Search results for: venous congestion

Authors: R. N. Nataria, A. D. Paryuni, R. Wasito

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Layer farms in Indonesia have still obstacles to increasing their productivity, especially due to poultry diseases. The red onion (Allium ascalonicum L.) is a plant that contains flavonoid and saponin. Flavonoid is useful as anti-inflammatory and antioxidant while saponin is useful as antivirus, anti-inflammatory, antifungal, and immunomodulator. This study aimed to know and determine the effect of onion extracts to pulmonary histopathological lesions in layer chickens which raised in the battery cage. This study used eighteen layer chickens at seventeen days old. The eighteen layer chickens were divided into three groups of six each, namely without administration of red onion extract (Group I), with administration red onion extract through drinking water (Group II) and with administration red onion extract peroral (Group III). Every ten days, six chickens were necropsied and then the lungs were processed for histopathological preparations and stained with routine hematoxylin and eosin. The results showed that the lungs of the Group I had severe congestion and diffuse hemorrhages. In Group II, lungs had moderate congestion and hemorrhages. In group III, lungs had mild congestion and hemorrhages. It is concluded, that red onion extract apparently has reduced the lungs lesions in layer chickens.

Keywords: histopathological lesions, layers, lungs, poultry diseases, red onion extract

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

Procedia PDF Downloads 138

Authors: Animesh Gupta

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Objective: The purpose of this study is to evaluate the versatility and outcome of lateral supra malleolar flap (LSMF) in soft tissue reconstruction of the regions including the distal leg, ankle, dorsal foot and heel. Methods: From March 2021 to April 2023, 18 patients with soft tissue defects in the regions, including the distal leg, ankle, dorsal foot and heel, who underwent LSMF repair for lower limb wound reconstruction were analyzed. The location, size of the defects, etiology, outcome, complications, and other alternative options were studied and presented. Results: The follow-up period of the cases was 3-6 months after surgery. All flaps were successful; however, one flap was complicated by venous congestion and was managed by loosening a few sutures and the patient was required to elevate the affected limb to resolve the issue. Conclusion: The LSMF has numerous advantages in repairing soft tissue defects in areas involving the ankle, distal leg, heel and dorsum of the foot. In comparison to reverse sural flaps for repairing defects in the heel and lower leg, LSMF offers shorter operation time, shorter hospitalization, lower cost, and fewer postoperative complications.

Keywords: lateral supra malleolar flap, LSMF, soft tissue reconstruction, lower leg defect

Procedia PDF Downloads 58

Authors: N. Ali, S. Nakayama, H. Yamaguchi, M. Nadeem

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Traffic congestion is a matter of prime concern in developing countries. This can be primarily attributed due to poor design practices and biased allocation of resources based on political will neglecting the technical feasibilities in infrastructure design. During the last decade, Lahore has expanded at an unprecedented rate as compared to surrounding cities due to more funding and resource allocation by the previous governments. As a result of this, people from surrounding cities and areas moved to the Lahore city for better opportunities and quality of life. This migration inflow inherited the city with an increased population yielding the inefficiency of the existing infrastructure to accommodate enhanced traffic demand. This leads to traffic congestion on major arterial roads of the city. In this simulation study, a major arterial road was selected to evaluate the performance of the five intersections by changing the geometry of the intersections or signal control type. Simulations were done in two software; Highway Capacity Software (HCS) and Synchro Studio and Sim Traffic Software. Some of the traffic management strategies that were employed include actuated-signal control, semi-actuated signal control, fixed-time signal control, and roundabout. The most feasible solution for each intersection in the above-mentioned traffic management techniques was selected with the least delay time (seconds) and improved Level of Service (LOS). The results showed that Jinnah Hospital Intersection and Akbar Chowk Intersection improved 92.97% and 92.67% in delay time reduction, respectively. These results can be used by traffic planners and policy makers for decision making for the expansion of these intersections keeping in mind the traffic demand in future years.

Keywords: traffic congestion, traffic simulation, traffic management, congestion problems

