Search results for: post disasters
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4726

Search results for: post disasters

3886 Understanding Post-Displacement Earnings Losses: The Role of Wealth Inequality

Authors: M. Bartal

Abstract:

A large empirical evidence points to sizable lifetime earnings losses associated with the displacement of tenured workers. The causes of these losses are still not well-understood. Existing explanations are heavily based on human capital depreciation during non-employment spells. In this paper, a new avenue is explored. Evidence on the role of household liquidity constraints in accounting for the persistence of post-displacement earning losses is provided based on SIPP data. Then, a directed search and matching model with endogenous human capital and wealth accumulation is introduced. The model is computationally tractable thanks to its block-recursive structure and highlights a non-trivial, yet intuitive, interaction between wealth and human capital. Constrained workers tend to accept jobs with low firm-sponsored training because the latter are (endogenously) easier to find. This new channel provides a plausible explanation for why young (highly constrained) workers suffer persistent scars after displacement. Finally, the model is calibrated on US data to show that the interplay between wealth and human capital is crucial to replicate the observed lifecycle pattern of earning losses. JEL— E21, E24, J24, J63.

Keywords: directed search, human capital accumulation, job displacement, wealth accumulation

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3885 Rectus Sheath Block to Extend the Effectiveness of Post Operative Epidural Analgesia

Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail

Abstract:

Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.

Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric

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3884 Design an Architectural Model for Deploying Wireless Sensor Network to Prevent Forest Fire

Authors: Saurabh Shukla, G. N. Pandey

Abstract:

The fires have become the most serious disasters to forest resources and the human environment. In recent years, due to climate change, human activities and other factors the frequency of forest fires has increased considerably. The monitoring and prevention of forest fires have now become a global concern for forest fire prevention organizations. Currently, the methods for forest fire prevention largely consist of patrols, observation from watch towers. Thus, software like deployment of the wireless sensor network to prevent forest fire is being developed to get a better estimate of the temperature and humidity prospects. Now days, wireless sensor networks are beginning to be deployed at an accelerated pace. It is not unrealistic to expect that in coming years the world will be covered with wireless sensor networks. This new technology has lots of unlimited potentials and can be used for numerous application areas including environmental, medical, military, transportation, entertainment, crisis management, homeland defense, and smart spaces.

Keywords: deployment, sensors, wireless sensor networks, forest fires

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3883 Peripheral Neuropathy after Locoregional Anesthesia

Authors: Dalila Chaid, Bennameur Fedilli, Mohammed Amine Bellelou

Abstract:

The study focuses on the experience of lower-limb amputees, who face both physical and psychological challenges due to their disability. Chronic neuropathic pain and various types of limb pain are common in these patients. They often require orthopaedic interventions for issues such as dressings, infection, ulceration, and bone-related problems. Research Aim: The aim of this study is to determine the most suitable anaesthetic technique for lower-limb amputees, which can provide them with the greatest comfort and prolonged analgesia. The study also aims to demonstrate the effectiveness and cost-effectiveness of ultrasound-guided local regional anaesthesia (LRA) in this patient population. Methodology: The study is an observational analytical study conducted over a period of eight years, from 2010 to 2018. It includes a total of 955 cases of revisions performed on lower limb stumps. The parameters analyzed in this study include the effectiveness of the block and the use of sedation, the duration of the block, the post-operative visual analog scale (VAS) scores, and patient comfort. Findings: The study findings highlight the benefits of ultrasound-guided LRA in providing comfort by optimizing post-operative analgesia, which can contribute to psychological and bodily repair in lower-limb amputees. Additionally, the study emphasizes the use of alpha2 agonist adjuvants with sedative and analgesic properties, long-acting local anaesthetics, and larger volumes for better outcomes. Theoretical Importance: This study contributes to the existing knowledge by emphasizing the importance of choosing an appropriate anaesthetic technique for lower-limb amputees. It highlights the potential of ultrasound-guided LRA and the use of specific adjuvants and local anaesthetics in improving post-operative analgesia and overall patient outcomes. Data Collection and Analysis Procedures: Data for this study were collected through the analysis of medical records and relevant documentation related to the 955 cases included in the study. The effectiveness of the anaesthetic technique, duration of the block, post-operative pain scores, and patient comfort were analyzed using statistical methods. Question Addressed: The study addresses the question of which anaesthetic technique would be most suitable for lower-limb amputees to provide them with optimal comfort and prolonged analgesia. Conclusion: The study concludes that ultrasound-guided LRA, along with the use of alpha2 agonist adjuvants, long-acting local anaesthetics, and larger volumes, can be an effective approach in providing comfort and improving post-operative analgesia for lower-limb amputees. This technique can potentially contribute to the psychological and bodily repair of these patients. The findings of this study have implications for clinical practice in the management of lower-limb amputees, highlighting the importance of personalized anaesthetic approaches for better outcomes.

Keywords: neuropathic pain, ultrasound-guided peripheral nerve block, DN4 quiz, EMG

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3882 A Seven Year Single-Centre Study of Dental Implant Survival in Head and Neck Oncology Patients

Authors: Sidra Suleman, Maliha Suleman, Stephen Brindley

Abstract:

Oral rehabilitation of head and neck cancer patients plays a crucial role in the quality of life for such individuals post-treatment. Placement of dental implants or implant-retained prostheses can help restore oral function and aesthetics, which is often compromised following surgery. Conventional prosthodontic techniques can be insufficient in rehabilitating such patients due to their altered anatomy and reduced oral competence. Hence, there is a strong clinical need for the placement of dental implants. With an increasing incidence of head and neck cancer patients, the demand for such treatment is rising. Aim: The aim of the study was to determine the survival rate of dental implants in head and neck cancer patients placed at the Restorative and Maxillofacial Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: All patients who received dental implants between January 1, 2013 to December 31, 2020 were identified. Patients were excluded based on three criteria: 1) non-head and neck cancer patients, 2) no outpatient follow-up post-implant placement 3) provision of non-dental implants. Scanned paper notes and electronic records were extracted and analyzed. Implant survival was defined as fixtures that had remained in-situ / not required removal. Sample: Overall, 61 individuals were recruited from the 143 patients identified. The mean age was 64.9 years, with a range of 35 – 89 years. The sample included 37 (60.7%) males and 24 (39.3%) females. In total, 211 implants were placed, of which 40 (19.0%) were in the maxilla, 152 (72.0%) in the mandible and 19 (9.0%) in autogenous bone graft sites. Histologically 57 (93.4%) patients had squamous cell carcinoma, with 43 (70.5%) patients having either stage IVA or IVB disease. As part of treatment, 42 (68.9%) patients received radiotherapy, which was carried out post-operatively for 29 (69.0%) cases. Whereas 21 (34.4%) patients underwent chemotherapy, 13 (61.9%) of which were post-operative. The Median follow-up period was 21.9 months with a range from 0.9 – 91.4 months. During the study, 23 (37.7%) patients died and their data was censored beyond the date of death. Results: In total, four patients who had received radiotherapy had one implant failure each. Two mandibular implants failed secondary to osteoradionecrosis, and two maxillary implants did not survive as a result of failure to osseointegrate. The overall implant survival rates were 99.1% at three years and 98.1% at both 5 and 7 years. Conclusions: Although this data shows that implant failure rates are low, it highlights the difficulty in predicting which patients will be affected. Future studies involving larger cohorts are warranted to further analyze factors affecting outcomes.

