Search results for: spiral case

Authors: Syed Dawood Md. Taimur, Md. Hasanur Rahman, Syeda Fahmida Afrin, Farzana Islam

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The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur either spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing the safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of the acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.

Keywords: coronary artery disease, percutaneous coronary intervention, myocardial injury, pharmacology

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Authors: Syed Muhammad Wajih ul Hassan

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This research looks at the perception of first-time voters in Pakistan on the political dynamics of the country. This paper shall review the researches that were conducted by Gallup Pakistan and compare it with our findings regarding the voter behavior and factors that affect the priorities of the voters. A country where democracy has just completed its 2 consecutive tenures for the first time, one would always want to know about the voting trends among youth where young population makes 60% of the population in the country. In that case, it is not only a big task to find out voter patterns and trends voters might adhere to while a general election is approaching. Also, the paper discovers the psychology of young Pakistani voters on the upcoming election of 2018 but also the factors that influence the voting decisions of a voter. This research tries to study the relations among voters and how they view each other in general. The paper also explores the views of voters on the factors that impact decision making of a voter while casting his/her vote in Pakistan. The paper thoroughly studies the expectations of the voters from the current system that prevails in the country. The reason this research was conducted is that this kind of positive approach towards finding out the voter perception is heavily untouched in Pakistani academia. This study can benefit a lot of institutions and professions in the future too. The constraints and obstacles that came while this research was being conducted are also identified in the paper. The mode of research is primary research as it was impossible to find out the perceptions of first-time voters without going on the field and carrying out the research. The research was conducted in one of the most reputable and liberal educational institutions of Pakistan. This research is based on a survey that was conducted through questionnaires where responses were collected through a mix process of random and convenient sampling. The major findings of the study show that young voters have a realistic perspective about the electoral process in the country. The research also articulates the factors that affect the priorities of young voters, and also how young voters view other voters that belong from other sections of the society. To conclude, we can say that this research will give us a perspective that can define and identify the voter priorities of the future in Pakistan.

Keywords: first time voters, general election 2018, Pakistan, young

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Authors: Abdus-Samiᶜi Imam Arikewuyo

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Islam enjoins the spirit of cooperation among fellow mankind. This is particularly entrenched in the brotherhood phenomenon advocated by Islam. With cooperation, a group of people with diverse qualities and opportunities can facilitate a breakthrough in what is seemingly difficult, if not impossible. This understanding underscores the initiative of establishing multi-purpose cooperative societies for thrifts and savings among bonafide members, especially in developing nations. The spirit and objectives of the Multi-Purpose Cooperatives Societies gave birth to the founding of several of these organizations as a plausible economic outfit in Nigeria to provide succor to the socio-economic predicaments of members. Pertinently, many Islamic cooperative societies sprang up, carving a niche for themselves as Shariᶜah-based economic outfits to accommodate the yearnings of the Muslim populace. KWASU Al-Halal Cooperative Society, Malete, Nigeria, is one such organization that is not only Shariᶜah inclined but also institutional-based. This paper, therefore, aims to examine the operations and activities of this society with a view to determining its strength as a Shariᶜah-based economic outfit for the survival of its clients in a competitive multi-religious atmosphere. The study is both historical and descriptive; thus, it employed interview, observation, focus group discussion and hermeneutical methods as pertinent research tools. The research findings indicated that adopting the Shariᶜah prescriptions, KWASU Al-Halal Cooperative Society, as a representation of the Islamic cooperatives society, fulfilled the essence and goal of its establishment, serving as an outlet for meeting the socio-economic demands of its members regardless of religious inclinations. The paper recommended that stronger efforts should be made on proper record keeping, the conscientiousness of beneficiaries on loan refunds or payments on purchases and education of the loanees and guarantors.

Keywords: efficacy, Islamic cooperatives society, Kwasu al-halal cooperative society, shariᶜah

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Authors: Babatunde Dosumu, Obuks Ejohwomu, Akilu Yunusa-Kaltungo

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Cost estimation in construction is often difficult, particularly when dealing with risks and uncertainties, which are inevitable and peculiar to developing countries like Nigeria. Direct consequences of these are major deviations in cost, duration, and quality. The fundamental aim of this study is to develop a framework for assessing the impacts of risk on cost estimation, which in turn causes variabilities between contract sum and final account. This is very important, as initial estimates given to clients should reflect the certain magnitude of consistency and accuracy, which the client builds other planning-related activities upon, and also enhance the capabilities of construction industry professionals by enabling better prediction of the final account from the contract sum. In achieving this, a systematic literature review was conducted with cost variability and construction projects as search string within three databases: Scopus, Web of science, and Ebsco (Business source premium), which are further analyzed and gap(s) in knowledge or research discovered. From the extensive review, it was found that factors causing deviation between final accounts and contract sum ranged between 1 and 45. Besides, it was discovered that a cost estimation framework similar to Building Cost Information Services (BCIS) is unavailable in Nigeria, which is a major reason why initial estimates are very often inconsistent, leading to project delay, abandonment, or determination at the expense of the huge sum of money invested. It was concluded that the development of a cost estimation framework that is adjudged an important tool in risk shedding rather than risk-sharing in project risk management would be a panacea to cost estimation problems, leading to cost variability in the Nigerian construction industry by the time this ongoing Ph.D. research is completed. It was recommended that practitioners in the construction industry should always take into account risk in order to facilitate the rapid development of the construction industry in Nigeria, which should give stakeholders a more in-depth understanding of the estimation effectiveness and efficiency to be adopted by stakeholders in both the private and public sectors.