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Authors: O’Day Luke

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Purpose: To validate virtual non-contrast reconstructions generated from dual-layer spectral computed tomography (DL-CT) data as an alternative for the acquisition of a dedicated true non-contrast dataset during multiphase contrast studies. Material and methods: Thirty-three patients underwent a routine multiphase clinical CT examination, using Dual-Layer Spectral CT, from March to August 2021. True non-contrast (TNC) and virtual non-contrast (VNC) datasets, generated from both portal venous and arterial phase imaging were evaluated. For every patient in both true and virtual non-contrast datasets, a region-of-interest (ROI) was defined in aorta, liver, fluid (i.e. gallbladder, urinary bladder), kidney, muscle, fat and spongious bone, resulting in 693 ROIs. Differences in attenuation for VNC and TNV images were compared, both separately and combined. Consistency between VNC reconstructions obtained from the arterial and portal venous phase was evaluated. Results: Comparison of CT density (HU) on the VNC and TNC images showed a high correlation. The mean difference between TNC and VNC images (excluding bone results) was 5.5 ± 9.1 HU and > 90% of all comparisons showed a difference of less than 15 HU. For all tissues but spongious bone, the mean absolute difference between TNC and VNC images was below 10 HU. VNC images derived from the arterial and the portal venous phase showed a good correlation in most tissue types. The aortic attenuation was somewhat dependent however on which dataset was used for reconstruction. Bone evaluation with VNC datasets continues to be a problem, as spectral CT algorithms are currently poor in differentiating bone and iodine. Conclusion: Given the increasing availability of DL-CT and proven accuracy of virtual non-contrast processing, VNC is a promising tool for generating additional data during routine contrast-enhanced studies. This study shows the utility of virtual non-contrast scans as an alternative for true non-contrast studies during multiphase CT, with potential for dose reduction, without loss of diagnostic information.

Keywords: dual-layer spectral computed tomography, virtual non-contrast, true non-contrast, clinical comparison

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Authors: Akshit Singhal, Xuan Wang, Zhijun Wang, Hao Che, Hong Jiang

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Multiple Path Transmission Control Protocols (MPTCPs) allow flows to explore path diversity to improve the throughput, reliability and network resource utilization. However, the existing solutions may discourage users to adopt the solutions in the face of multipath scenario where different paths are charged based on different pricing structures, e.g., WiFi vs cellular connections, widely available for mobile phones. In this paper, we propose a Hybrid MPTCP (H-MPTCP) with a built-in mechanism to incentivize users to use multiple paths with different pricing structures. In the meantime, H-MPTCP preserves the nice properties enjoyed by the state-of-the-art MPTCP solutions. Extensive real Linux implementation results verify that H-MPTCP can indeed achieve the design objectives.

Keywords: network, TCP, WiFi, cellular, congestion control

Procedia PDF Downloads 674

Authors: Bachir Chemani, Rachid Halfaoui

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The aim of study was to evaluate pressure distribution characteristics of the elastic textile bandages using two instrumental techniques: a prototype Instrument and a load Transference. The prototype instrument which simulates shape of real leg has pressure sensors which measure bandage pressure. Using this instrument, the results show that elastic textile bandages presents different pressure distribution characteristics and none produces a uniform distribution around lower limb. The load transference test procedure is used to determine whether a relationship exists between elastic textile bandage structure and pressure distribution characteristics. The test procedure assesses degree of load, directly transferred through a textile when loads series are applied to bandaging surface. A range of weave fabrics was produced using needle weaving machine and a sewing technique. A textile bandage was developed with optimal characteristics far superior pressure distribution than other bandages. From results, we find that theoretical pressure is not consistent exactly with practical pressure. It is important in this study to make a practical application for specialized nurses in order to verify the results and draw useful conclusions for predicting the use of this type of elastic band.

Keywords: textile, cotton, pressure, venous ulcers, elastic

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Authors: Saad Roustom, Hajo Ribberink

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In most cities in the world, traffic has increased strongly over the last decades, causing high levels of congestion and deteriorating inner-city air quality. This study analyzes the impact of connected and automated vehicles (CAVs) on traffic performance and greenhouse gas (GHG) emissions under different CAV penetration rates in mixed fleet environments of CAVs and driver-operated vehicles (DOVs) and under three different traffic demand levels. Utilizing meso-scale traffic simulations of the City of Ottawa, Canada, the research evaluates the traffic performance of three distinct CAV driving behaviors—Cautious, Normal, and Aggressive—at penetration rates of 25%, 50%, 75%, and 100%, across three different traffic demand levels. The study employs advanced correlation models to estimate GHG emissions. The results reveal that Aggressive and Normal CAVs generally reduce traffic congestion and GHG emissions, with their benefits being more pronounced at higher penetration rates (50% to 100%) and elevated traffic demand levels. On the other hand, Cautious CAVs exhibit an increase in both traffic congestion and GHG emissions. However, results also show deteriorated traffic flow conditions when introducing 25% penetration rates of any type of CAVs. Aggressive CAVs outperform all other driving at improving traffic flow conditions and reducing GHG emissions. The findings of this study highlight the crucial role CAVs can play in enhancing urban traffic performance and mitigating the adverse impact of transportation on the environment. This research advocates for the adoption of effective CAV-related policies by regulatory bodies to optimize traffic flow and reduce GHG emissions. By providing insights into the impact of CAVs, this study aims to inform strategic decision-making and stimulate the development of sustainable urban mobility solutions.

