Search results for: rare stroke

Authors: Ali D. El-mehdawi, Ibrahim E. Elkanouni

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Thick pre-Upper Cretaceous sandstones, sandstones intercalated with red/black shale or quarzitic sandstones, traditionally known to range in age from Cambrian to Early Cretaceous, mostly overlie the subsurface basement rocks of the Sirt Basin of Libya. These sediments known as Nubian, Sarir, Amal or Cambro-Ordovician sandstones. They are usually barren of any age datable palynomorphs and microfossils and represent the main hydrocarbon reservoirs in the basin. As a part of an ongoing regional project concerned with revision and updating of the stratigraphic nomenclature of the Sirt Basin and adjacent areas, sixteen core and ditch cutting samples from four wells penetrating the known Cambro-Ordovician sediments in the central and eastern parts of the basin were examined palynologicaly to investigate its age and the depositional paleoenvironment. The samples proved to be barren or yielded rare palynomorph assemblage, which dominated by dark grey to black small and large-sized sphaeromorph acritarchs assemblage of leiosphaerid types. The dominated species are Kildinosphaera chagrinata, K. cf. chagrinata, Kildinella ripheica, Kilinella timanica, Leiosphaeridia asperata and Leiosphaeridia spp. These leiosphaerides assemblage are comparable to those have been reported from the Late Precambrian, late Riphean age in Cyrenaica Platform, NE Libya, and would indicated shallow marine depositional environment. The age assignment suggests that this interval most probably equates to Mourizide, Bir Bayai and Wadi alHayt formations known in the Murzuq, Kufrah and Cyrenaica areas, respectively. This study proves the presence of Precambrian sediments in Jaghbub high and Amal Platform in the eastern part of Sirt Basin and probably in Maradah Trough and Aj Jahamah/Zoltun Platform northwestern part of the Sirt Basin.

Keywords: palynology, leiosphaerides, precambrian, sirt basin, libya

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Authors: Abdurrauf M. Gusbi, Mahmud H. Arhima, Abdurrahim A. Elouzi, Ebtisam A. Benomran, Salsabeela Elmezwghi, Aram Elhatan, Nafesa Elgusbi

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Mass poisonings with methanol are rare but occur regularly both in developed and in non-developing countries. As a result of the tragedy that happened in the city of Tripoli Libya in March during year 2013 a number of patients were admitted to Tripoli Medical Center and Tripoli Central Hospital suffering from poisoning following ingestion of methanol by mistake. Our aims have been formulated to collect Information about those cases as much as we can from the archiving departments from the two hospitals including the number of cases that had been admitted, recovered patients and died victims. This retrospective study was planned to find out the reasons which allow those patients to drink methanol in our Muslim community and also the role of pharmacist to prevent such a disaster that claimed the lives of many people. During this tragedy 291 ospitalized patients their ages between 16-32 years old were admitted to both hospitals, total number of died 189 (121 at Tripoli medical center) and (68 at Tripoli central hospital), demographic data also shows that most of them are male (97%) and (3% female), about 4% of the patients foreigners and 96% were Libyans. There were a lot of obstacles and poor facilities at the time of patient admission as recognized in many cases including lack of first line of treatment. The morbidity was high due to the lack of antidote and availability of dialysis machines at this two main hospitals in Tripoli also according to survey done to the medical staff and also a random number of medical students shows about 28% have no idea about the first aid procedure used for methanol poisoning cases and this due to the absence of continuing education for all medical staff through the establishment of training courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: ethanol, fomepizole, methanol, poisoning

Procedia PDF Downloads 341

Authors: K. Vrinda

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Coastal ecosystems across the world are facing a lot of challenges due to natural phenomena as well as from uncontrolled human interventions. Here, Alappad, a coastal island situated in Kerala, India is undergoing significant damage and is gradually losing its environmental and social sustainability. The area is blessed with very rare and precious black mineral sand deposits. Sand mining for these minerals started in 1911 and is still continuing. But, unfortunately all the problems that Alappad faces now, have its root on mining of this mineral sand. The land area is continuously diminishing due to sea erosion. The mining has also caused displacement of people and environmental degradation. Marine life also is getting affected by mining on beach and pollution. The inhabitants are fishermen who are largely dependent on the eco-system for a living. So loss of environmental sustainability subsequently affects social sustainability too. Now the damage has reached a point beyond which our actions may not be able to make any impact. This was one of the most affected areas of the 2004 tsunami and the environmental degradation has further increased the vulnerability. So this study focuses on understanding the concerns related to the resource utilization, environment and the indigenous community staying there, and on formulating suitable strategies to restore the sustainability of the area. An extensive study was conducted on site, to find out the physical, social, and economical characteristics of the area. A focus group discussion with the inhabitants shed light on different issues they face in their day-to-day life. The analysis of all these data, led to the formation of a new development vision for the area which focuses on environmental restoration and socio-economic development while allowing controlled exploitation of resources. A participatory approach is formulated which enables these three aspects through community based programs.