Keywords: cost variability, construction projects, future studies, Nigeria

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Authors: Sofiya An, Akbota Kanderzhanova, Assel Akhmetova, Faye Foster, Chee K. Chan

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Healthcare, education and social support for children with autism in Kazakhstan has been evolving and transforming over the last three decades. There is still limited knowledge of the use of complementary and alternative medicine by families caring for autistic children in this post-Soviet region. An exploratory qualitative focus group study of Kazakhstani families was carried out to capture and understand their experiences of using complementary and alternative (CAM) medicine. A total of six focus groups were conducted in five cities across the country including Nur-Sultan, Almaty, Kyzylorda, Karaganda and Taraz. The perceived factors driving the availability, choice, and use of complementary and alternative medicine by families of autistic children in the country were distilled and evaluated. The data collected was analyzed using a framework analysis and themes and subthemes were developed. Two major themes stood out. The first was the “unmet needs”, which relates to the predisposing factors that motivate parents to CAM uptake, and the second was the “chasing hope”, which relates to the enabling factors that facilitate parents’ uptake of CAM. Fear of missing out (FOMO) is a latent underlying motivation underscoring these two themes as well. Parents of autism spectrum disorder (ASD) children in Kazakhstan have to deal with many challenges when seeking treatment for their children with ASD. They are prepared and resort to try out whatever CAM interventions available. The motivation and rationale of choice of use is driven by the lack of options and the hope of any potential positive outcome rather than from rational decisions based on efficacy or the evidence-based data of CAM. Parents get desperate and are willing to try CAM regardless of and independent of their cultural and belief systems and they do not want to miss out just in case it might work. This study also gives an international and cross-cultural perspective on the motives, choice and practice of parents with ASD children using CAM in Kazakhstan, a Central Asian country.

Keywords: autism spectrum disorder, Central Asia, complementary and alternative medicine, cross-cultural perspective, qualitative research

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Authors: Saidulu Gadari, Manoj Kumar Yadav, V. K. Satheesh, Debasis Bhattacharyya, S. S. V. Ramakumar, Subhajit Sarkar

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Most Fluid Catalytic Cracking Units (FCCUs) are big profit makers and hence, always operated with several constraints. It is the primary source for production of gasoline, light olefins as petrochemical feedstocks, feedstock for alkylate & oxygenates, LPG, etc. in a refinery. Increasing unit capacity and improving product yields as well as qualities such as gasoline RON have dramatic impact on the refinery economics. FCCUs are often debottlenecked significantly beyond their original design capacities. Depending upon the unit configuration, operating conditions, and feedstock quality, the FCC unit can have a variety of bottlenecks. While some of these are aimed to increase the feed rate, improve the conversion, etc., the others are aimed to improve the reliability of the equipment or overall unit. Apart from investment cost, the other factors considered generally while evaluating the debottlenecking options are shutdown days, faster payback, risk on investment, etc. A low-cost solution such as replacement of feed injectors, air distributor, steam distributors, spent catalyst distributor, efficient cyclone system, etc. are the preferred way of upgrading FCCU. It also has lower lead time from idea inception to implementation. This paper discusses various bottlenecks generally encountered in FCCU and presents a case study on improvement of performance of one of the FCCUs in IndianOil through implementation of cost-effective technical solution including use of improved internals in Reactor-Regeneration (R-R) section. After implementation reduction in regenerator air, gas superficial velocity in regenerator and cyclone velocities by about 10% and improvement of CLO yield from 10 to 6 wt% have been achieved. By ensuring proper pressure balance and optimum immersion of cyclone dipleg in the standpipe, frequent formation of perforations in regenerator cyclones could be addressed which in turn improved the unit on-stream factor.