Keywords: connected and automated vehicles, congestion, GHG emissions, mixed fleet environment, traffic performance, traffic simulations

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Authors: Mohanad Rezeq, Tarik Aouam, Frederik Gailly

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In times of armed conflicts, various security checkpoints are placed by authorities to control the flow of merchandise into and within areas of conflict. The flow of humanitarian trucks that is added to the regular flow of commercial trucks, together with the complex security procedures, creates congestion and long waiting times at the security checkpoints. This causes distribution costs to increase and shortages of relief aid to the affected people to occur. Our research proposes a decision-support tool to assist planners and policymakers in building efficient plans for the distribution of relief aid, taking into account congestion at security checkpoints. The proposed tool is built around a multi-item humanitarian distribution planning model based on multi-phase design science methodology that has as its objective to minimize distribution and back ordering costs subject to capacity constraints that reflect congestion effects using nonlinear clearing functions. Using the 2014 Gaza War as a case study, we illustrate the application of the proposed tool, model the underlying relief-aid humanitarian supply chain, estimate clearing functions at different security checkpoints, and conduct computational experiments. The decision support tool generated a shipment plan that was compared to two benchmarks in terms of total distribution cost, average lead time and work in progress (WIP) at security checkpoints, and average inventory and backorders at distribution centers. The first benchmark is the shipment plan generated by the fixed capacity model, and the second is the actual shipment plan implemented by the planners during the armed conflict. According to our findings, modeling and optimizing supply chain flows reduce total distribution costs, average truck wait times at security checkpoints, and average backorders when compared to the executed plan and the fixed-capacity model. Finally, scenario analysis concludes that increasing capacity at security checkpoints can lower total operations costs by reducing the average lead time.

Keywords: humanitarian distribution planning, relief-aid distribution, congestion, clearing functions

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Authors: Amira Mabrouk, Chokri Abdennadher

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The reduction of road congestion which is inherent to the use of vehicles is an obvious priority to public authority. Therefore, assessing the willingness to pay of an individual in order to save trip-time is akin to estimating the change in price which was the result of setting up a new transport policy to increase the networks fluidity and improving the level of social welfare. This study holds an innovative perspective. In fact, it initiates an economic calculation that has the objective of giving an estimation of the monetized time value during the trips made in Sfax. This research is founded on a double-objective approach. The aim of this study is to i) give an estimation of the monetized value of time; an hour dedicated to trips, ii) determine whether or not the consumer considers the environmental variables to be significant, iii) analyze the impact of applying a public management of the congestion via imposing taxation of city tolls on urban dwellers. This article is built upon a rich field survey led in the city of Sfax. With the use of the contingent valuation method, we analyze the “declared time preferences” of 450 drivers during rush hours. Based on the fond consideration of attributed bias of the applied method, we bring to light the delicacy of this approach with regards to the revelation mode and the interrogative techniques by following the NOAA panel recommendations bearing the exception of the valorization point and other similar studies about the estimation of transportation externality.

Keywords: willingness to pay, contingent valuation, time value, city toll

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Authors: Elsayed Fath Khalifa, Samer Mohamed Daghash

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The aim of the current work study to increase the anatomical knowledge about the cattle egret which considered economically important for farmers. The study was carried out on ten adult, apparently healthy cattle egrets of both sexes. Each bird was exsanguinated; the caudal vena cava was cannulated and flushed with warm normal saline solution (0.9%) then injected with blue colored neoprine (60%) latex in order to study the tributaries of the hepatic portal vein. The origin, course and tributaries of the right and left hepatic portal veins were studied. The hepatic portal venous system collected venous blood from the abdominal viscera including; glandular and muscular stomachs, liver, pancreas, spleen, small intestine and large intestine. The hepatic portal vein was formed by the left and the right hepatic portal veins. The smaller left one drained blood from the glandular and muscular stomachs through the ventral and the left proventriculus as well as the left gastric veins. The most tributaries of the right hepatic portal vein drained blood from the rest of the gastrointestinal tract and the spleen by the proventriculosplenic, the gastropancreaticoduodenal and the common mesenteric veins.

Keywords: cattle egret, common mesenteric vein, hepatic portal vein, anatomy

Procedia PDF Downloads 388

Authors: Ntaganda J.M., Maniraguha J.D., Mukeshimana S., Harelimana D, Bizimungu T., Ruataganda E.

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This paper presents the design of Graphic User Interface (GUI) in Matlab as interaction tool between human and machine. The designed GUI can be used by medical doctors and other experts particularly the physiologists. Matlab packages and estimated parameters of the mathematical model of cardiovascular-respiratory system developed in Rwandan context are used in GUI. The ordinary differential equations (ODE’s) govern a mathematical model in designing GUI in Matlab and a window that sets model estimated parameters and the measured parameters by any user. For healthy subject, these measured parameters include heart rate, systolic blood and diastolic blood pressure, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, concentration of bound and dissolved oxygen in the mixed venous blood entering the lungs, and concentration of bound and dissolved carbon dioxide in the mixed venous blood entering the lungs. The results of numerical test give a consistent appearance as empirically known results.