Keywords: oncology, dental implants, survival, restorative

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3881 Ultra-deformable Drug-free Sequessome™ Vesicles (TDT 064) for the Treatment of Joint Pain Following Exercise: A Case Report and Clinical Data

Authors: Joe Collins, Matthias Rother

Abstract:

Background: Oral non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of joint pain during and post-exercise. However, oral NSAIDs increase the risk of systemic side effects, even in healthy individuals, and retard recovery from muscle soreness. TDT 064 (Flexiseq®), a topical formulation containing ultra-deformable drug-free Sequessome™ vesicles, has demonstrated equivalent efficacy to oral celecoxib in reducing osteoarthritis-associated joint pain and stiffness. TDT 064 does not cause NSAID-related adverse effects. We describe clinical study data and a case report on the effectiveness of TDT 064 in reducing joint pain after exercise. Methods: Participants with a pain score ≥3 (10-point scale) 12–16 hours post-exercise were randomized to receive TDT 064 plus oral placebo, TDT 064 plus oral ketoprofen, or ketoprofen in ultra-deformable phospholipid vesicles plus oral placebo. Results: In the 168 study participants, pain scores were significantly higher with oral ketoprofen plus TDT 064 than with TDT 064 plus placebo in the 7 days post-exercise (P = 0.0240) and recovery from muscle soreness was significantly longer (P = 0.0262). There was a low incidence of adverse events. These data are supported by clinical experience. A 24-year-old male professional rugby player suffered a traumatic lisfranc fracture in March 2014 and underwent operative reconstruction. He had no relevant medical history and was not receiving concomitant medications. He had undergone anterior cruciate ligament reconstruction in 2008. The patient reported restricted training due to pain (score 7/10), stiffness (score 9/10) and poor function, as well as pain when changing direction and running on consecutive days. In July 2014 he started using TDT 064 twice daily at the recommended dose. In November 2014 he noted reduced pain on running (score 2-3/10), decreased morning stiffness (score 4/10) and improved joint mobility and was able to return to competitive rugby without restrictions. No side effects of TDT 064 were reported. Conclusions: TDT 064 shows efficacy against exercise- and injury-induced joint pain, as well as that associated with osteoarthritis. It does not retard muscle soreness recovery after exercise compared with an oral NSAID, making it an alternative approach for the treatment of joint pain during and post-exercise.

Keywords: exercise, joint pain, TDT 064, phospholipid vesicles

Procedia PDF Downloads 480
3880 Enhanced Physiological Response of Blood Pressure and Improved Performance in Successive Divided Attention Test Seen with Classical Instrumental Background Music Compared to Controls

Authors: Shantala Herlekar

Abstract:

Introduction: Entrainment effect of music on cardiovascular parameters is well established. Music is being used in the background by medical students while studying. However, does it really help them relax faster and concentrate better? Objectives: This study was done to compare the effects of classical instrumental background music versus no music on blood pressure response over time and on successively performed divided attention test in Indian and Malaysian 1st-year medical students. Method: 60 Indian and 60 Malaysian first year medical students, with an equal number of girls and boys were randomized into two groups i.e music group and control group thus creating four subgroups. Three different forms of Symbol Digit Modality Test (to test concentration ability) were used as a pre-test, during music/control session and post-test. It was assessed using total, correct and error score. Simultaneously, multiple Blood Pressure recordings were taken as pre-test, during 1, 5, 15, 25 minutes during music/control (+SDMT) and post-test. The music group performed the test with classical instrumental background music while the control group performed it in silence. Results were analyzed using students paired t test. p value < 0.05 was taken as statistically significant. A drop in BP recording was indicative of relaxed state and a rise in BP with task performance was indicative of increased arousal. Results: In Symbol Digit Modality Test (SDMT) test, Music group showed significant better results for correct (p = 0.02) and total (p = 0.029) scores during post-test while errors reduced (p = 0.002). Indian music group showed decline in post-test error scores (p = 0.002). Malaysian music group performed significantly better in all categories. Blood pressure response was similar in music and control group with following variations, a drop in BP at 5minutes, being significant in music group (p < 0.001), a steep rise in values till 15minutes (corresponding to SDMT test) also being significant only in music group (p < 0.001) and the Systolic BP readings in controls during post-test were at lower levels compared to music group. On comparing the subgroups, not much difference was noticed in recordings of Indian student’s subgroups while all the paired-t test values in the Malaysian music group were significant. Conclusion: These recordings indicate an increased relaxed state with classical instrumental music and an increased arousal while performing a concentration task. Music used in our study was beneficial to students irrespective of their nationality and preference of music type. It can act as an “active coping” strategy and alleviate stress within a very short period of time, in our study within a span of 5minutes. When used in the background, during task performance, can increase arousal which helps the students perform better. Implications: Music can be used between lectures for a short time to relax the students and help them concentrate better for the subsequent classes, especially for late afternoon sessions.