Keywords: Community development, Disaster resilience, Ecological restoration, Environmental sustainability, Social-environmental planning, Social Sustainability

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Authors: Shaho Ghafur Ahmed

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The right to self-determination of peoples is a fundamental human right recognized by the principles of international law. It could be embodied in the internal level in the form of federalism. Most federal constitutions prevented the secession of constituent entities, while some remained silent, as the case of Iraq, and rare instances of them recognize it. But, after the failure of federalism, these entities seek to separate whenever the opportunity arises. In several cases, they have resort to peaceful methods in some others they resort to force. The constitutional Supreme Court, which guaranty the unity and integrity of the State, often prevent these attempts. After not a commitment of federalism in Iraq, which has been founded since 2004, the Kurdistan region, as the only federated entity, has conducted a unilateral referendum on 25 September 2017 for its independence. The Iraqi government refused it. The Iraqi Federal Supreme Court, through interpreting the constitutional provisions, decided that this referendum and it’s purposes, which was the independence of the region, was unconstitutional. Subsequently, the Iraqi government used forces and blockaded the region so as to force it to turn off this process. So, in this paper, the right to self-determination of the peoples in federated entities and its obstacles will be discussed through the comparative legal basis and analyzing the decisions of the Federal Constitutional Courts. We will compare the role that the Supreme Court of Canada played regarding the referendum that operated in Quebec in 1995, in which it refused only the unilaterally attempts for the independence of this province. While, in the case of the Kurdistan region, the Iraqi Federal Supreme Court has definitively refused this right. No measures were taken by this Court to protect the region from the Iraqi government reactions. This decision led to the questioning of the neutrality of this Court. So, from the point of view of the Kurdistan region, this Court became a political instrument to prevent it to be independent in the international community, in the absence of a clear constitutional provision, through an abstract and an incomplete interpretation of federal constitutional provisions.

Keywords: right of self-determination, federal supreme court, supremacy of federal constitution

Procedia PDF Downloads 143

Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

Procedia PDF Downloads 62

Authors: Maryam Shayani Rad, Seyed Ahmad Mohajeri, Mohsen Mouhebati, Seyed Danial Mousavi

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High blood pressure is one of the most important and serious health-threatening because of no symptoms in most people, which can lead to sudden heart attack, heart failure, and stroke. Nowadays, herbal medicine is one of the best and safest strategies for treatment that have no adverse effects. Apium graveolens (celery) can be used as an alternative treatment for many health conditions such as hypertension. Natural compounds reduce blood pressure via different mechanisms in which Apium graveolens extract provides potent calcium channel blocking properties. A randomized, double-blind, placebo-controlled, cross-over clinical trial was done to evaluate the efficacy of formulated Apium graveolens extract with a maximum yield of 3-n-butylphthalide to reduce systolic and diastolic blood pressure in patients with hypertension. 54 hypertensive patients in the range of 20-68 years old were randomly assigned to the treatment group (26 cases) and the placebo control group (26 cases) and were crossed over after washout duration. The treatment group received at least 2 grams of formulated powder in hard capsules orally, before each meal, 2 times daily. The control group received 2 grams of placebo in hard capsules orally, exactly as the same as shape, time, and doses of treatment group. Treatment was administrated in 12 weeks with 4 weeks washout period at the middle of the study, meaning 4 weeks drug consumption for the treatment group, 4 weeks washout and 4 weeks placebo consumption, and vice versa for the placebo control group. The clinical assessment was done 4 times, including at the beginning and ending of the drug and placebo consumption period by 24-hour ambulatory blood pressure monitoring (ABPM) holter, which measured blood pressure every 15 minutes continuously. There was a statistically significant decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the end of drug duration compared to baseline. The changes after 4 weeks on average was about 12.34 mm Hg for the SBP (P < 0.005) and 7.83 mm Hg for the DBP (P < 0.005). The results from this clinical trial study showed this Apium graveolens extract formulation in the mentioned dosage had a significant effect on blood pressure-lowering for hypertensive patients.