Keywords: Graphic User Interface, mathematical model, cardiovascur-respiratory system, walking physical activity, blood pressure, oxygen

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Authors: Ren Moses, Emmanuel Kidando, Eren Ozguven, Yassir Abdelrazig

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This study applied traffic speed and occupancy to develop clustering models that identify different traffic conditions. Particularly, these models are based on the Dirichlet Process Mixture of Generalized Linear regression (DML) and change-point regression (CR). The model frameworks were implemented using 2015 historical traffic data aggregated at a 15-minute interval from an Interstate 295 freeway in Jacksonville, Florida. Using the deviance information criterion (DIC) to identify the appropriate number of mixture components, three traffic states were identified as free-flow, transitional, and congested condition. Results of the DML revealed that traffic occupancy is statistically significant in influencing the reduction of traffic speed in each of the identified states. Influence on the free-flow and the congested state was estimated to be higher than the transitional flow condition in both evening and morning peak periods. Estimation of the critical speed threshold using CR revealed that 47 mph and 48 mph are speed thresholds for congested and transitional traffic condition during the morning peak hours and evening peak hours, respectively. Free-flow speed thresholds for morning and evening peak hours were estimated at 64 mph and 66 mph, respectively. The proposed approaches will facilitate accurate detection and prediction of traffic congestion for developing effective countermeasures.

Keywords: traffic congestion, multistate speed distribution, traffic occupancy, Dirichlet process mixtures of generalized linear model, Bayesian change-point detection

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Authors: Manish Kumar Rajak, Sanjay Gupta

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Mobile ad hoc networks (MANETs) are infrastructure less and intercommunicate using single-hop and multi-hop paths. Network based congestion avoidance which involves managing the queues in the network devices is an integral part of any network. QoS: A set of service requirements that are met by the network while transferring a packet stream from a source to a destination. Especially in MANETs, packet loss results in increased overheads. This paper presents a new algorithm to avoid congestion using one or more queue on nodes and corresponding flow rate decided in advance for each node. When any node attains an initial value of queue then it sends this status to its downstream nodes which in turn uses the pre-decided flow rate of packet transfer to its upstream nodes. The flow rate on each node is adjusted according to the status received from its upstream nodes. This proposed algorithm uses the existing infrastructure to inform to other nodes about its current queue status.

Keywords: mesh networks, MANET, packet count, threshold, throughput

Procedia PDF Downloads 450

Authors: P. K. Sarkar, Amit Kumar Jain

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The demand for Urban transportation is characterised by a large scale temporal and spatial variations which causes heavy congestion inside metro trains in peak hours near Centre Business District (CBD) of the city. The conventional approach to address peak hour congestion, metro trains has been to increase the supply by way of introduction of more trains, increasing the length of the trains, optimising the time table to increase the capacity of the system. However, there is a limitation of supply side measures determined by the design capacity of the systems beyond which any addition in the capacity requires huge capital investments. The demand side interventions are essentially required to actually spread the demand across the time and space. In this study, an attempt has been made to identify the potential Transport Demand Management tools applicable to Urban Rail Transportation systems with a special focus on differential pricing. A conceptual price elasticity model has been developed to analyse the effect of various combinations of peak and nonpeak hoursfares on demands. The elasticity values for peak hour, nonpeak hour and cross elasticity have been assumed from the relevant literature available in the field. The conceptual price elasticity model so developed is based on assumptions which need to be validated with actual values of elasticities for different segments of passengers. Once validated, the model can be used to determine the peak and nonpeak hour fares with an objective to increase overall ridership, revenue, demand levelling and optimal utilisation of assets.

Keywords: urban transport, differential fares, congestion, transport demand management, elasticity

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Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier

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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.

Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas

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Authors: Adedayo Jeremiah Adeyekun, Samuel Oluwagbemiga Ishola

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This research paper focuses on the study of the master plan of rural Farrukhnagar, a town in Gurugram with an aim to proffer solutions to the problems associated with the planning of the town. The commercial zone has been selected for the case study. The findings from the case studies will reveal problems that will require a proposed design of a new ultra-modern market to position traders selling along the road in well-deserved stalls, waste disposal/incinerator system for proper management of waste and cleanliness within the market square, design of stormwater drainage to avoid flood during the rainy season and the design of car/auto – tricycle parks to create more space in the existing market cycle and thereby avoiding congestion. The research proposes urban and architectural solutions to improve the rural commercial service settings in Farrukhnagar which is a study area in Gurugram, Haryana, India.