Keywords: FCC, low-cost, revamp, debottleneck, internals, distributors, cyclone, dipleg

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Authors: Nizika Sorokhaibam

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With the collapse of the Soviet Union in 1989, that marked the end of the prolonged struggle of ideologies between capitalism of the United States of America and communism of the Soviet Union, the world entered a new era of free markets, trade and economic liberalization. Through analysis of various literatures on North Korea, this study focuses on the impact of Globalization on North Korea- its people, economy and the regime. The study also takes a glance at the Juche ideology, which was crafted by the Supreme Leader Kim Il Sung, for the people of DPRK and its role and influence in shaping the North Korean economy. The new buzz word being Globalization, as businesses started to expand on international scale, demanding the need for co-operation, connectivity and interdependence of countries around the world. States tilted their focus towards industrialization, production of raw materials, production of goods to meet the growing demands and grabbing markets for the manufactured products. This became the norm as many newly independent countries adopted democracy and aligned their views with globalization processes. Socialist and communist regimes either fell one after the other to join the globalization trend or reformed their economic system to meet the globalization trends. However, even after staying isolated for more than six decades, Democratic People’s Republic of Korea, the Hermit Kingdom, refuses to open up its economy to the globalised world. North Korean regime still controls all the sectors of the country and no trade and investment freedom is given to the people. North Korea vigorously makes efforts to emphasize on its Juche ideology of self-sustenance and self-reliance to keep away from actively engaging in global trade and process of globalization, which they refer to as “Americanization” of the world. Nevertheless, the reality is that North Korea’s economy is not self sustained and is collapsing from within, which led them to solicit foreign aid from the United States of America, South Korea (Republic of Korea) and People’s Republic of China. The regime needs to implement reforms and make adjustments for the economy to survive in the competing world.

Keywords: economic globalization, economic isolation, Juche, North Korea

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Authors: Gusa Hall, Barrie Keeler, Achal Khanna

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Introduction: NICE guidelines have highlighted the consequences of IV fluid mismanagement. The main aim of this study was to audit fluid prescribing post laparotomies to identify if fluids were prescribed in accordance to NICE guidelines. Methodology: Retrospective database search of eight specific laparotomy procedures (colectomy right and left, Hartmann’s procedure, small bowel resection, perforated ulcer, abdominal perineal resection, anterior resection, pan proctocolectomy, subtotal colectomy) highlighted 29 laparotomies between April 2019 and May 2019. Two of 29 patients had secondary procedures during the same admission, n=27 (patients). Database case notes were reviewed for date of procedure, length of admission, fluid prescribed and amount, nasal gastric tube output, daily bloods results for electrolytes sodium and potassium and operational losses. Results: n=27 based on 27 identified patients between April 2019 – May 2019, 93% (25/27) received IV fluids, only 19% (5/27) received the correct IV fluids in accordance to NICE guidelines, 93% (25/27) who received IV fluids had the correct electrolytes levels (sodium & potassium), 100% (27/27) patients received blood tests (U&E’s) for correct electrolytes levels. 0% (0/27) no documentation on operational losses. IV fluids matched nasogastric tube output in 100% (3/3) of the number of patients that had a nasogastric tube in situ. Conclusion: A PubMed database literature review on barriers to safer IV prescribing highlighted educational interventions focused on prescriber knowledge rather than how to execute the prescribing task. This audit suggests IV fluids post laparotomies are not being prescribed consistently in accordance to NICE guidelines. Surgical management plans should be clearer on IV fluids and electrolytes requirements for the following 24 hours after the plan has been initiated. In addition, further teaching and training around IV prescribing is needed together with frequent surgical audits on IV fluid prescribing post-surgery to evaluate improvements.

Keywords: audit, IV Fluid prescribing, laparotomy, NICE guidelines

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Authors: Loubna Khalile, Hicham Lahlaoi, Hassan Rhinane, A. Kaoukaya, S. Fal

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Green spaces is an essential element, they contribute to improving the quality of lives of the towns around them. They are a place of relaxation, walk and rest a playground for sport and youths. According to United Nations Organization Forests cover 31% of the land. In Morocco in 2013 that cover 12.65 % of the total land area, still, a small proportion compared to the natural needs of forests as a green lung of our planet. The Benslimane Forest is a large green area It belongs to Chaouia-Ouardigha Region and Greater Casablanca Region, it is located geographically between Casablanca is considered the economic and business Capital of Morocco and Rabat the national political capital, with an area of 12261.80 Hectares. The essential problem usually encountered in suburban forests, is visitation and tourism pressure it is anthropogenic actions, as well as other ecological and environmental factors. In recent decades, Morocco has experienced a drought year that has influenced the forest with increasing human pressure and every day it suffers heavy losses, as well as over-exploitation. The Moroccan forest ecosystems are weak with intense ecological variation, domanial and imposed usage rights granted to the population; forests are experiencing a significant deterioration due to forgetfulness and immoderate use of forest resources which can influence the destruction of animal habitats, vegetation, water cycle and climate. The purpose of this study is to make a model of the degree of degradation of the forest and know the causes for prevention by using remote sensing and geographic information systems by introducing climate and ancillary data. Analytic hierarchy process was used to find out the degree of influence and the weight of each parameter, in this case, it is found that anthropogenic activities have a fairly significant impact has thus influenced the climate.