Keywords: Apium graveolens extract, clinical trial, cross-over, hypertension

Procedia PDF Downloads 185

Authors: Angel Liduvino Vara-Vela, Dirceu Luis Herdies, Debora Souza Alvim, Eder Paulo Vendrasco, Silvio Nilo Figueroa, Jayant Pendharkar, Julio Pablo Reyes Fernandez

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Biomass-burning episodes are quite common in the central Amazon rainforest and represent a dominant source of aerosols during the dry season, between August and October. The increase in the occurrence of fires in 2019 in the world’s largest biomes has captured the attention of the international community. In particular, a rare and extreme smoke-related event occurred in the afternoon of Monday, August 19, 2019, in the most populous city in the Western Hemisphere, the São Paulo Metropolitan Area (SPMA), located in southeastern Brazil. The sky over the SPMA suddenly blackened, with the day turning into night, as reported by several news media around the world. In order to clarify whether or not the smoke that plunged the SPMA into sudden darkness was related to wildfires in the Amazon rainforest region, a set of 48-hour simulations over South America were performed using the Weather Research and Forecasting with Chemistry (WRF-Chem) model at 20 km horizontal resolution, on a daily basis, during the period from August 16 to August 19, 2019. The model results were satisfactorily compared against satellite-based data products and in situ measurements collected from air quality monitoring sites. Although a very strong smoke transport coming from the Amazon rainforest was observed in the middle of the afternoon on August 19, its impact on air quality over the SPMA took place in upper levels far above the surface, where, conversely, low air pollutant concentrations were observed.

Keywords: Amazon rainforest, biomass burning aerosols, São Paulo metropolitan area, WRF-Chem model

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Authors: Biswajit Pal, Amit Mallik, Anil K. Barik

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Current years have witnessed a phenomenal growth in the research on the rare earth-doped transparent host materials, the essential components in optoelectronics that meet up the increasing demand for fabrication of high quality optical devices especially in telecommunication system. The combination of low phonon energy (because of fluoride environment) and high chemical durability with superior mechanical stability (due to oxide environment) makes the oxyfluoride glass–ceramics the promising and useful materials in optoelectronics. The present work reports on the undoped and doped (1 mol% Pr2O3) glass ceramics of composition 16.52 Al2O3•1.5AlF3• 12.65LaF3•4.33Na2O•64.85 SiO2 (mol%), prepared by melting technique initially that follows annealation at 450 ºC for 1 h. The glass samples so obtained were heat treated at constant 600 ºC with a variation in heat treatment schedule (10- 80 h). TEM techniques were employed to structurally characterize the glass samples. Pr2O3 affects the phase separation in the glass and delays the onset of crystallization in the glass ceramic. The modified crystallization mechanism is established from the analysis of advanced STEM/EDXS results. The phase separated droplets after annealing turn into 10-20 nm of LaF3 nano crystals those upon scrutiny are found to be dotted with the doped Pr3+ ions within the crystals themselves. The EDXS results also suggest that the inner LaF3 crystal core is swallowed by an Al enriched layer that follows a Si enriched surrounding shell as the outer core. This greatly increases the viscosity in the periphery of the crystals that restricts further crystal growth to account for the formation of nano sized crystals.

Keywords: advanced STEM/EDXS, crystallization mechanism, nano crystals, pr3+ ion doped glass and glass ceramic, structural characterization

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Authors: Saif Ullah

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Survey of avian fauna of Bara Gali Summer Campus, University of Peshawar in the Hazara District was conducted from April to October, 2013. A total of 21 species belonging to 5 orders and 15 families were recorded. Out of these 6 were resident, 12 were summer visitor and 3 were rare. Order Passeriformes was represented by 16 species which are Certhia himalayana, Megalaima virens, Phylloscopus trochiloides, Garrulax lineatus, Passer rutilans, Corvus macrorhynchos, Hypsipetes leucocephalus, Acridotheres tristis, Delichon dasypus cashmeriensis, Hirundo rustica, Muscicapa thalassina, Saxicola ferrea, Myiophoneus caeruleus, Parus melonolophus, Parus rufonuchalis, Parus monticolus, belonging to 11 families. Two species Dendrocopos himalayansis and Picus squamatus belongs to only 1 family of order Piciformes. Only one species from the remaining 3 orders were recorded i.e. Accipiter virgatus belongs to order Accipitriformes, Upupa epops from order Coraciformes, while order Psittaciformes represented by Psittacula himalayana .The distribution and abundance varied with season and maximum number of species was found during the monsoon season when most of the birds migrate for breeding. Some habits and behaviors like nesting, feeding, breeding and vocalizations were also studied which are very unique from other birds. Among bird species adapted to diverse habitat in the field, Himalayan Jungle Crow, Common Mynas, Bulbuls, Barn Swallows, barbets were prominent. Interesting feature of the avian fauna is familiarity with flora was greatly observed. Human related impacts such as grazing by livestock, removal of shrub cover, disturbance of habitat etc. were also studied.

