing the day to day affairs of the mission. Secretary of the Public Education Department will serve as the Mission Secretary and the Chairperson of Task Force. As the Task Force will stress on teacher training and the use of information technology, experts in the field, as well as Directors of SCERT, IT School, SSA, and RMSA, will also be a part of it.

Keywords: educational standards, methodology, pedagogy, technology

Procedia PDF Downloads 128
3800 The Use of Geographic Information System and Spatial Statistic for Analyzing Leukemia in Kuwait for the Period of 2006-2012

Authors: Muhammad G. Almatar, Mohammad A. Alnasrallah

Abstract:

This research focuses on the study of three main issues: 1) The temporal analysis of leukemia for a period of six years (2006-2012), 2) spatial analysis by investigating this phenomenon in the Kuwaiti society spatially in the residential areas within the six governorates, 3) the use of Geographic Information System technology in investigating the hypothesis of the research and its variables using the linear regression, to show the pattern of linear relationship. The study depends on utilizing the map to understand the distribution of blood cancer in Kuwait. Several geodatabases were created for the number of patients and air pollution. Spatial interpolation models were used to generate layers of air pollution in the study area. These geodatabases were tested over the past six years to reach the conclusion: Is there a relationship with significant significance between the two main variables of the study: blood cancer and air pollution? This study is the first to our best knowledge. As far as the researchers know, the distribution of this disease has not been studied geographically at the level of regions in Kuwait within six years and in specific areas as described above. This study investigates the concentration of this type of disease. The study found that there is no relationship of significant value between the two variables studied, and this may be due to the nature of the disease, which are often hereditary. On the other hand, this study has reached a number of suggestions and recommendations that may be useful to decision-makers and interested in the study of leukemia in Kuwait by focusing on the study of genetic diseases, which may be a cause of leukemia rather than air pollution.

Keywords: Kuwait, GIS, cancer, geography

Procedia PDF Downloads 110
3799 Resilence and Adaptation to Water Scarcity in San Martín de las Palmas, Santiago Tilantongo, Nochixtlán Oaxaca

Authors: E. Montesinos-Pedro, L. G. Toscano-Flores, N. Domínguez-Ramírez

Abstract:

Water scarcity is a worldwide issue, coupled with climate change is a relevant problem, that affect not only large cities, but also rural areas. The Municipality of Santiago Tilantongo belongs to the district of Nochixtlán Oaxaca, it’s built up from 14 communities, one of them San Martin de las Palmas. This community was founded in 1900, at that time the inhabitants were supplied with water through rivers of the region which were abundant (they used containers filled in the river for that purpose); However, over the years the level of the rivers began to drop and in 1994 specific wells were located to store water and at the same time make it drinkable, this whit support of the state of Oaxaca and the program Procampo. By the year 2000 the shortage of water in the supply sources was notorious, the community requested support from the Oaxaca State government to solve the problem. The government’s response consisted in the implementation of ferro-cement tanks (2005) and water wells (2010), both for rainwater collection, Hower, it was not enough. Now days the community has a population of 60 inhabitants who have resisted and adapted to water scarcity, not only with the programs implemented by the government, but they also have implemented important structural analysis strategies. The objective of this research is to know the adaptation strategies used by the community to analyze them and propose improvements for water conservation and mitigation of this scarcity.

Keywords: adaptation, climate change, mitigation, resiliencia

Procedia PDF Downloads 89
3798 Kurma (Kerma Culture) at Nubia: Migration to Dholavira (Indus Valley Civilization)

Authors: Dhanpat Singh Dhania

Abstract:

Kurma-avatara and the Kachchhapraj is the name of the same person. Tortoise is called Kurma in Kerma valley (Nubia) and also called Kachchhap in India. Wherever a culture migrates, its faiths and beliefs remain intact. The tortoise culture of Kurma valley migrated to Dholavira, and its cultural symbolism remained the same as Kurma, the tortoise. Culture is known by burial traditions, pottery formations, language use, faiths, and beliefs. Following the cultural identification methodology, the Kurma culture buried their dead in circular burials found during excavation at Toshka, Nubia, and built their houses the type of tortoise shell. The Nubian tortoise of a specific species had a triangular on the shell found to be extinct was the cultural symbolism of the culture found on the excavated pottery. Kurma cultural head known as the Seth was known as Kurma-avatara. The Seth of Egypt came to know when the combined efforts of the Seth and the Osiris defeated the Egyptian 1st dynastic rule in about 2775 BCE. Osiris became the king of the 2nd dynastic Egypt. It annoyed Seth. He killed the Osiris and went to Rann of Kachchh and declared him as the Chachchhapraj, the king of Kachchh (now Gujarat, India). The Kurma (Kachchhap) culture migration at Dholavira (Gujarat) attested by the Dholavira signboard found during excavation and deciphered as the ‘Chakradhar’, the eighth incarnation of Kurma-avatara.