Keywords: blood pressure, classical instrumental background music, ethnicity, symbol digit modality test

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3879 Topographic Mapping of Farmland by Integration of Multiple Sensors on Board Low-Altitude Unmanned Aerial System

Authors: Mengmeng Du, Noboru Noguchi, Hiroshi Okamoto, Noriko Kobayashi

Abstract:

This paper introduced a topographic mapping system with time-saving and simplicity advantages based on integration of Light Detection and Ranging (LiDAR) data and Post Processing Kinematic Global Positioning System (PPK GPS) data. This topographic mapping system used a low-altitude Unmanned Aerial Vehicle (UAV) as a platform to conduct land survey in a low-cost, efficient, and totally autonomous manner. An experiment in a small-scale sugarcane farmland was conducted in Queensland, Australia. Subsequently, we synchronized LiDAR distance measurements that were corrected by using attitude information from gyroscope with PPK GPS coordinates for generation of precision topographic maps, which could be further utilized for such applications like precise land leveling and drainage management. The results indicated that LiDAR distance measurements and PPK GPS altitude reached good accuracy of less than 0.015 m.

Keywords: land survey, light detection and ranging, post processing kinematic global positioning system, precision agriculture, topographic map, unmanned aerial vehicle

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3878 Clinically-Based Improvement Project Focused on Reducing Risks Associated with Diabetes Insipidus, Syndrome of Inappropriate ADH, and Cerebral Salt Wasting in Paediatric Post-Neurosurgical and Traumatic Brain Injury Patients

Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

Abstract:

Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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3877 The Role of Glyceryl Trinitrate (GTN) in 99mTc-HIDA with Morphine Provocation Scan for the Investigation of Type III Sphincter of Oddi Dysfunction (SOD)

Authors: Ibrahim M Hassan, Lorna Que, Michael Rutland

Abstract:

Type I SOD is usually diagnosed by anatomical imaging such as ultrasound, CT and MRCP. However, the types II and III SOD yield negative results despite the presence of significant symptoms. In particular, the type III is difficult to diagnose due to the absence of significant biochemical or anatomical abnormalities. Nuclear Medicine can aid in this diagnostic dilemma by demonstrating functional changes in the bile flow. Low dose Morphine (0.04mg/Kg) stimulates the tone of the sphincter of Oddi (SO) and its usefulness has been shown in diagnosing SOD by causing a delay in bile flow when compared to a non morphine provoked - baseline scan. This work expands on that process by using sublingual GTN at 60 minutes post tracer and morphine injection to relax the SO and induce an improvement in bile outflow, and in some cases show immediate relief of morphine induced abdominal pain. The criteria for positive SOD are as follows: if during the first hour of the morphine provocation showed (1) delayed intrahepatic biliary ducts tracer accumulation; plus (2) delayed appearance but persistent retention of activity in the common bile duct, and (3) delayed bile flow into the duodenum. In addition, patients who required GTN within the first hour to relieve abdominal pain were regarded as highly supportive of the diagnosis. Retrospective analysis of 85 patients (pts) (78F and 6M) referred for suspected SOD (type III) who had been intensively investigated because of recurrent right upper quadrant or abdominal pain post cholecystectomy. 99mTc-HIDA scan with morphine-provocation is performed followed by GTN at 60 minutes post tracer injection and a further thirty minutes of dynamic imaging are acquired. 30 pts were negative. 55 pts were regarded as positive for SOD and 38/55 (60%) of these patients with an abnormal result were further evaluated with a baseline 99mTc-HIDA. As expected, all 38 pts showed better bile flow characteristics than during the morphine provocation. 20/55 (36%) patients were treated by ERCP sphincterotomy and the rest were managed conservatively by medical therapy. In all cases regarded as positive for SOD, the sublingual GTN at 60 minutes showed immediate improvement in bile flow. 11/55(20%) who developed severe post-morphine abdominal pain were relieved by GTN almost instantaneously. We propose that GTN is a useful agent in the diagnosis of SOD when performing 99mTc-HIDA scan and that the satisfactory response to the sublingual GTN could offer additional information in patients who have severe pain at the time the procedure or when presenting to the emergency unit because of biliary pain. And also in determining whether a trial of medical therapy may be used before considering surgery.

Keywords: GTN, HIDA, MORPHINE, SOD

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3876 Mental Health of the Elderly: Evaluating a Newly Developed Structured Life-Review Manual Using a Within-Subjects Pre-Post Design

Authors: Wladislaw Mill, Hariet Kirschner, Anna Zimmermann, Sashi Singh, Simon Forstmeier, Uwe Berger, Bernhard Strauss, Benedikt Werner

Abstract:

Introduction: A promising method to improve mental health of elderly people are structured life-reviews. We report the evaluation of our newly developed manual for structured life-reviews. The manual was created with the emphasis on straightforward application so that it can be used by professionals and lay people alike. Method: A within-subjects pre-post design is used to evaluate the manual using a geriatric depression scale and a self-integrity measure. Participants are elderly people living by themselves and in nursing homes. Findings: It is shown that elderly people perceive the structured life-review as a very positive experience. More importantly, it is shown that a negative trend of self-integrity and geriatric depression is significantly reduced by the intervention. Conclusion: The data suggest that the manual contributes positively to self- perception and mental health. We conclude that this newly developed device is very valuable to augment elderly care.

Keywords: structured life-review, self-integrity, geriatric depression, preventation research

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3875 Exploration of Community Space Environment Renewal Strategies Based on the Concept of Disaster Chain

Authors: Ma Chaoyang

Abstract:

With the acceleration of urbanization, old communities are facing renewal problems such as an aging material environment, declining living quality, and insufficient resilience. The once glorious old communities have become the most vulnerable areas in the city. Through a re-understanding of the ‘disaster chain’ and resilient communities, it is believed that considering the construction of resilient communities during community renewal is of great significance for promoting the sustainable development of communities. This article proposes renewal strategies for old communities based on the concept of preventing the occurrence of disaster chains. After analyzing the main demand characteristics of old communities, it proposes a reflection on improving community spatial safety resilience based on the ‘broken chain’ concept. In the four stages of ‘pre-disaster, mid-disaster, and post-disaster’, it elaborates that considering the occurrence of disaster chain in community renewal is the main content of research on spatial safety resilience construction and clarifies that community resilience is the idea and principle of responding with the process of disaster chain. The study focuses on the four dimensions of ‘pre-disaster, mid-disaster, and post-disaster’. This can provide ideas and references for resilience construction in community updates.