Keywords: birds, summer visitor, Phylloscopus trochiloides, Parus monticolus

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Authors: Bo-Jian Wu, Si-Heng Wu

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Objectives: Frailty is a condition of a person who has chronic health problems complicated by a loss of physiological reserve and deteriorating functional abilities. The frailty syndrome was defined by Fried and colleagues, i.e., weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. However, to our best knowledge, there have been rare studies exploring the prevalence of frailty and its association with falls in patients with schizophrenia. Methods: A total of 559 hospitalized patients were recruited from a public psychiatric hospital in 2013. The majority of the subjects were males (361, 64.6%). The average age was 53.5 years. All patients received the assessment of frailty status defined by Fried and colleagues. The status of a fall within one year after the assessment of frailty, clinical and demographic data was collected from medical records. Logistic regression was used to calculate the odds ratio of associated factors. Results : A total of 9.2% of the participants met the criteria of frailty. The percentage of patients having a fall was 7.2%. Age were significantly associated with frailty (odds ratio = 1.057, 95% confidence interval = 1.025-1.091); however, sex was not associated with frailty (p = 0.17). After adjustment for age and sex, frailty status was associated with a fall (odds ratio = 3.62, 95% confidence interval = 1.58-8.28). Concerning the components of frailty, decreased grip strength (odds ratio = 2.44, 95% confidence interval = 1.16-5.14), slow gait speed (odds ratio = 2.82, 95% confidence interval = 1.21-6.53), and low physical activity (odds ratio = 2.64, 95% confidence interval = 1.21-5.78) were found to be associated with a fall. Conclusions: Our findings suggest the prevalence of frailty was about 10% in hospitalized patients with chronic patients with schizophrenia, and frailty status was significant with a fall in this group. By using the status of frailty, it may be beneficial to potential target candidates having fallen in the future as early as possible. The effective intervention of prevention of further falls may be given in advance. Our results bridge this gap and open a potential avenue for the prevention of falls in patients with schizophrenia. Frailty is certainly an important factor for maintaining wellbeing among these patients.

Keywords: fall, frailty, schizophrenia, Taiwan

Procedia PDF Downloads 134

Authors: Balázs Ádám, Randi Nørgaard Fløe Pedersen, Jørgen Riis Jepsen

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Volatile chemicals that accumulate and release from freight containers constitute significant health risks. Fumigation to prevent spread of pests and off-gassing of freight are sources of hazardous chemicals. The aim of our study was to investigate the regulation and practice of container handling with focus on preventive measures applied against chemical exposures in Denmark. A comprehensive systematic search of scientific literature and organizational domains of international and Danish regulatory bodies was performed to explore regulations related to safe work with transport containers. The practice of container work was investigated in a series of semi-structured interviews with managers and health and safety representatives of organizations that handle transport containers. Although there are several international and national regulations and local safety instructions that relate to container handling, the provided information is not specific or up-to-date enough to conduct safe practice in many aspects. The interviewees estimate high frequency of containers with chemical exposure and deem that they can potentially damage health, although recognizable health effects are rare. Knowledge is limited about the chemicals and most of them cannot be measured by available devices. Typical preventive measures are passive ventilation and personal protective equipment but their use is not consistent and may not provide adequate protection. Hazardous chemicals are frequently present in transport containers; however, managers, workers and even occupational health professionals have limited knowledge about the problem. Detailed risk assessment and specific instructions on risk management are needed to provide safe conditions for work with containers.