Keywords: analytic hierarchy process, degradation, forest, geographic information system

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Authors: Jonas A. R. H. Lima, Maria Antonia Carravilla

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As productivity concepts are widely related to industrial savings, it is becoming particularly important in a more and more competitive world, to really understand how productivity can be well used in industrial management techniques. Nowadays, consumers are no more willing to pay for mistakes and inefficiencies. Therefore, one way for companies to stay competitive is to control and increase their productivity. This study aims to define clearly the productivity concept, understand how a company can affect productivity, and, if possible, identify the relation between each identified productivity factor. This will help managers, by clarifying the main issues behind productivity concepts and proposing a methodology to measure, control and increase productivity. The main questions to be answered are: what is the importance of productivity for the Portuguese Wood Furniture Industry? Is it possible to control productivity internally, or is it a phenomenon external to companies, hard or even impossible to control? How to understand, control and adjust productivity performance? How to make productivity to become one main asset for maximizing the use of the available resources? This essay will follow a constructive approach mostly based in the research hypothesis mentioned above. For that, a literature review is being done to find the main conceptual frameworks and empirical studies that already exist, and by doing so, highlight eventual knowledge or conflicting research to be addressed in this work. We expect to build theoretical explanations and test theoretical predictions from participants understandings and own experiences, by elaborating field surveys and interviews, to select adjusted productivity indicators and analyze the productivity evolution according the adjustments on other variables. Its intended the conduction of an exploratory work that can simultaneous clarify productivity concepts, objectives, and define frameworks. This investigation intends to migrate from merely academic concepts to a daily basis operational reality of the companies from the Portuguese Wood Furniture Industry highlighting productivity increased importance within modern engineering and industrial management. The ambition is to clarify, systemize and develop a management tool that may not only control but positively influence the way resources are used.

Keywords: industrial management, motivation, productivity, performance indicators, reward management, wood furniture industry

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Authors: Dacheng Li, Bo Huang, Qinjin Han, Ming Li

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Remotely sensed imagery with the high spatial and temporal characteristics, which it is hard to acquire under the current land observation satellites, has been considered as a key factor for monitoring environmental changes over both global and local scales. On a basis of the limited high spatial-resolution observations, challenged studies called spatiotemporal fusion have been developed for generating high spatiotemporal images through employing other auxiliary low spatial-resolution data while with high-frequency observations. However, a majority of spatiotemporal fusion approaches yield to satisfactory assumption, empirical but unstable parameters, low accuracy or inefficient performance. Although the spatiotemporal fusion methodology via sparse representation theory has advantage in capturing reflectance changes, stability and execution efficiency (even more efficient when overcomplete dictionaries have been pre-trained), the retrieval of high-accuracy dictionary and its response to fusion results are still pending issues. In this paper, we employ additional image pairs (here each image-pair includes a Landsat Operational Land Imager and a Moderate Resolution Imaging Spectroradiometer acquisitions covering the partial area of Baotou, China) only into the coupled dictionary training process based on K-SVD (K-means Singular Value Decomposition) algorithm, and attempt to improve the fusion results of two existing sparse representation based fusion models (respectively utilizing one and two available image-pair). The results show that more eligible image pairs are probably related to a more accurate overcomplete dictionary, which generally indicates a better image representation, and is then contribute to an effective fusion performance in case that the added image-pair has similar seasonal aspects and image spatial structure features to the original image-pair. It is, therefore, reasonable to construct multi-dictionary training pattern for generating a series of high spatial resolution images based on limited acquisitions.

Keywords: spatiotemporal fusion, sparse representation, K-SVD algorithm, dictionary learning

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Authors: Genevieve R. Kan, Jolyon Ford

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Background: Caesarean section has become the routine route of delivery for breech fetuses, but breech cesarean deliveries are hypothesized to have poorer immediate neonatal outcomes when compared to cephalic deliveries. In accordance with this, in many Australian hospitals, the pediatric team is routinely required to attend every elective breech cesarean section in case urgent resuscitation is required. Our study aimed to determine whether term elective breech deliveries indeed had worse immediate neonatal outcomes at delivery, which will justify the necessity of pediatric staff presence at every elective breech cesarean delivery and influence the workload for the pediatric team. Objective: Elective breech cesarean deliveries were compared to elective cephalic cesarean deliveries at 37 weeks gestation or above to evaluate the immediate neonatal outcomes (Apgar scores <7 at 5 minutes, and Special Care Nursery admissions on Day 1 of life) of each group. Design: A retrospective cohort study Method: This study examined 2035 elective breech and cephalic singleton cesarean deliveries at term over 5 years from July 2017 to July 2022 at Frankston Hospital, a metropolitan hospital in Melbourne, Australia. There were 260 breech deliveries and 1775 cephalic deliveries. De-identified patient data were collected retrospectively from the hospital’s electronically integrated pregnancy and birth records to assess demographics and neonatal outcomes. Results: Apgar scores <7 at 5 minutes of life were worse in the breech group compared to the cephalic group (3.4% vs 1.6%). Special Care Nursery admissions on Day 1 of life were also higher for the breech cohort compared to the cephalic cohort (9.6% vs 8.7%). Conclusions: Our results support the expected findings that breech deliveries are associated with worse immediate neonatal outcomes. It, therefore, suggests that routine attendance at elective breech cesarean deliveries by the pediatric team is indeed required to assist with potentially higher needs for neonatal resuscitation and special care nursery admission.