Keywords: management, commercial, service, planning, congestion

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Authors: Athina Thanou, Eirini Eleni Tsiropoulou, Symeon Papavassiliou

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The problem of museum visitor experience and congestion management – in various forms - has come increasingly under the spotlight over the last few years, since overcrowding can significantly decrease the quality of visitors’ experience. Evidence suggests that on busy days the amount of time a visitor spends inside a crowded house museum can fall by up to 60% compared to a quiet mid-week day. In this paper we consider the aforementioned problem, by treating museums as evolving social systems that induce constraints. However, in a cultural heritage space, as opposed to the majority of social environments, the momentum of the experience is primarily controlled by the visitor himself. Visitors typically behave selfishly regarding the maximization of their own Quality of Experience (QoE) - commonly expressed through a utility function that takes several parameters into consideration, with crowd density and waiting/visiting time being among the key ones. In such a setting, congestion occurs when either the utility of one visitor decreases due to the behavior of other persons, or when costs of undertaking an activity rise due to the presence of other persons. We initially investigate how visitors’ behavioral risk attitudes, as captured and represented by prospect theory, affect their decisions in resource sharing settings, where visitors’ decisions and experiences are strongly interdependent. Different from the majority of existing studies and literature, we highlight that visitors are not risk neutral utility maximizers, but they demonstrate risk-aware behavior according to their personal risk characteristics. In our work, exhibits are organized into two groups: a) “safe exhibits” that correspond to less congested ones, where the visitors receive guaranteed satisfaction in accordance with the visiting time invested, and b) common pool of resources (CPR) exhibits, which are the most popular exhibits with possibly increased congestion and uncertain outcome in terms of visitor satisfaction. A key difference is that the visitor satisfaction due to CPR strongly depends not only on the invested time decision of a specific visitor, but also on that of the rest of the visitors. In the latter case, the over-investment in time, or equivalently the increased congestion potentially leads to “exhibit failure”, interpreted as the visitors gain no satisfaction from their observation of this exhibit due to high congestion. We present a framework where each visitor in a distributed manner determines his time investment in safe or CPR exhibits to optimize his QoE. Based on this framework, we analyze and evaluate how visitors, acting as prospect-theoretic decision-makers, respond and react to the various pricing policies imposed by the museum curators. Based on detailed evaluation results and experiments, we present interesting observations, regarding the impact of several parameters and characteristics such as visitor heterogeneity and use of alternative pricing policies, on scalability, user satisfaction, museum capacity, resource fragility, and operation point stability. Furthermore, we study and present the effectiveness of alternative pricing mechanisms, when used as implicit tools, to deal with the congestion management problem in the museums, and potentially decrease the exhibit failure probability (fragility), while considering the visitor risk preferences.

Keywords: museum resource and visitor management, congestion management, propsect theory, cyber physical social systems

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Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

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Authors: Anju Rani, Geeta, Sudha Rani, Choudhary, Puhal

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Method- A total of 300 patients were studied, with 100 patients in each group. Patients aged 16-60 years, ASA grade I and II undergoing elective general surgical, urology and orthopedic procedures were included in the study. The patients were randomly allocated to any of the three groups by Using Sealed envelopes. 1. Group A: EMLA (eutectic mixture of 2.5% lidocaine with 2.5% prilocaine) - Patients receiving eutectic Lidocaine/ Prilocaine cream (2gm/10cm2) of Prilox cream), for 60- 70 min under occlusive dressing. 2. Group B - Patients receiving topical diclofenac 4 % spray gel for 60- 70 min, covering an absorption area of 50 cm2 3. Group C: control – Direct cannulation was done without any intervention. Results - Group B showed significantly least number of patients complaining pain on IV cannulation in comparison to group A and group C. The Mean VAS scores were found to be maximum in GROUP C: control-8.76 ± 4.14, then in GROUP A: EMLA- 2.54 ± 4.21.and least in GROUP B: Diclofenac 4% spray-1.13 ± 3.05. Erythema, induration and edema were significantly reported to be higher for the control group. Also group A patients reported adverse skin reactions more than patients in group B. Conclusion - It can be concluded that diclofenac spray 4 % and EMLA cream are effective in reducing the incidence and severity of venous cannulation pain as compared to the control group. However, a higher incidence of skin blanching, erythema, and oedema associated with EMLA cream and a lower incidence of these adverse effects favours the use of diclofenac spray 4%. They are promising agents for the treatment of venous cannulation pain.