Keywords: chemical exposure, fumigation, occupational health and safety regulation, transport container

Procedia PDF Downloads 359

Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: J. Vinay , Kusumbati Besra, Niharika Pattnaik, Shivaram Prasad Singh, Manjusha Dixit

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Gallbladder cancer (GBC) is rare but highly malignant cancer; its prevalence is more in certain geographical regions and ethnic groups, which include the Northern and Eastern states of India. Previous studies in India have reported genetic predisposition as one of the risk factors in GBC pathogenesis. Although the matrix metalloproteinase-14 (MMP14) is a well-known modulator of the tumor microenvironment and tumorigenesis and TCGA data also suggests its upregulation yet, its role in the genetic predisposition for GBC is completely unknown. We elucidated the role of MMP14 promoter variants as genetic risk factors and their implications in expression modulation. We screened MMP14 promoter variants association with GBC using Sanger’s sequencing in approximately 300 GBC and 300 control subjects and 26 GBC tissue samples of Indian ethnicity. The immunohistochemistry was used to check the MMP14 protein expression in GBC tissue samples. The role of promoter variants on expression levels was elucidated using a luciferase reporter assay. The variants rs1004030 (p-value = 0.0001) and rs1003349 (p-value = 0.0008) were significantly associated with gallbladder cancer. The luciferase assay in two different cell lines, HEK-293 (p = 0.0006) and TGBC1TKB (p = 0.0036) showed a significant increase in relative luciferase activity in the presence of risk alleles for both the single nucleotide polymorphisms (SNPs). Similarly, genotype-phenotype correlation in patients samples confirmed that the presence of risk alleles at rs1004030 and rs1003349 increased MMP14 expression. Overall, this study unravels the genetic association of MMP14 promoter variants with gallbladder cancer, which may contribute to pathogenesis by increasing its expression.

Keywords: gallbladder cancer, matrix metalloproteinase-14, single nucleotide polymorphism, case control study, genetic association study

Procedia PDF Downloads 154

Authors: David Martinez-Pernia, Alvaro Rivera-Rei, Alejandro Troncoso, Gonzalo Forno, Andrea Slachevsky, David Huepe, Victoria Silva-Mack, Jorge Calderon, Mayte Vergara, Valentina Carrera

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Background: Recent theories in the field of emotions have taken the relevance of motor control beyond a system related to personal autonomy (walking, running, grooming), and integrate it into the emotional dimension. However, to our best knowledge, there are no studies that specifically investigate how emotional stimuli related to motor control modify emotional states in terms of postural control and phenomenological experience. Objective: The main aim of this work is to investigate the emotions produced by stimuli of bodily imbalance (neutral, pleasant and unpleasant) in the postural control and the phenomenological experience of young, healthy adults. Methodology: 46 healthy young people are shown emotional videos (neutral, pleasant, motor unpleasant, and non-motor unpleasant) related to the body imbalance. During the period of stimulation of each of the videos (60 seconds) the participant is standing on a force platform to collect temporal and spatial data of postural control. In addition, the electrophysiological activity of the heart and electrodermal activity is recorded. In relation to the two unpleasant conditions (motor versus non-motor), a phenomenological interview is carried out to collect the subjective experience of emotion and body perception. Results: Pleasant and unpleasant emotional videos have significant changes with respect to the neutral condition in terms of greater area, higher mean velocity, and greater mean frequency power on the anterior-posterior axis. The results obtained with respect to the electrodermal response was that the pleasurable and unpleasant conditions produced a significant increase in the phasic component with respect to the neutral condition. Regarding the electrophysiology of the heart, no significant change was found in any condition. Phenomenological experiences in the two unpleasant conditions differ in body perception and the emotional meaning of the experience. Conclusion: Emotional stimuli related to bodily imbalance produce changes in postural control, electrodermal activity, and phenomenological experience. This experimental setting could be relevant to be implemented in people with motor disorders (Parkinson, Stroke, TBI) to know how emotions affect motor control.

Keywords: body imbalance stimuli, emotion, phenomenological experience, postural control

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Authors: M. Torres, A. Moulay, M. Zhuldybina, M. Rozel, N. D. Trinh, C. Bois