Keywords: breech, cesarean section, Apgar scores, special care nursery admission

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Authors: Tonghua Li

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Under the neoliberal corporate food regime, biofuels are a double-edged sword that exacerbates tensions between national food security and trade in green agricultural products. Biofuels have the potential to help achieve green sustainable development goals, but they threaten food security by exacerbating competition for land and changing global food trade patterns. The U.S.-China trade war complicates this debate. Under the influence of different political and corporate coordination mechanisms in China and the US, trade disputes can have different impacts on sustainable agricultural practices. This paper develops an actor-centred ‘network governance framework’ focusing on trade in soybean and corn-based biofuels to explain how trade wars can change the actions of governmental and non-governmental actors in the context of oligopolistic competition and market concentration in agricultural trade. There is evidence that the US-China trade decoupling exacerbates the conflict between national security, free trade in agriculture, and the realities and needs of green and sustainable energy development. The US government's trade policies reflect concerns about China's relative gains, leading to a loss of trade profits, making it impossible for the parties involved to find a balance between the three objectives and, consequently, to get into a biofuels and soybean industry dilemma. Within the setting of prioritizing national security and strategic interests, the government has replaced the dominant position of large agribusiness in the neoliberal food system, and the goal of environmental sustainability has been marginalized by high politics. In contrast, China faces tensions in the trade war between food security self-sufficiency policy and liberal sustainable trade, but the state-capitalist model ensures policy coordination and coherence in trade diversion and supply chain adjustment. Despite ongoing raw material shortages and technological challenges, China remains committed to playing a role in global environmental governance and promoting green trade objectives.

Keywords: food security, green trade, biofuels, soybeans, US-China trade war

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Authors: Prashant Das, Tushar Singh, Virendra Byadwal

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The present study attempted to understand the role of cognitive flexibility and employee engagement in predicting employees’ turnover intentions. Employee turnover is a significant problem that many organizations are facing these days. Employee turnover is not only extremely expensive for the employer but also results in poor production levels. In developing countries like India, organizations once believed to have most stable employees, are facing major turnover problems. One such organization is banking organizations. Due to globalization, banks are now changing their work scenarios under which the employees have many different roles to perform. Cognitive flexibility which refers to an individual’s ability to shift cognitive sets and to adapt to one’s changing environment, thus seems to be an important factor that are responsible for the employee turnover in organizations. It is hypothesized that those with higher cognitive flexibility would be more able to adapt to the changing work demands of the organizations and thus would show less turnover intentions. Another factor that seems to be important in predicting turnover is employee engagement. Kahn referred to engagement in terms of the harnessing of organization members’ selves to their work roles [by which they] employ and express themselves physically, cognitively, and emotionally during role performances. Studies have shown a strong relationship between employee engagement and turnover intentions. Those with higher engagement with their jobs have found to show low turnover intentions. This study thus hypothesizes that employees with higher engagement will show lower levels of turnover intentions. A total of 150 bank employees (75 from private and 75 from public) participated in this study. They were administered Cognitive Flexibility Scale, Gallup Questionnaire and Intention to Stay Questionnaire along with another questionnaire asking for their demographic details. Results of the study revealed that employees with higher levels of cognitive flexibility and employee engagement show lover levels of turnover intentions. However, the effect is more prominent in case of employees of private banks. Demographic characteristics such as level of the employee and years of engagement in the current job have also been found to be influencing the relationship between cognitive flexibility, employee engagement and turnover intentions. Results of the study are interpreted in accordance to the prevalent literature and theoretical positions.