Keywords: diclofenac spray, EMLA, intravenous, pain

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Authors: Hatem Abou-Senna

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Interstate 4 (I-4) is a primary east-west transportation corridor between Tampa and Daytona cities, serving commuters, commercial and recreational traffic. I-4 is known to have severe recurring congestion during peak hours. The congestion spans about 11 miles in the evening peak period in the central corridor area as it is considered the only non-tolled limited access facility connecting the Orlando Central Business District (CBD) and the tourist attractions area (Walt Disney World). Florida officials had been skeptical of tolling I-4 prior to the recent legislation, and the public through the media had been complaining about the excessive toll facilities in Central Florida. So, in search for plausible mitigation to the congestion on the I-4 corridor, this research is implemented to evaluate the effectiveness of different toll pricing alternatives that might divert traffic from I-4 to the toll facilities during the peak period. The network is composed of two main diverging limited access highways, freeway (I-4) and toll road (SR 417) in addition to two east-west parallel toll roads SR 408 and SR 528, intersecting the above-mentioned highways from both ends. I-4 and toll road SR 408 are the most frequently used route by commuters. SR-417 is a relatively uncongested toll road with 15 miles longer than I-4 and $5 tolls compared to no monetary cost on 1-4 for the same trip. The results of the calibrated Orlando PARAMICS network showed that percentages of route diversion vary from one route to another and depends primarily on the travel cost between specific origin-destination (O-D) pairs. Most drivers going from Disney (O1) or Lake Buena Vista (O2) to Lake Mary (D1) were found to have a high propensity towards using I-4, even when eliminating tolls and/or providing real-time information. However, a diversion from I-4 to SR 417 for these OD pairs occurred only in the cases of the incident and lane closure on I-4, due to the increase in delay and travel costs, and when information is provided to travelers. Furthermore, drivers that diverted from I-4 to SR 417 and SR 528 did not gain significant travel-time savings. This was attributed to the limited extra capacity of the alternative routes in the peak period and the longer traveling distance. When the remaining origin-destination pairs were analyzed, average travel time savings on I-4 ranged between 10 and 16% amounting to 10 minutes at the most with a 10% increase in the network average speed. High propensity of diversion on the network increased significantly when eliminating tolls on SR 417 and SR 528 while doubling the tolls on SR 408 along with the incident and lane closure scenarios on I-4 and with real-time information provided. The toll roads were found to be a viable alternative to I-4 for these specific OD pairs depending on the user perception of the toll cost which was reflected in their specific travel times. However, on the macroscopic level, it was concluded that route diversion through toll reduction or elimination on surrounding toll roads would only have a minimum impact on reducing I-4 congestion during the peak period.

Keywords: congestion pricing, dynamic feedback assignment, microsimulation, paramics, route diversion

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Authors: Mohd Aslam Aslam

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Chronic renal failure is a debilitating condition responsible for high morbidity and mortality. Because of its costs and the complexity of its treatment, proper care is available to very few patients in India. According to researchers, the number of adults aged 30 or older who have chronic kidney disease is projected to increase from 13.2 percent currently, to 14.4 percent in 2020 and 16.7 percent in 2030. The aerial part of Aerva lanata (Busehri booti) have been used in kidney disorders by the Unani physicians. In the present study, the effect of extract of Aerva lanata was investigated on cisplatin-induced nephrotoxicity in rats. The renal effects of this drug was evaluated by monitoring levels of blood urea nitrogen (BUN), serum creatinine, serum uric acid in blood and histopathological examination of kidney. Aerva lanata was evaluated at two different doses (1400 mg/kg and 2800 mg/kg). The effect of higher dose was more pronounced in terms of inhibition in the rise of BUN, serum creatinine and uric acid. Higher dose show greater prevention in the rise of BUN, serum creatinine, and uric acid. The histopathological examination of the kidney tissue of the rats treated with aqueous methanolic extract of Aerva lanata (Higher dose-2800 mg/kg) showed marked inhibition of glomerular congestion, tubular casts, peritubular congestion, epithelial desquamation, blood vessel congestion, interstitial edema and inflammatory cells produced by the cisplatin-induced nephrotoxicity. This finding clearly indicates the protective role of Aerva lanata at higher dose. Present investigation validates the use of Aerva lanata in kidney disorders by Unani physicians.

Keywords: Aerva lanata, Busehri booti, nephroprotective, unani medicine

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Authors: Attiq Ur Rahman Dogar, Sohaib Ishaq

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Pakistan had experienced rapid motorization in the last decade. Due to the soft leasing schemes of banks and increase in average household income, even the middle class can now afford cars. The public transit system is inadequate and sparse. Due to these reasons, traffic demand on urban arterials has increased manifold. Poor urban transit planning and aging transportation systems have resulted in traffic congestion. The focus of this study is to improve traffic flow on a section of N-5 passing through the Rawalpindi downtown. Present efforts aim to carry out the analysis of traffic conditions on this section and to investigate the impact of traffic signal co-ordination on travel time. In addition to signal co-ordination, we also examined the effect of different infrastructure improvements on the travel time. After the economic analysis of alternatives and discussions, the improvement plan for Rawalpindi downtown urban arterial section is proposed for implementation.