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Printed electronics are a fast-growing market as their applications cover a large range of industrial needs, their production cost is low, and the additive printing techniques consume less materials than subtractive manufacturing methods used in traditional electronics. With the growing demand for printed electronics, there are concerns about their harmful and irreversible contribution to the environment. Indeed, it is estimated that 80% of the environmental load of a product is determined by the choices made at the conception stage. Therefore, examination through a life cycle approach at the developing stage of a novel product is the best way to identify potential environmental issues and make proactive decisions. Life cycle analysis (LCA) is a comprehensive scientific method to assess the environmental impacts of a product in its different stages of life: extraction of raw materials, manufacture and distribution, use, and end-of-life. Impacts and major hotspots are identified and evaluated through a broad range of environmental impact categories of the ReCiPe (H) middle point method. At the conception stage, the LCA is a tool that provides an environmental point of view on the choice of materials and processes and weights-in on the balance between performance materials and eco-friendly materials. Using the life cycle approach, the current work aims to provide a cradle-to-grave life cycle assessment of a roll-to-roll hybrid printed smart label designed for the food cold chain. Furthermore, this presentation will present the environmental impact of metallic conductive inks, a comparison with promising conductive polymers, evaluation of energy vs. performance of industrial printing processes, a full assessment of the impact from the smart label applied on a cellulosic-based substrate during the recycling process and the possible recovery of precious metals and rare earth elements.

Keywords: Eco-design, label, life cycle assessment, printed electronics

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Authors: Dong Yinan, Zhou Zijie

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Urban fringe belt is an important part of urban morphology research. Different from the relatively fixed central district of city, the position of fringe belt is changing. In the process of urban expansion, the original fringe belt is likely to be merged by the new-built city, even become new city public center. During the change, we are facing the dialectic between restoring the organicity of old urban form and creating new urban image. There are lots of relevant research in urban scale, but when we focus on building scale, rare design method can be proposed, thus some new individual building cannot match the overall urban planning intent. The expansion project of the second middle school in Xuancheng is facing this situation. The existing campus is located in the south fringe belt of Xuancheng, Anhui province, China, adjacent to farmland and ponds. While based on the Xucheng urban planning, the farmland and ponds will be transformed into a big lake, around which new public center will be built; the expansion of the school becomes an important part of the boundary of the new public center. Therefore, the expansion project faces challenges from both urban and building scale. In urban scale, we analyze and summarize the fringe belt characters through the reading of existing and future urban organism, in order to determine the form of the expansion project. Meanwhile, in building scale, we study on different types of school buildings and select appropriate type which can satisfy to both urban form and school function. This research attempts to investigate design methods based on an under construction project in Xuancheng, a historic city in southeast China. It also aims to bridge the gap from urban design to individual building design through the typo-morphological research.

Keywords: design methods, urban fringe belt, typo-morphological research, middle school

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Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

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Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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Authors: Carolina Beltran, Carlos De Los Reyes

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Acquired brain injury (ABI) is any physical and functional injury secondary to events that affect the brain tissue. It is one of the biggest causes of disability in the world and it has a high annual incidence in the pediatric population. There are several causes of ABI such as traumatic brain injury, central nervous system infection, stroke, hypoxia, tumors and others. The consequences can be cognitive, behavioral, emotional and functional. The cognitive rehabilitation is necessary to achieve the best outcomes for pediatric people with ABI. Cognitive orientation to daily occupational performance (CO-OP) is an individualized client-centered, performance-based, problem-solving approach that focuses on the strategy used to support the acquisition of three client-chosen goals. It has demonstrated improvements in the pediatric population with other neurological disorder but not in Spanish speakers with ABI. Aim: The main objective of this study was to determine the efficacy of cognitive orientation to daily occupational performances (CO-OP) adapted to Spanish speakers, in the level of independence and behavior in a pediatric population with ABI. Methods: Case studies with measure pre/post-treatment were used in three children with ABI, sustained at least before 6 months assessment, in school, aged 8 to 16 years, age ABI after 6 years old and above average intellectual ability. Twelve sessions of CO-OP adapted to Spanish speakers were used and videotaped. The outcomes were based on cognitive, behavior and functional independence measurements such as Child Behavior Checklist (CBCL), Behavior Rating Inventory of Executive Function (BRIEF), The Vineland Adaptive Behavior Scales (VINELAND, Social Support Scale (MOS-SSS) and others neuropsychological measures. This study was approved by the ethics committee of Universidad del Norte in Colombia. Informed parental written consent was obtained for all participants. Results: children were able to identify three goals and use the global strategy ‘goal-plan-do-check’ during each session. Verbal self-instruction was used by all children. CO-OP showed a clinically significant improvement in goals regarding with independence level and behavior according to parents and teachers. Conclusion: The results indicated that CO-OP and the use of a global strategy such as ‘goal-plan-do-check’ can be used in children with ABI in order to improve their specific goals. This is a preliminary version of a big study carrying in Colombia as part of the experimental design.