Keywords: cognitive flexibility, employee engagement, organization, turnover intentions

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Authors: Soukat Kumar Das

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Rapid industrialization and increase in population has resulted in the scarcity of suitable ground conditions. It has driven the need of ground improvement by means of reinforcement with geosynthetics with the minimum possible settlement and with maximum possible safety. Prestressing the geosynthetics offers an economical yet safe method of gaining the goal. Commercially available software PLAXIS 3D has made the analysis of prestressed geosynthetics simpler with much practical simulations of the ground. Attempts have been made so far to analyse the effect of prestressing geosynthetics and the effect of interference of footing on Unreinforced (UR), Geogrid Reinforced (GR) and Prestressed Geogrid Reinforced (PGR) soil on the load bearing capacity and the settlement characteristics of prestressed geogrid reinforced soil using the numerical analysis by using the software PLAXIS 3D. The results of the numerical analysis have been validated and compared with those given in the referred paper. The results have been found to be in very good agreement with those of the actual field values with very small variation. The GR soil has been found to be improve the bearing pressure 240 % whereas the PGR soil improves it by almost 500 % for 1mm settlement. In fact, the PGR soil has enhanced the bearing pressure of the GR soil by almost 200 %. The settlement reduction has also been found to be very significant as for 100 kPa bearing pressure the settlement reduction of the PGR soil has been found to be about 88 % with respect to UR soil and it reduced to up to 67 % with respect to GR soil. The prestressing force has resulted in enhanced reinforcement mechanism, resulting in the increased bearing pressure. The deformation at the geogrid layer has been found to be 13.62 mm for GR soil whereas it decreased down to mere 3.5 mm for PGR soil which certainly ensures the effect of prestressing on the geogrid layer. The parameter Improvement factor or conventionally known as Bearing Capacity Ratio for different settlements and which depicts the improvement of the PGR with respect to UR and GR soil and the improvement of GR soil with respect to UR soil has been found to vary in the range of 1.66-2.40 in the present analysis for GR soil and was found to be vary between 3.58 and 5.12 for PGR soil with respect to UR soil. The effect of prestressing was also observed in case of two interfering square footings. The centre to centre distance between the two footings (SFD) was taken to be B, 1.5B, 2B, 2.5B and 3B where B is the width of the footing. It was found that for UR soil the improvement of the bearing pressure was up to 1.5B after which it remained almost same. But for GR soil the zone of influence rose up to 2B and for PGR it further went up to 2.5B. So the zone of interference for PGR soil has increased by 67% than Unreinforced (UR) soil and almost 25 % with respect to GR soil.

Keywords: bearing, geogrid, prestressed, reinforced

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Authors: Cristian Cazacu, Bela Kobulniczky

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Even though nowadays the median area of the Bucharest’s Sector 1 owns one of the best reputations in terms of quality of life level, the problems in urban planning from the last twenty years, as well as those related to the urban environment, became more and more obvious and shrill. And all this happened as long as non-compliance with urban and spatial planning laws, corroborated with uncontrolled territorial expansion on certain areas and faulty management of public and private spaces were more acute. The action of all these factors has been felt more and more strongly in the territory in the last twenty years, generating the degradation of the quality of the urban environment and affecting in parallel the general level of the inhabitants¬’ quality of life. Our methodology is based on analyzing a wide range of environmental parameters and it is also based on using advanced resources and skills for mapping planning and environmental dysfunctions as well as the possibility of integrating information into GIS programs, all data sets corroborated with problems related to spatial planning management and inaccuracies of the urbanistic sector. In the end, we managed to obtain a calculated and realistic image of the dysfunctions and a quantitative view of their magnitude in the territory. We also succeeded to create a full general map of the degree of degradation of the urban environment by typologies of urban tissues. Moreover, the methods applied by us can also be used globally to calculate and create realistic images and intelligent maps over the quality of the environment in areas larger than this one. Our study shows that environmental degradation occurred differently in the urban tissues from our study area, depending on several factors, reviewing the faulty way in which the processes of recovery / urban regeneration of the gap in recent years have led to the creation of new territorial dysfunctions. The general, centralized results show that the analyzed space has a much wider range of problems than initially thought, although notoriety and social etiquette place them far above other spaces from the same city of study.

Keywords: environment, GIS, planning, urban tissues

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Authors: Slah Eddine Ben Fadhel

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Despite the development of new pedagogic methods, current teaching practices put more emphasis on the learning products than on the processes learners deploy. In school syllabi, for instance, very little time is devoted to both the explanation and analysis of strategies aimed at resolving problems by means of targeting students’ metacognitive procedures. Within a cognitive framework, teaching/learning contexts are conceived of in terms of cognitive, metacognitive and affective activities intended for the treatment of information. During these activities, learners come to develop an array of knowledge and strategies which can be subsumed within an active and constructive process. Through the investigation of strategies and metacognition concepts, the purpose is to reflect upon the modalities at the heart of the learning process and to demonstrate, similarly, the inherent significance of a cognitive approach to learning. The scope of this paper is predicated on a study where the population is a group of 76 primary school pupils who experienced difficulty with learning French. The population was divided into two groups: the first group was submitted during three months to a strategy-based training to learn French. All through this phase, the teachers centred class activities round making learners aware of the strategies the latter deployed and geared them towards appraising the steps these learners had themselves taken by means of a variety of tools, most prominent among which is the logbook. The second group was submitted to the usual learning context with no recourse whatsoever to any strategy-oriented tasks. The results of both groups point out the improvement of linguistic competences in the French language in the case of those pupils who were trained by means of strategic procedures. Furthermore, this improvement was noted in relation with the native language (Arabic), a fact that tends to highlight the importance of the interdisciplinary investigation of (meta-)cognitive strategies. These results show that strategic learning promotes in pupils the development of a better awareness of their own processes, which contributes to improving their general linguistic competences.