Keywords: signal coordination, infrastructure intervention, infrastructure improvement, cycle length, fuel consumption cost, travel time cost, economic analysis, travel time, Rawalpindi, Pakistan, traffic signals

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Authors: Sourabh Jain, Sukhvir Singh Jain, Gaurav V. Jain

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Intelligent Transportation System (ITS) is the application of technology for developing a user–friendly transportation system for urban areas in developing countries. The goal of urban corridor management using ITS in road transport is to achieve improvements in mobility, safety, and the productivity of the transportation system within the available facilities through the integrated application of advanced monitoring, communications, computer, display, and control process technologies, both in the vehicle and on the road. This paper attempts to present the past studies regarding several ITS available that have been successfully deployed in urban corridors of India and abroad, and to know about the current scenario and the methodology considered for planning, design, and operation of Traffic Management Systems. This paper also presents the endeavor that was made to interpret and figure out the performance of the 27.4 Km long study corridor having eight intersections and four flyovers. The corridor consisting of 6 lanes as well as 8 lanes divided road network. Two categories of data were collected on February 2016 such as traffic data (traffic volume, spot speed, delay) and road characteristics data (no. of lanes, lane width, bus stops, mid-block sections, intersections, flyovers). The instruments used for collecting the data were video camera, radar gun, mobile GPS and stopwatch. From analysis, the performance interpretations incorporated were identification of peak hours and off peak hours, congestion and level of service (LOS) at mid blocks, delay followed by the plotting speed contours and recommending urban corridor management strategies. From the analysis, it is found that ITS based urban corridor management strategies will be useful to reduce congestion, fuel consumption and pollution so as to provide comfort and efficiency to the users. The paper presented urban corridor management strategies based on sensors incorporated in both vehicles and on the roads.

Keywords: congestion, ITS strategies, mobility, safety

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Authors: Ferdi Sönmez, Nihal Yorulmaz

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Decision making on the true planning of the public transportation systems to serve potential users is a must for metropolitan areas. To take attraction of travelers to projected modes of transport, adequately fair overall travel times should be provided. In this fashion, other benefits such as lower traffic congestion, road safety and lower noise and atmospheric pollution may be earned. The congestion which comes with increasing demand of public transportation is becoming a part of our lives and making residents’ life difficult. Hence, regulations should be done to reduce this congestion. To provide a constructive and balanced regulation in public transportation systems, right stations should be located in right places. In this study, it is aimed to design and implement a Decision Support System (DSS) Application to determine the optimal bus stop places for public transport in Istanbul which is one of the biggest and oldest cities in the world. Required information is gathered from IETT (Istanbul Electricity, Tram and Tunnel) Enterprises which manages all public transportation services in Istanbul Metropolitan Area. By using the most real-like values, cost assignments are made. The cost is calculated with the help of equations produced by bi-level optimization model. For this study, 300 buses, 300 drivers, 10 lines and 110 stops are used. The user cost of each station and the operator cost taken place in lines are calculated. Some components like cost, security and noise pollution are considered as significant factors affecting the solution of set covering problem which is mentioned for identifying and locating the minimum number of possible bus stops. Preliminary research and model development for this study refers to previously published article of the corresponding author. Model results are represented with the intent of decision support to the specialists on locating stops effectively.

Keywords: operator cost, bi-level optimization model, user cost, urban transportation

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Authors: Mardi Falck, André Theron

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Traffic congestion on the Northern side of Table Bay is a major problem. In Gauteng, the implementation of the Gautrain between Pretoria and Johannesburg, solved their traffic congestion. In 2002 two entrepreneurs endeavoured to implement a hovercraft ferry service across the bay from Table View to the Port of Cape Town. However, the EIA process proved that disgruntled residents from the area did not agree with their location for a launch site. 17 years later the traffic problem has not gone away, but instead the congestion has increased. While property prices in the City Bowl of Cape Town are ever increasing, people tend to live more on the outskirts of the CBD and commute to work. This means more vehicles on the road every day and the public transport services cannot keep up with the demand. For this reason, the study area of the previous hovercraft plans is being extended further North. The study’s aim is thus to determine the feasibility of a launch site North of Bloubergstrand to launch and receive a public transport ferry across Table Bay. The feasibility is being established by researching ferry services across the world and on what makes them successful. Different types of ferries and their operational capacities in terms of weather and waves are researched and by establishing the offshore and nearshore wind and wave climate for the area, an appropriate protected launch site is determined. It was concluded that travel time could potentially be halved. A hovercraft proved to be the most feasible ferry type, because it does not require a conventional harbour. Other types of vessels require a protected launch site because of the wave climate. This means large breakwaters that influence the cost substantially. The Melkbos Cultural Centre proved to be the most viable option for the location of the launch site, because it already has buildings and infrastructure. It is recommended that, if a harbour is chosen for the proposed ferry service, it could be used for more services like fishing, eco-tourism and leisure. Further studies are recommended to optimise the feasibility of such a harbour.