Keywords: cognitive rehabilitation, acquired brain injury, pediatric population, cognitive orientation to daily occupational performance

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Authors: Vidhi Chandra, Arshpreet Singh Grewal

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A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

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Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

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Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

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Authors: Bremmy Laksono, Riksa Parikrama, Nur A. Rosyada, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

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Down syndrome (DS) is a chromosomal abnormality characterised by complete 21 chromosome trisomy (classical or non-disjunction), or partial 21 chromosome trisomy (mosaicism), or chromosome rearrangement involving chromosome 21 (translocation). This study was carried out to describe the frequency of DS patients in a research institution in the city of Bandung, Indonesia. This descriptive study also provides a picture of the residential location and surrounding area of their dwellings. This study involved people with DS in various age whose chromosome were evaluated by conventional karyotyping method and FISH. Data were collected from 60 patients with DS from a total 150 patients during the period of September 2015 to August 2016 who were referred to Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Results showed that the most common type of DS was non-disjunction (93%), followed by mosaicism (5%), no patient with translocation DS (0%), and a very rare type of tetrasomy 21 (2%). There were 39 males (65%) and 21 females (35%) of DS patient. Most of them live in suburban area beyond Bandung city (55%) while the rest live inside urban area of Bandung city (45%). They live mostly in dense area of greater Bandung area (65%) and only a few live in mid-density area (25%) and the least live in sparse populated area (10%). Their houses are mostly located in residential estate area (55%), nearby industrial area (37%), and around agricultural area (8%). Based on the study, it could be concluded that non-disjunction DS is the most common type. DS patients referred to the laboratory mostly came from dense residential zone in suburban area outside Bandung city. The low number of DS patients referred to the laboratory for chromosome analysis was the highlight to improve health service for people with genetic disorder. This study offered several information regarding area of DS patients’ residence and the condition of neighbourhood in Bandung city where they live as well.

Keywords: chromosome, descriptive, Down syndrome, prevalence

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Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

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Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: colorectal cancer, Hail Region, changing pattern, distal shift

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Authors: Aikaterini Amanatidou

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We describe the case of a 20-year-old female patient diagnosed with Ehlers-Danlos Syndrome (EDS) who was scheduled to undergo a wisdom teeth extraction in outpatient surgery. EDS is a hereditary connective tissue disorder characterized by joint hypermobility, skin hyper-extensibility, and vascular and soft tissue fragility. There are six subtypes of Ehlers-Danlos, and in our case, the patient had EDS hyper-mobility (HT) type disorder. One important clinical feature of this syndrome is chronic pain, which is often poorly understood and treated. Our patient had a long history of articular and lumbar pain when she was diagnosed. She was prescribed analgesic treatment for acute and neuropathic pain and had multiple sessions of psychotherapy and physiotherapy to ease the pain. Unfortunately, her extensive medical history was underrated by our anesthetic team, and no further measures were taken for the operation. Despite an uneventful intra-operative phase, the patient experienced several episodes of hyperalgesia during the immediate post-operative care. Management of pain was challenging for the anesthetic team: initial opioid treatment had only a temporary effect and a paradoxical reaction after a while. Final pain relief was eventually obtained with psycho-physiologic treatment, high doses of ketamine, and patient-controlled analgesia infusion of morphine-ketamine-dehydrobenzperidol. We suspected an episode of Opioid-Induced hyperalgesia. This case report supports the hypothesis that anti-hyperalgesics such as ketamine as well as lidocaine, and dexmedetomidine should be considered intra-operatively to avoid opioid-induced hyperalgesia and may be an alternative solution to manage complex chronic pain like others in neuropathic pain syndromes.

Keywords: Ehlers-Danlos, post-operative management, hyperalgesia, opioid-induced hyperalgesia, rare disease

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Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

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Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

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Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

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Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

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Authors: Paras Agarwal

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Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.

Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer

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Authors: Yu-Sheng Lin, Sheng-Teng Huang