Keywords: community updates, disaster chain concept, community resilience, space environment

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3874 Probabilistic Modeling of Post-Liquefaction Ground Deformation

Authors: Javad Sadoghi Yazdi, Robb Eric S. Moss

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This paper utilizes a probabilistic liquefaction triggering method for modeling post-liquefaction ground deformation. This cone penetration test CPT-based liquefaction triggering is employed to estimate the factor of safety against liquefaction (FSL) and compute the maximum cyclic shear strain (γmax). The study identifies a maximum PL value of 90% across various relative densities, which challenges the decrease from 90% to 70% as relative density decreases. It reveals that PL ranges from 5% to 50% for volumetric strain (εvol) less than 1%, while for εvol values between 1% and 3.2%, PL spans from 50% to 90%. The application of the CPT-based simplified liquefaction triggering procedures has been employed in previous researches to estimate liquefaction ground-failure indices, such as the Liquefaction Potential Index (LPI) and Liquefaction Severity Number (LSN). However, several studies have been conducted to highlight the variability in liquefaction probability calculations, suggesting a more accurate depiction of liquefaction likelihood. Consequently, the utilization of these simplified methods may not offer practical efficiency. This paper further investigates the efficacy of various established liquefaction vulnerability parameters, including LPI and LSN, in explaining the observed liquefaction-induced damage within residential zones of Christchurch, New Zealand using results from CPT database.

Keywords: cone penetration test (CPT), liquefaction, postliquefaction, ground failure

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3873 Preoperative Smoking Cessation Audit: A Single Centre Experience from Metropolitan Melbourne

Authors: Ya-Chu May Tsai, Ibrahim Yacoub, Eoin Casey

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The Australian and New Zealand College of Anaesthetists (ANZCA) advises that smoking should not be permitted within 12 hours of surgery. There is little information in the medical literature regarding patients awareness of perioperative smoking cessation recommendations nor their appreciation of how smoking might negatively impact their perioperative course. The aim of the study is to assess the prevalence of current smokers presenting to Werribee Mercy Hospital (WMH) and to evaluate if pre-operative provision of both written and verbal pre-operative advice was, 1: Effective in improving patient awareness of the benefits of pre-operative smoking cessation, 2: Associated with an increase in the number of elective surgical patients who stop smoking at least 12 hours pre-operatively. Methods: The initial survey included all patients who presented to WMH for elective surgical procedures from 19 – 30 September 2016 using a standardized questionnaire focused on patients’ smoking history and their awareness of smoking cessation preoperatively. The intervention consisted of a standard pre-operative phone call to all patients advising them of the increased perioperative risks associated with smoking, and advised patients to cease 12 hours prior. In addition, written information on smoking cessation strategies were sent out in mail at least 1 week prior to planned procedure date to all patients. Questionnaire-based study after the intervention was conducted on day of elective procedure from 10 – 21 October 2016 inclusive. Primary outcomes measured were patient’s awareness of smoking cessation and proportion of smokers who quit >12 hours, considered a clinically meaning duration to reduce anaesthetics complications. Comparison of pre and post intervention results were made using SPSS 21.0. Results: In the pre-intervention group (n=156), 36 (22.4%) patients were current smokers, 46 were ex-smokers (29.5%) and 74 were non-smokers (48.1%). Of the smokers, 12 (33%) reported having been informed of smoking cessation prior to operation and 8 (22%) were aware of increased intra- and perioperative adverse events associated with smoking. In the post-intervention group n= 177, 38 (21.5%) patients were current smokers, 39 were ex-smokers (22.0%) and 100 were non-smokers (56.5%). Of the smokers, 32 (88.9%) reported having been informed of smoking cessation prior to operation and 35 (97.2%) reported being aware of increased intra- and perioperative adverse events associated with smoking. The median time since last smoke in the pre-intervention group was 5.5 hours (Q1-Q3 = 2-14) compared with 13 hours (Q1-Q3 = 5-24) in post intervention group. Amongst the smokers, smoking cessation at least 12 hours prior to surgery significantly increased from 27.8% pre-intervention to 52.6% post intervention (P=0.03). Conclusion: A standard preoperative phone call and written instruction on smoking cessation guidelines at time of waitlist placement increase preoperative smoking cessation rates by almost 2-fold.

Keywords: anaesthesia, audit, perioperative medicine, smoking cessation

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3872 Collaborative Early Warning System: An Integrated Framework for Mitigating Impacts of Natural Hazards in the UAE

Authors: Abdulla Al Hmoudi

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The impacts and costs of natural disasters on people, properties and the environment is often severe when they occur on a large scale or when not prepared for. Factors such as impacts of climate change, urban growth, poor planning to mention a few, have continued to significantly increase the frequencies and aggravate the impacts of natural hazards across the world; the United Arab Emirates (UAE) inclusive. The lack of deployment of an early warning system, low risk and hazard knowledge and impact of natural hazard experienced in some communities in the UAE have emphasised the need for more effective early warning systems. This paper focuses on the collaborative approach taken to instituting and implementing an early warning system. Using mixed methods 888 people completed the questionnaire and eight people were interviewed in Abu Dhabi. The results indicate that the collaborative approach to early warning system is UAE is needed, but lacks essential principles of the early warning system and currently underutilised. It is recommended that the collaborative early warning system is applied at every stage of the early warning system with the specific responsibility of each stakeholder and actor.

Keywords: community, early warning system, emergency management, UAE

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3871 The Positive Effects of Processing Instruction on the Acquisition of French as a Second Language: An Eye-Tracking Study

Authors: Cecile Laval, Harriet Lowe

Abstract:

Processing Instruction is a psycholinguistic pedagogical approach drawing insights from the Input Processing Model which establishes the initial innate strategies used by second language learners to connect form and meaning of linguistic features. With the ever-growing use of technology in Second Language Acquisition research, the present study uses eye-tracking to measure the effectiveness of Processing Instruction in the acquisition of French and its effects on learner’s cognitive strategies. The experiment was designed using a TOBII Pro-TX300 eye-tracker to measure participants’ default strategies when processing French linguistic input and any cognitive changes after receiving Processing Instruction treatment. Participants were drawn from lower intermediate adult learners of French at the University of Greenwich and randomly assigned to two groups. The study used a pre-test/post-test methodology. The pre-tests (one per linguistic item) were administered via the eye-tracker to both groups one week prior to instructional treatment. One group received full Processing Instruction treatment (explicit information on the grammatical item and on the processing strategies, and structured input activities) on the primary target linguistic feature (French past tense imperfective aspect). The second group received Processing Instruction treatment except the explicit information on the processing strategies. Three immediate post-tests on the three grammatical structures under investigation (French past tense imperfective aspect, French Subjunctive used for the expression of doubt, and the French causative construction with Faire) were administered with the eye-tracker. The eye-tracking data showed the positive change in learners’ processing of the French target features after instruction with improvement in the interpretation of the three linguistic features under investigation. 100% of participants in both groups made a statistically significant improvement (p=0.001) in the interpretation of the primary target feature (French past tense imperfective aspect) after treatment. 62.5% of participants made an improvement in the secondary target item (French Subjunctive used for the expression of doubt) and 37.5% of participants made an improvement in the cumulative target feature (French causative construction with Faire). Statistically there was no significant difference between the pre-test and post-test scores in the cumulative target feature; however, the variance approximately tripled between the pre-test and the post-test (3.9 pre-test and 9.6 post-test). This suggests that the treatment does not affect participants homogenously and implies a role for individual differences in the transfer-of-training effect of Processing Instruction. The use of eye-tracking provides an opportunity for the study of unconscious processing decisions made during moment-by-moment comprehension. The visual data from the eye-tracking demonstrates changes in participants’ processing strategies. Gaze plots from pre- and post-tests display participants fixation points changing from focusing on content words to focusing on the verb ending. This change in processing strategies can be clearly seen in the interpretation of sentences in both primary and secondary target features. This paper will present the research methodology, design and results of the experimental study using eye-tracking to investigate the primary effects and transfer-of-training effects of Processing Instruction. It will then provide evidence of the cognitive benefits of Processing Instruction in Second Language Acquisition and offer suggestion in second language teaching of grammar.

Keywords: eye-tracking, language teaching, processing instruction, second language acquisition

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3870 Management of Gastrointestinal Metastasis of Invasive Lobular Carcinoma

Authors: Sally Shepherd, Richard De Boer, Craig Murphy

Abstract:

Background: Invasive lobular carcinoma (ILC) can metastasize to atypical sites within the peritoneal cavity, gastrointestinal, or genitourinary tract. Management varies depending on the symptom presentation, extent of disease burden, particularly if the primary disease is occult, and patient wishes. Case Series: 6 patients presented with general surgical presentations of ILC, including incomplete large bowel obstruction, cholecystitis, persistent lower abdominal pain, and faecal incontinence. 3 were diagnosed with their primary and metastatic disease in the same presentation, whilst 3 patients developed metastasis from 5 to 8 years post primary diagnosis of ILC. Management included resection of the metastasis (laparoscopic cholecystectomy), excision of the primary (mastectomy and axillary clearance), followed by a combination of aromatase inhibitors, biologic therapy, and chemotherapy. Survival post diagnosis of metastasis ranged from 3 weeks to 7 years. Conclusion: Metastatic ILC must be considered with any gastrointestinal or genitourinary symptoms in patients with a current or past history of ILC. Management may not be straightforward to chemotherapy if the acute pathology is resulting in a surgically resectable disease.

Keywords: breast cancer, gastrointestinal metastasis, invasive lobular carcinoma, metastasis

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3869 Remote Sensing Application on Snow Products and Analyzing Disaster-Forming Environments Xinjiang, China

Authors: Gulijianati Abake, Ryutaro Tateishi

Abstract:

Snow is one kind of special underlying surface, has high reflectivity, low thermal conductivity, and snow broth hydrological effect. Every year, frequent snow disaster in Xinjiang causing considerable economic loss and serious damage to towns and farms, such as livestock casualties, traffic jams and other disaster, therefore monitoring SWE (snow volume) in Xinjiang has a great significance. The problems of how this disaster distributes and what disaster-forming environments are important to its occurrence are the most pressing problems in disaster risk assessment and salvage material arrangement. The present study aims 1) to monitor accurate SWE using MODIS, AMSRE, and CMC data, 2) to establish the regularity of snow disaster outbreaks and the important disaster-forming environmental factors. And a spatial autocorrelation analysis method and a canonical correlation analysis method are used to answer these two questions separately, 3) to prepare the way to salvage material arrangements for snow disasters.

Keywords: snow water equivalent (snow volume), AMSR-E, CMC snow depth, snow disaster

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3868 The Language of Hip-Hop and Rap in Tunisia: Symbol of Cultural Change in Post-Arab Spring Tunisia

Authors: Zouhir Gabsi

Abstract:

The Arab Spring has had noticeable effects on Tunisia in socio-economic, political, and cultural terms. Few have predicted that the music of hip-hop and rap could engage with the socio-political situation in Tunisia, especially after the downfall of Ben Ali’s regime. Having survived as underground music since the year 2000, the genre of hip-hop and rap remains an aberration from the folkloric tradition. By adhering to the socio-economic reality of the Tunisian street, rappers attempt to claim authenticity mainly in both thematic and language uses, and by usurping the power of ‘space’ from the regime’s control. With the songs’ fast-paced rhythms, catchy phrases, puns, vulgarisms, and linguistic innovations using metaphors, hip-hop, and rap have struck a chord with Tunisia’s youth. Tunisia’s new social reality has allowed Tunisian rappers to express dissent and voice people’s despair over the socio-economic and political situation. This paper argues that rap artists use language as a vehicle to claim the authenticity of their message. It also explores how the performative nature of the language of hip-hop and rap interacts with the Tunisian culture and argues the power of music in the context of political and socio-economic grievances in post-Arab Spring Tunisia.

Keywords: Arab Spring, hip-hop, eevolution, Tunisia, Tunisian Arabic

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3867 Broad Protection against Avian Influenza Virus by Using a Modified Vaccinia Ankara Virus Expressing a Mosaic Hemagglutinin

Authors: Attapon Kamlangdee, Brock Kingstad-Bakke, Tavis K. Anderson, Tony L. Goldberg, Jorge E. Osorio

Abstract:

A critical failure in our preparedness for an influenza pandemic is the lack of a universal vaccine. Influenza virus strains diverge by 1 to 2% per year, and commercially available vaccines often do not elicit protection from one year to the next, necessitating frequent formulation changes. This represents a major challenge to the development of a cross-protective vaccine that can protect against circulating viral antigenic diversity. We have constructed a recombinant modified vaccinia virus Ankara (MVA) that expresses an H5N1 mosaic hemagglutinin (H5M) (MVA-H5M). This mosaic was generated in silico using 2,145 field-sourced H5N1 isolates. A single dose of MVA-H5M provided 100% protection in mice against clade 0, 1, and 2 avian influenza viruses and also protected against seasonal H1N1 virus (A/Puerto Rico/8/34). It also provided short-term (10 days) and long-term (6 months) protection post vaccination. Both neutralizing antibodies and antigen-specific CD4+and CD8+ T cells were still detected at 5 months post vaccination, suggesting that MVA-H5M provides long-lasting immunity.