Keywords: Cape Town, ferry, public, Table Bay

Procedia PDF Downloads 133

Authors: Dinoo Kirthinanda, Sujani Wijeratne

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Pseudohyperkalaemia is a common benign in vitro phenomenon caused by the release of potassium ions (K+) from cells during specimen processing. Analysis of haemolysed blood samples for predominantly intracellular electrolytes may lead to re-investigation and potentially harmful interventions. We report a case of a 52-year male with myeloproliferative disease manifested as Polycythaemia Rubra Vera, Hypertension and hypertensive nephropathy with stage 3 chronic kidney disease admitted to Neuro-intensive care unit (NICU) with an intra-cerebral haemorrhage secondary to hypertensive bleed. His initial blood investigations showed hyperkalemia with serum K+ 6.2 mmol/L yet the bedside arterial blood gas analysis yielded K+ of 4.6 mmol/L. The patient was however given hyperkalemia regime twice based on venous electrolyte analysis. The discrepancy between the bedside electrolyte analysis using arterial blood and venous blood prompted further evaluation. The 12 lead Electrocardiogram showed U waves and sinus bradycardia corresponding to the serum K+ of 2.8 mmol/L on arterial blood gas analysis. Immediate K+ replacement ensured the patient did not develop life-threatening cardiac complications. Pseudohyperkalaemia may pose diagnostic challenges in the absence of detectable haemolysis and should be suspected in susceptible patients with normal Electrocardiogram and Glomerular Filtration Rate to avoid potentially life-threatening interventions. When in doubt, rapid analysis of arterial blood gas may be useful for accurate quantification of potassium.

Keywords: patient safety, pseudohyperkalaemia, haemolysis, myeloproliferative disorder

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Authors: Tomas Berhanu Bekele

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Traffic congestion is one of the main problems related to transportation in developed as well as developing countries. Traffic control systems are based on the idea of avoiding traffic instabilities and homogenizing traffic flow in such a way that the risk of accidents is minimized and traffic flow is maximized. Lately, Intelligent Transport Systems (ITS) has become an important area of research to solve such road traffic-related issues for making smart decisions. It links people, roads and vehicles together using communication technologies to increase safety and mobility. Moreover, accurate prediction of road traffic is important to manage traffic congestion. The aim of this study is to develop an ANN model for the prediction of traffic flow and to compare the ANN model with the linear regression model of traffic flow predictions. Data extraction was carried out in intervals of 15 minutes from the video player. Video of mixed traffic flow was taken and then counted during office work in order to determine the traffic volume. Vehicles were classified into six categories, namely Car, Motorcycle, Minibus, mid-bus, Bus, and Truck vehicles. The average time taken by each vehicle type to travel the trap length was measured by time displayed on a video screen.

Keywords: intelligent transport system (ITS), traffic flow prediction, artificial neural network (ANN), linear regression

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Authors: Sourabh Jain, Sukhvir Singh Jain, Gaurav V. Jain

Abstract:

Intelligent Transportation System is an integrated application of communication, control and monitoring and display process technologies for developing a user–friendly transportation system for urban areas in developing countries. In fact, the development of a country and the progress of its transportation system are complementary to each other. Urban traffic has been growing vigorously due to population growth as well as escalation of vehicle ownership causing congestion, delays, pollution, accidents, high-energy consumption and low productivity of resources. The development and management of urban transport in developing countries like India however, is at tryout stage with very few accumulations. Under the umbrella of ITS, urban corridor management strategy have proven to be one of the most successful system in accomplishing these objectives. The present study interprets and figures out the performance of the 27.4 km long Urban Bus route having six intersections, five flyovers and 29 bus stops that covers significant area of the city by causality analysis. Performance interpretations incorporate Passenger Boarding and Alighting, Dwell time, Distance between Bus Stops and Total trip time taken by bus on selected urban route.

Keywords: congestion, dwell time, passengers boarding alighting, travel time

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Authors: Sathish Kumar Jayaraj

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The study of urban traffic dynamics, underpinned by the principles of fluid dynamics, offers a distinct perspective to comprehend and enhance the efficiency of traffic flow within bustling cityscapes. Leveraging the concept of the Traffic Flow Factor (TFF) as an analog to the Reynolds number, this research delves into the intricate interplay between traffic density, velocity, and road category, drawing compelling parallels to fluid dynamics phenomena. By introducing the notion of Vehicle Shearing Resistance (VSR) as an analogy to dynamic viscosity, the study sheds light on the multifaceted influence of traffic regulations, lane management, and road infrastructure on the smoothness and resilience of traffic flow. The TFF equation serves as a comprehensive metric for quantifying traffic dynamics, enabling the identification of congestion hotspots, the optimization of traffic signal timings, and the formulation of data-driven traffic management strategies. The study underscores the critical significance of integrating fluid dynamics principles into the domain of urban traffic management, fostering sustainable transportation practices, and paving the way for a more seamless and resilient urban mobility ecosystem.

Keywords: traffic flow factor (TFF), urban traffic dynamics, fluid dynamics principles, vehicle shearing resistance (VSR), traffic congestion management, sustainable urban mobility

Procedia PDF Downloads 39