Keywords: Kurma, Egyptian, Kachchhap, Dholavira, Harappan

Procedia PDF Downloads 72
3797 Early Warning System of Financial Distress Based On Credit Cycle Index

Authors: Bi-Huei Tsai

Abstract:

Previous studies on financial distress prediction choose the conventional failing and non-failing dichotomy; however, the distressed extent differs substantially among different financial distress events. To solve the problem, “non-distressed”, “slightly-distressed” and “reorganization and bankruptcy” are used in our article to approximate the continuum of corporate financial health. This paper explains different financial distress events using the two-stage method. First, this investigation adopts firm-specific financial ratios, corporate governance and market factors to measure the probability of various financial distress events based on multinomial logit models. Specifically, the bootstrapping simulation is performed to examine the difference of estimated misclassifying cost (EMC). Second, this work further applies macroeconomic factors to establish the credit cycle index and determines the distressed cut-off indicator of the two-stage models using such index. Two different models, one-stage and two-stage prediction models, are developed to forecast financial distress, and the results acquired from different models are compared with each other, and with the collected data. The findings show that the two-stage model incorporating financial ratios, corporate governance and market factors has the lowest misclassification error rate. The two-stage model is more accurate than the one-stage model as its distressed cut-off indicators are adjusted according to the macroeconomic-based credit cycle index.

Keywords: Multinomial logit model, corporate governance, company failure, reorganization, bankruptcy

Procedia PDF Downloads 371
3796 Application of the Sufficiency Economy Philosophy to Integrated Instructional Model of In-Service Teachers of Schools under the Project Initiated by H.R.H Princess in Maha Chakri Sirindhorn, Nakhonnayok Educational Service Area Office

Authors: Kathaleeya Chanda

Abstract:

The schools under the Project Initiated by H.R.H Princess in Maha Chakri Sirindhorn in Nakhonnayok Educational Service Area Office are the small schools, situated in a remote and undeveloped area.Thus, the school-age youth didn’t have or have fewer opportunities to study at the higher education level which can lead to many social and economic problems. This study aims to solve these educational issues of the schools, under The Project Initiated by H.R.H Princess in Maha Chakri Sirindhorn, Nakhonnayok Educational Service Area Office, by the development of teachers, so that teachers could develop teaching and learning system with the ultimate goal to increase students’ academic achievement, increase the educational opportunities for the youth in the area, and help them learn happily. 154 in-service teachers from 22 schools and 4 different districts in Nakhonnayok participated in this teacher training. Most teachers were satisfied with the training content and the trainer. Thereafter, the teachers were given the test to assess the skills and knowledge after training. Most of the teachers earned a score higher than 75%. Accordingly, it can be concluded that after attending the training, teachers have a clear understanding of the contents. After the training session, the teachers have to write a lesson plan that is integrated or adapted to the Sufficiency Economy Philosophy. The teachers can either adopt intradisciplinary or interdisciplinary integration according to their actual teaching conditions in the school. Two weeks after training session, the researchers went to the schools to discuss with the teachers and follow up the assigned integrated lesson plan. It was revealed that the progress of integrated lesson plan could be divided into 3 groups: 1) the teachers who have completed the integrated lesson plan, but are concerned about the accuracy and consistency, 2) teachers who almost complete the lesson plan or made a great progress but are still concerned, confused in some aspects and not fill in the details of the plan, and 3), the teachers who made few progress, are uncertain and confused in many aspects, and may had overloaded tasks from their school. However, a follow-up procedure led to the commitment of teachers to complete the lesson plan. Regarding student learning assessment, from an experiment teaching, most of the students earned a score higher than 50 %. The rate is higher than the one from actual teaching. In addition, the teacher have assessed that the student is happy, enjoys learning, and providing a good cooperates in teaching activities. The students’ interview about the new lesson plan shows that they are happy with it, willing to learn, and able to apply such knowledge in daily life. Integrated lesson plan can increases the educational opportunities for youth in the area.

Keywords: sufficiency, economy, philosophy, integrated education syllabus

Procedia PDF Downloads 177
3795 Road Traffic Accidents Analysis in Mexico City through Crowdsourcing Data and Data Mining Techniques

Authors: Gabriela V. Angeles Perez, Jose Castillejos Lopez, Araceli L. Reyes Cabello, Emilio Bravo Grajales, Adriana Perez Espinosa, Jose L. Quiroz Fabian

Abstract:

Road traffic accidents are among the principal causes of traffic congestion, causing human losses, damages to health and the environment, economic losses and material damages. Studies about traditional road traffic accidents in urban zones represents very high inversion of time and money, additionally, the result are not current. However, nowadays in many countries, the crowdsourced GPS based traffic and navigation apps have emerged as an important source of information to low cost to studies of road traffic accidents and urban congestion caused by them. In this article we identified the zones, roads and specific time in the CDMX in which the largest number of road traffic accidents are concentrated during 2016. We built a database compiling information obtained from the social network known as Waze. The methodology employed was Discovery of knowledge in the database (KDD) for the discovery of patterns in the accidents reports. Furthermore, using data mining techniques with the help of Weka. The selected algorithms was the Maximization of Expectations (EM) to obtain the number ideal of clusters for the data and k-means as a grouping method. Finally, the results were visualized with the Geographic Information System QGIS.

Keywords: data mining, k-means, road traffic accidents, Waze, Weka

Procedia PDF Downloads 402
3794 Single Stage “Fix and Flap” Orthoplastic Approach to Severe Open Tibial Fractures: A Systematic Review of the Outcomes

Authors: Taylor Harris

Abstract:

Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

Procedia PDF Downloads 83