Keywords: constructive approach, cognitive strategies, metacognition, learning

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Authors: F. Nasser-Abu Alhija

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In many countries, much efforts and resources are devoted to empowering and integrating minorities within the mainstream population. Major ventures in this route are crafted in higher education institutions where different outreach programs and methods such as lenient entry requirements, monitory incentives, learning skills workshops, tutoring and mentoring, are utilized. Although there is some information regarding these programs, their effectiveness still needs to be thoroughly examined. The Ethiopian community In Israel is one of the minority groups that has been targeted by sponsoring foundations and higher education institutions with the aim to ease the access, persistence and success of its young people in higher education and later in the job market. The evaluation study we propose to present focuses on the implementation of a program designed for this purpose. This program offers relevant candidates for study at a prestigious university a variety of generous incentives that include tuitions, livening allowance, tutoring, mentoring, skills and empowerment workshops and cultural meetings. Ten students were selected for the program and they started their studies in different subject areas before three and half years. A longitudinal evaluation has been conducted since the implementation of the program. Data were collected from different sources: participating students, program coordinator, mentors, tutors, program documents and university records. Questionnaires and interviews were used for collecting data on the different components of the program and on participants' perception of their effectiveness. Participants indicate that the lenient entry requirements and the monitory incentives are critical for starting their studies. During the first year, skills and empowering workshops, torturing and mentoring were evaluated as very important for persistence and success in studies. Tutoring was perceived as very important also at the second year but less importance is attributed to mentoring. Mixed results regarding integration in the Israeli culture emerged. The results are discussed with reference to findings from different settings around the world.

Keywords: access to higher education, minority groups, monitory incentives, torturing, mentoring

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Authors: Miao Li, Mengyuan Xu

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As a low-carbon travel mode, bicycling has drawn increasing political interest in the contemporary Chinese urban context, and the public sharing bikes have become the most popular ways of bike usage in China now. This research aims to explore the spatial-temporal relationship between sharing bike usage and different characteristics of the urban street built environment. In the research, street segments were used as the analytic unit of the street built environment defined by street intersections. The sharing bike usage data in the research include a total of 2.64 million samples that are the entire sharing bike distribution data recorded in two days in 2018 within a neighborhood of 185.4 hectares in the city of Wuhan, China. And these data are assigned to the 97 urban street segments in this area based on their geographic location. The built environment variables used in this research are categorized into three sections: 1) street design characteristics, such as street width, street greenery, types of bicycle lanes; 2) condition of other public transportation, such as the availability of metro station; 3) Street function characteristics that are described by the categories and density of the point of interest (POI) along the segments. Spatial Lag Models (SLM) were used in order to reveal the relationships of specific urban streets built environment characteristics and the likelihood of sharing bicycling usage in whole and different periods a day. The results show: 1) there is spatial autocorrelation among sharing bicycling usage of urban streets in case area in general, non-working day, working day and each period of a day, which presents a clustering pattern in the street space; 2) a statistically strong association between bike sharing usage and several different built environment characteristics such as POI density, types of bicycle lanes and street width; 3) the pattern that bike sharing usage is influenced by built environment characteristics depends on the period within a day. These findings could be useful for policymakers and urban designers to better understand the factors affecting bike sharing system and thus propose guidance and strategy for urban street planning and design in order to promote the use of sharing bikes.

Keywords: big data, sharing bike usage, spatial statistics, urban street built environment

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Authors: Samar Swaid

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Today, corporates are moving toward the adoption of Design-Thinking techniques to develop products and services, putting their consumer as the heart of the development process. One of the leading companies in Design-Thinking, IDEO (Innovation, Design, Engineering Organization), defines Design-Thinking as an approach to problem-solving that relies on a set of multi-layered skills, processes, and mindsets that help people generate novel solutions to problems. Design thinking may result in new ideas, narratives, objects or systems. It is about redesigning systems, organizations, infrastructures, processes, and solutions in an innovative fashion based on the users' feedback. Tim Brown, president and CEO of IDEO, sees design thinking as a human-centered approach that draws from the designer's toolkit to integrate people's needs, innovative technologies, and business requirements. The application of design thinking has been witnessed to be the road to developing innovative applications, interactive systems, scientific software, healthcare application, and even to utilizing Design-Thinking to re-think business operations, as in the case of Airbnb. Recently, there has been a movement to apply design thinking to machine learning and artificial intelligence to ensure creating the "wow" effect on consumers. The Association of Computing Machinery task force on Data Science program states that" Data scientists should be able to implement and understand algorithms for data collection and analysis. They should understand the time and space considerations of algorithms. They should follow good design principles developing software, understanding the importance of those principles for testability and maintainability" However, this definition hides the user behind the machine who works on data preparation, algorithm selection and model interpretation. Thus, the Data Science program includes design thinking to ensure meeting the user demands, generating more usable machine learning tools, and developing ways of framing computational thinking. Here, describe the fundamentals of Design-Thinking and teaching modules for data science programs.