Keywords: modified vaccinia Ankara, MVA, H5N1, hemagglutinin, influenza vaccine

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3866 Understanding Social Networks in Community's Coping Capacity with Floods: A Case Study of a Community in Cambodia

Authors: Ourn Vimoil, Kallaya Suntornvongsagul

Abstract:

Cambodia is considered as one of the most disaster prone countries in South East Asia, and most of natural disasters are related to floods. Cambodia, a developing country, faces significant impacts from floods, such as environmental, social, and economic losses. Using data accessed from focus group discussions and field surveys with villagers in Ba Baong commune, prey Veng province, Cambodia, the research would like to examine roles of social networks in raising community’s coping capacity with floods. The findings indicate that social capital play crucial roles in three stages of floods, namely preparedness, response, and recovery to overcome the crisis. People shared their information and resources, and extent their assistances to one another in order to adapt to floods. The study contribute to policy makers, national and international agencies working on this issue to pay attention on social networks as one factors to accelerate flood coping capacity at community level.

Keywords: social network, community, coping capacity, flood, Cambodia

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3865 Physical Activity and Sport Research with People with Impairments: Oppression–Empowerment Continuum

Authors: Gyozo Molnar, Nancy Spencer-Cavaliere

Abstract:

Research in the area of physical activity and sport, while becoming multidisciplinary, is still dominated by post-positivist approaches that have the tendency to position the researcher as an expert and the participant as subordinate thereby perpetuating an unequal balance of power. Despite physical activity’s and sport’s universal appeal, their historic practices have excluded particular groups of people who assumed lesser forms of human capital. Adapted physical activity (APA) is a field that has responded to those segregations with specific application and relevance to people with impairments. Nevertheless, to date, similar to physical activity and sport, research in APA is still dominated by post-positivist epistemology. Stemming from this, there is gradually growing criticism within the field related to the abundance of research ‘on’ people with impairments and lack of research ‘with’ and ‘by’ people with impairments. Furthermore, research questions in the field are most often pursued from a single axis of analysis and constructed by non-disabled researchers. Concurrently, while calls for interdisciplinary approaches to understanding disability are growing in popularity, there is also a clear need to take an intersectionality-informed research methodology to understanding physical activity and sport and power (im)balances therein. In other words, impairment needs to be considered in conjunction with other socially and politically constructed and historically embedded differences such as gender, race, class, etc. when analyzing physical activity and sport experiences for people with impairments. Moreover, it is reasonable to argue that non-disabled researchers must recognize and theorize ableism in its complicated intersectional manifestation to show the structural constraints that disabled scholars face in the field. Consequently, this presentation will offer an alternative approach that acknowledges and prioritizes the perspectives and experiences of people with impairments to expand the field of APA. As such, the importance of broadening epistemologies in APA and prioritizing an appreciation for multiple bits of knowledge of people with impairments through intersections of social locations (e.g., gender, race, class) will be considered.

Keywords: adapted physical activity, disability, intersectionality, post-positivist, power imbalances

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3864 Combating Fake News: A Qualitative Evidence Synthesis of Organizational Stakeholder Trust in Social Media Communication during Crisis

Authors: Todd R. Walton

Abstract:

Social media would seem to be an ideal mechanism for crisis communication, yet it has been met with varied results. Natural disasters, such as hurricanes, provide a slow moving view of how social media can be leveraged to guide stakeholders and the public through a crisis. Crisis communication managers have struggled to reach target audiences with credible messaging. This Qualitative Evidence Synthesis (QES) analyzed the findings of eight studies published in the last year to determine how organizations effectively utilize social media for crisis communication. Additionally, the evidence was analyzed to note strategies for establishing credibility in a medium fraught with misinformation. Studies indicated wide agreement on the use of multiple social media channels in addition to frequent accurate messaging in order to establish credibility. Studies indicated mixed agreement on the use of text based emergency notification systems. The findings in this QES will help crisis communication professionals plan for social media use for crisis communication.

Keywords: crisis communication, crisis management, emergency response, social media

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3863 Effect of Mindfulness-Based Self-Care Training on Self-Esteem and Body Image Concern on Candidate Patients of Orthognathic Surgery

Authors: Hamide Azimi Lolaty, Fateme Alsadat Ghanipoor, Azar Ramzani, Reza Ali Mohammadpoor, Alireza Babaei

Abstract:

Background and Objective: Despite the merits behind orthognathic surgery, self-care training in such patients seems logical. The current research was performed pursuing the goal of outlining the effect of training mindfulness-based self-care on Self-Esteem (SE) and Body Image Concern (BIC) of orthognathic surgery candidate patients. Material and Methods: The present study was performed using a semi-experimental method with pre-and post-design in the control and intervention groups. The eligible patients to enter the Babol-based Shahid Beheshti Orthognathic Surgery Clinic were conveniently divided into two 25-person groups. The variables of Self-Esteem and Body Image Concern were measured before and after executing the eight 90-minute training sessions and in the follow-up period done three months after executing the intervention using Cooper Smith’s Self-Esteem Inventory (CSEI) and Body Image Concern Inventory (BICI). The data were analyzed using ANOVA and the independent t-test and using SPSS-26, the data were analyzed at a 0.05 level. Results: As a result of the intervention, the intervention group’s SE score critically changed on average from 25.4±7.31 in the pre-intervention to 31.16±7.05 in the post-intervention and to 40.45±3.51 in the follow-up period (P=0.01), the intervention group’s BIC score changed on average from 60.28±16.47 in the pre-intervention to 47.15±80.47 in the post-intervention and to 32.20 ± 10.73 in the follow-up period. This difference was meaningful (P=0.001). But due to time and the intervention interaction, the control group underwent this significant reduction with a delay. The study revealed the scores of the SE as 32± 6.84 and that of the BIC as 43.32±10.64 in the control group didn’t result in any meaningful statistical difference (P<0.05). Conclusion: Training mindfulness-based self-care exerts an effect on the SE and BIC of the patients undergoing orthognathic surgery. Therefore, it’s recommended to train mindfulness-based self-care for orthognathic surgery candidate patients.