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In recent years, the issue of corporate social responsibility has become an enthusiastic discussion and hottest issue around the world. To make the enterprises be sustainable management and sustainable development, more and more enterprises realize that fulfill its corporate social responsibility is the good choice. It is an essential, important issue that the leader needs know how to lead the staff in balance benefit, also emphasize on economic, social and environmental aspects to impact the company, then enhance the consensus. The leader needs to improve cohesion of personnel, and implement the corporate social responsibility in staff behavior, in order to show a performance in the effort of corporate social responsibility of enterprises. The previous literature mostly is committed to comparison of corporate social responsibility in the industry and service industry, regarding to literature of shipping companies were relatively rare. This paper aims to take the domestic and foreign shipping companies of corporate social responsibility reports as the data analysis, and refer to the international convention (GRI) such as association and organization of CSR standard values. Overall comparison with shipping companies of CSR reports, annual reports and other public information, and taking Taiwan shipping companies as the target, respectively, with the international conventions and the world's top ten leading shipping companies to do the comparison and analysis. Shipping companies in Taiwan are bound to the standard that set by the international convention for the first goal diligently and following step is contend with the world's top ten leading shipping companies. There are 3 ~ 5 experts to be involved in interview after the result is completed. They will indicate the superiority and inferiority then provide the opinion, recommendation in the needed action. Through this study, we can explore the importance of corporate social responsibility report for shipping companies, and also provide the clear orientation to external providers to improve corporate social responsibility. In addition, it can provide the academic research and business experts as a reference; finally, serving shipping companies to complete another contribution.

Keywords: Corporate social responsibility (CSR), CSR reports, statistical methods, expert interview method

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Authors: Muhammad Afief Maruf

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Kacapuri foundation is the traditional shallow foundation of building which has been used since long by traditional communities in Borneo, Indonesia. Kacapuri foundation is a foundation that uses a combination of ironwood (eusideroxylon zwageri) as a column and truss and softwood (Melaleuca leucadendra syn. M. leucadendron) as a raft. In today's modern era, ironwood happened to be a rare item, and it is protected by the Indonesian government. This condition then triggers the idea to maintain the shape of the traditional foundation by modifying the material. The suggestion is replacing the ironwood column with reinforced concrete column. In addition, the number of stem softwood is added to sustain the burden of replacing the column material. Although this modified form of Kacapuri foundation is currently still not been tested in applications in society, some research on the modified Kacapuri foundation has been conducted by some researchers and government unit. This paper will try to give an overview of the theoretical foundation bearing capacity Kacapuri modifications applied to the soft alluvial soil located in Borneo, Indonesia, where the original form of Kacapuri is implemented this whole time. The foundation is modeled buried depth in 2m below the ground surface and also below the ground water level. The calculation of the theoretical bearing capacity and then is calculated based on the bearing capacity equation suggested Skempton, Terzaghi and Ohsuki using the data of soft alluvial soil in Borneo. The result will then compared with the bearing capacity of the Kacapuri foundation original design from some previous research. The results show that the ultimate bearing capacity of the Modified Kacapuri foundation using Skempton equation amounted to 329,26 kN, Terzaghi for 456,804kN, and according Ohsaki amounted to 491,972 kN. The ultimate bearing capacity of the original Kacapuri foundation model based on Skempton equation is 18,23 kN. This result shows that the modification added the ultimate bearing capacity of the foundation, although the replacement of ironwood to reinforced concrete will also add some dead load to the total load itself.

Keywords: bearing capacity, Kacapuri, modified foundation, shallow foundation

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Authors: Yan Wang, Wei Wu

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In recent years, with the gradual change of Chinese urban development mode from 'incremental development' to 'stock-based renewal', the urban design method of ‘grand scene’ in the past could only cope with the planning and construction of incremental spaces such as new towns and new districts, while the problems involved in the renewal of the stock lands such as historic blocks of ancient cities are more complex. 'Simplified' large-scale demolition and construction may lead to the damage of the ancient city's texture and the overall cultural atmosphere; thus it is necessary to re-explore the urban design path of historical blocks in the conservation context of the ancient city. Through the study of the cultural context of the ancient city of Suzhou in China and the interpretation of its current characteristics, this paper explores the methods and paths for the renewal of historical and cultural blocks in the ancient city. It takes No. 12 and No. 13 historical blocks in the ancient city of Suzhou as examples, coordinating the spatial layout and the landscape and shaping the regional characteristics to improve the quality of the ancient city's life. This paper analyses the idea of conservation and regeneration from the aspects of culture, life, business form, and transport. Guided by the planning concept of ‘block repair and cultural infiltration’, it puts forward the urban design path of ‘conservation priority, activation and utilization, organic renewal and strengthening guidance’, with a view to continuing the cultural context and stimulating the vitality of ancient city, so as to realize the integration of history, modernity, space and culture. As a rare research on urban design in the scope of Suzhou ancient city, the paper expects to explore the concepts and methods of urban design for the historic blocks on the basis of the conservation of the history, space, and culture and provides a reference for other similar types of urban construction.

Keywords: historical block, Suzhou ancient city, stock-based renewal, urban design

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