Keywords: self-care, mindfulness, self-esteem, body image concern, orthognathic surgery

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3862 The Role of Rapid Maxillary Expansion in Managing Obstructive Sleep Apnea in Children: A Literature Review

Authors: Suleman Maliha, Suleman Sidra

Abstract:

Obstructive sleep apnea (OSA) is a sleep disorder that can result in behavioral and psychomotor impairments in children. The classical treatment modalities for OSA have been continuous positive airway pressure and adenotonsillectomy. However, orthodontic intervention through rapid maxillary expansion (RME) has also been commonly used to manage skeletal transverse maxillary discrepancies. Aim and objectives: The aim of this study is to determine the efficacy of rapid maxillary expansion in paediatric patients with obstructive sleep apnea by assessing pre and post-treatment mean apnea-hypopnea index (AHI) and oxygen saturations. Methodology: Literature was identified through a rigorous search of the Embase, Pubmed, and CINAHL databases. Articles published from 2012 onwards were selected. The inclusion criteria consisted of patients aged 18 years and under with no systemic disease, adenotonsillar surgery, or hypertrophy who are undergoing RME with AHI measurements before and after treatment. In total, six suitable papers were identified. Results: Three studies assessed patients pre and post-RME at 12 months. The first study consisted of 15 patients with an average age of 7.5 years. Following treatment, they found that RME resulted in both higher oxygen saturations (+ 5.3%) and improved AHI (- 4.2 events). The second study assessed 11 patients aged 5–8 years and also noted improvements, with mean AHI reduction from 6.1 to 2.4 and oxygen saturations increasing from 93.1% to 96.8%. The third study reviewed 14 patients aged 6–9 years and similarly found an AHI reduction from 5.7 to 4.4 and an oxygen saturation increase from 89.8% to 95.5%. All modifications noted in these studies were statistically significant. A long-term study reviewed 23 patients aged 6–12 years post-RME treatment on an annual basis for 12 years. They found that the mean AHI reduced from 12.2 to 0.4, with improved oxygen saturations from 78.9% to 95.1%. Another study assessed 19 patients aged 9-12 years at two months into RME and four months post-treatment. Improvements were also noted at both stages, with an overall reduction of the mean AHI from 16.3 to 0.8 and an overall increase in oxygen saturations from 77.9% to 95.4%. The final study assessed 26 children aged 7-11 years on completion of individual treatment and found an AHI reduction from 6.9 to 5.3. However, the oxygen saturation remained stagnant at 96.0%, but this was not clinically significant. Conclusion: Overall, the current evidence suggests that RME is a promising treatment option for paediatric patients with OSA. It can provide efficient and conservative treatment; however, early diagnosis is crucial. As there are various factors that could be contributing to OSA, it is important that each case is treated on its individual merits. Going forward, there is a need for more randomized control trials with larger cohorts being studied. Research into the long-term effects of RME and potential relapse amongst cases would also be useful.

Keywords: orthodontics, sleep apnea, maxillary expansion, review

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3861 Effect of Foot Reflexology Treatment on Arterial Blood Gases among Mechanically Ventilated Patients

Authors: Maha Salah Abdullah Ismail, Manal S. Ismail, Amir M. Saleh

Abstract:

Reflexology treatment is a method for enhancing body relaxation. It is a widely recognized as an alternative therapy, effective for many health conditions. This study aimed to evaluate the effect of reflexology treatment on arterial blood gases among mechanically ventilated patients. A quasi-experimental (pre and post-test) research design was used. Research hypothesis was mechanically ventilated patients who will receive the reflexology treatment will have improvement in their arterial blood gases than those who will not. The current study was carried out in different Intensive Care Units at the Cairo University Hospitals. A purposeful sample of 100 adults’ mechanically ventilated patients was recruited over a period of three months of data collection. The participants were divided into two equally matched groups; (1) The study group who has received the routine care, in addition, two reflexology sessions on the feet, (2) The control group who has received only the routine care. One tool was utilized to collect data pertinent to the study; mechanically ventilated patients' data sheet that consists of demographic and medical data. Result: Majority (58% of the study group and 82% of the control group) were males, with mean age of 50.9 years in both groups. Patients who received the reflexology treatment significantly increase in the oxygen saturation pre second session (t=5.15, p=.000), immediate post sessions (t=4.4, p=.000) and post two hours (t= 4.7, p= .000). The study group was more likely to have lower PaO2 (F=5.025, p=.015), PaCo2 (F=4.952, p=.025) and higher HCo3 (F=15.211, p=.000) than the control group. Conclusion: This study results support the positive effect of reflexology treatment in improving some arterial blood gases among mechanically ventilated patients’ with the conventional therapy as in the study group there was increase in the oxygen saturation. In differences between groups there decrease PaO2, PaCo2 and increase HCo3 in the study group. Recommendation: Nurses should be trained how to demonstrate the foot reflexology among mechanically ventilated patients.

Keywords: arterial blood gases, foot, mechanical ventilated patient, reflexology

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3860 Effect of Core Stability Exercises on Balance between Trunk Muscles in Healthy Adult Subjects

Authors: Amir A. Beltagi, Ahmed R. Abdelbaki

Abstract:

Background: Core stability training has recently attracted attention for optimizing performance and improving muscle balance for healthy and unhealthy individuals. The purpose of this study was to investigate the effect of beginner’s core stability exercises on the trunk flexors’/extensors’ peak torque ratio and trunk flexors’ and extensors’ peak torques. Methods: Thirty five healthy individuals, randomly assigned into two groups; experimental (group I) and control (group II), participated in the study. Group I involved 20 participants (10 male & 10 female) with mean ±SD age, weight, and height of 20.7±2.4 years, 66.5±12.1 kg and 166.7±7.8 cm respectively. Group II involved 15 participants (6 male & 9 female) with mean ±SD age, weight, and height of 20.3±0.61 years, 68.57±12.2 kg and 164.28 ±7.59 cm respectively. Data were collected using the Biodex Isokinetic system. The participants were tested twice; before and after a 6-week period during which the experimental group performed a core stability training program. Findings: Statistical analysis using the 2x2 Mixed Design ANOVA revealed that there were no significant differences in the trunk flexors’/extensors’ peak torque ratio between the ‘pre’ and ‘post’ tests for either group (p > 0.025). Moreover, there were no significant differences in the trunk flexors’/extensors’ ratios between both groups at either test (p > 0.025). Meanwhile, the 2x2 Mixed Design MANOVA revealed that there were significant differences in the trunk flexors’ and extensors’ peak torques between the ‘pre’ and ‘post’ tests for group I (p < 0.025), while there were no significant differences inbetween for group II (p > 0.025). Moreover, there were no significant differences between both groups for the tested muscles’ peak torques at either test except for that of the trunk flexors at the ‘post’ test only (p < 0.025). Interpretation: The improvement in muscle performance indicated by the increase in the trunk flexors’ and extensors’ peak torques in the experimental group recommends including core stability training in the exercise programs that aim to improve muscle performance.

Keywords: core stability, isokinetic, trunk muscles, muscle balance

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3859 Postoperative Budesonide Nasal Irrigation vs Normal Saline Irrigation for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

Authors: Rakan Hassan M. Alzahrani, Ziyad Alzahrani, Bader Bashrahil, Abdulrahman Elyasi, Abdullah a Ghaddaf, Rayan Alzahrani, Mohammed Alkathlan, Nawaf Alghamdi, Dakheelallah Almutairi

Abstract:

Background: Corticosteroid irrigations, which regularly involve the off-label use of budesonide mixed with normal saline in high volume Sino-nasal irrigations, have been more commonly used in the management of post-operative chronic rhinosinusitis (CRS). Objective: This article attempted to measure the efficacy of post-operative budesonide nasal irrigation compared to normal saline-alone nasal irrigation in the management of chronic rhinosinusitis (CRS) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The databases PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched by two independent authors. Only RCTs comparing budesonide irrigation to normal saline alone irrigation for CRS with or without polyposis after functional endoscopic sinus surgery (FESS) were eligible. A random effect analysis model of the reported CRS-related quality of life (QOL) measures and the objective endoscopic assessment scales of the disease was done. Results: Only 6 RCTs met the eligibility criteria, with a total number of participants of 356. Compared to normal saline irrigation, budesonide nasal irrigation showed statically significant improvements in both the CRS-related quality of life (QOL) and the endoscopic findings (MD= -4.22 confidence interval [CI]: -5.63, -2.82 [P < 0.00001]), (SMD= -0.50 confidence interval [CI]: -0.93, -0.06 [P < 0.03]) respectively. Conclusion: Both intervention arms showed improvements in CRS-related QOL and endoscopic findings in post-FESS chronic rhinosinusitis with or without polyposis. However, budesonide irrigation seems to have a slight edge over conventional normal saline irrigation with no reported serious side effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.

Keywords: Budesonide, chronic rhinosinusitis, corticosteroids, nasal irrigation, normal saline

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3858 Air Breakdown Voltage Prediction in Post-arcing Conditions for Compact Circuit Breakers

Authors: Jing Nan

Abstract:

The air breakdown voltage in compact circuit breakers is a critical factor in the design and reliability of electrical distribution systems. This voltage determines the threshold at which the air insulation between conductors will fail or 'break down,' leading to an arc. This phenomenon is highly sensitive to the conditions within the breaker, such as the temperature and the distance between electrodes. Typically, air breakdown voltage models have been reliable for predicting failure under standard operational temperatures. However, in conditions post-arcing, where temperatures can soar above 2000K, these models face challenges due to the complex physics of ionization and electron behaviour at such high-energy states. Building upon the foundational understanding that the breakdown mechanism is initiated by free electrons and propelled by electric fields, which lead to ionization and, potentially, to avalanche or streamer formation, we acknowledge the complexity introduced by high-temperature environments. Recognizing the limitations of existing experimental data, a notable research gap exists in the accurate prediction of breakdown voltage at elevated temperatures, typically observed post-arcing, where temperatures exceed 2000K.To bridge this knowledge gap, we present a method that integrates gap distance and high-temperature effects into air breakdown voltage assessment. The proposed model is grounded in the physics of ionization, accounting for the dynamic behaviour of free electrons which, under intense electric fields at elevated temperatures, lead to thermal ionization and potentially reach the threshold for streamer formation as Meek's criterion. Employing the Saha equation, our model calculates equilibrium electron densities, adapting to the atmospheric pressure and the hot temperature regions indicative of post-arc temperature conditions. Our model is rigorously validated against established experimental data, demonstrating substantial improvements in predicting air breakdown voltage in the high-temperature regime. This work significantly improves the predictive power for air breakdown voltage under conditions that closely mimic operational stressors in compact circuit breakers. Looking ahead, the proposed methods are poised for further exploration in alternative insulating media, like SF6, enhancing the model's utility for a broader range of insulation technologies and contributing to the future of high-temperature electrical insulation research.

Keywords: air breakdown voltage, high-temperature insulation, compact circuit breakers, electrical discharge, saha equation

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3857 The Effect of Online Self-Assessment Diaries on Academic Achievement

Authors: Zi Yan

Abstract:

The pedagogical value of self-assessment is widely recognized. However, identifying effective methods to help students develop productive SA practices poses a significant challenge. Since most students do not acquire self-assessment skills intuitively, they need instruction and guidance. This study is a randomized controlled trial aiming to test the effect of online self-assessment diaries on students’ achievement scores compared to a control group. Two groups of secondary school students (N=59), recruited through convenience sampling, participated in the study. The two groups were randomly designated to one of two conditions: control (n = 31) and online self-assessment diary (n = 28). The participants completed a curriculum-specific pre-test and a baseline survey on the first week of the 10-week study, as well as completed a post-test and survey by the tenth week. The results showed that the SA diary intervention had a significantly positive effect on post-intervention language learning scores after controlling for baseline scores. The findings highlight the potential of self-assessment to enhance educational outcomes, emphasizing its significant implications for educational policies that promote the integration of SA strategies into pedagogical practices.

Keywords: self-assessment, online diary, academic achievement, experimenal study

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