Keywords: data science, design thinking, AI, currculum, transformation

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Authors: Sujing Wang, Song Wang, Jian Zhang, Qiang Xu

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Flaring emissions during abnormal operating conditions such as plant start-ups, shut-downs, and upsets in chemical process industries (CPI) are usually significant. Flare minimization can help to save raw material and energy for CPI plants, and to improve local environmental sustainability. In this paper, a systematic methodology based on plant-wide dynamic simulation is presented for CPI plant flare minimizations under abnormal operating conditions. Since off-specification emission sources are inevitable during abnormal operating conditions, to significantly reduce flaring emission in a CPI plant, they must be either recycled to the upstream process for online reuse, or stored somewhere temporarily for future reprocessing, when the CPI plant manufacturing returns to stable operation. Thus, the off-spec products could be reused instead of being flared. This can be achieved through the identification of viable design and operational strategies during normal and abnormal operations through plant-wide dynamic scheduling, simulation, and optimization. The proposed study includes three stages of simulation works: (i) developing and validating a steady-state model of a CPI plant; (ii) transiting the obtained steady-state plant model to the dynamic modeling environment; and refining and validating the plant dynamic model; and (iii) developing flare minimization strategies for abnormal operating conditions of a CPI plant via a validated plant-wide dynamic model. This cost-effective methodology has two main merits: (i) employing large-scale dynamic modeling and simulations for industrial flare minimization, which involves various unit models for modeling hundreds of CPI plant facilities; (ii) dealing with critical abnormal operating conditions of CPI plants such as plant start-up and shut-down. Two virtual case studies on flare minimizations for start-up operation (over 50% of emission savings) and shut-down operation (over 70% of emission savings) of an ethylene plant have been employed to demonstrate the efficacy of the proposed study.

Keywords: flare minimization, large-scale modeling and simulation, plant shut-down, plant start-up

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Authors: Pranay Mathur, Carlo Michelassi, Simi Karatha, Gilda Pedoto

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Industrial plant uptime is top most importance for reliable, profitable & sustainable operation. Trip and failed start has major impact on plant reliability and all plant operators focussed on efforts required to minimise the trips & failed starts. The performance of these CTQs are measured with 2 metrics, MTBT(Mean time between trips) and SR (Starting reliability). These metrics helps to identify top failure modes and identify units need more effort to improve plant reliability. Baker Hughes Trip reduction program structured to reduce these unwanted trip 1. Real time machine operational parameters remotely available and capturing the signature of malfunction including related boundary condition. 2. Real time alerting system based on analytics available remotely. 3. Remote access to trip logs and alarms from control system to identify the cause of events. 4. Continuous support to field engineers by remotely connecting with subject matter expert. 5. Live tracking of key CTQs 6. Benchmark against fleet 7. Break down to the cause of failure to component level 8. Investigate top contributor, identify design and operational root cause 9. Implement corrective and preventive action 10. Assessing effectiveness of implemented solution using reliability growth models. 11. Develop analytics for predictive maintenance With this approach , Baker Hughes team is able to support customer in achieving their Reliability Key performance Indicators for monitored units, huge cost savings for plant operators. This Presentation explains these approach while providing successful case studies, in particular where 12nos. of LNG and Pipeline operators with about 140 gas compressing line-ups has adopted these techniques and significantly reduce the number of trips and improved MTBT

Keywords: reliability, availability, sustainability, digital infrastructure, weibull, effectiveness, automation, trips, fail start

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Authors: Johanna Bapela, Heino Heyman, Marion Meyer

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Regardless of the significant advances accomplished in reducing the burden of malaria and other tropical diseases in recent years, malaria remains a major cause of mortality in endemic countries. This is especially the case in sub-Saharan Africa where 99% of the estimated global malaria deaths occurs on an annual basis. The emergence of resistant Plasmodium species and the lack of diversified chemotherapeutic agents provide the rationale for bioprospecting for antiplasmodial scaffolds. Crude extracts from twenty indigenous antimalarial plant species were screened for antimalarial activity and then subjected to 1H NMR-based metabolomic analysis. Ten plant extracts exhibited significant in vitro antiplasmodial activity (IC50 ≤ 5 µg/ml). The Principal Component Analysis (PCA) of the acquired 1H NMR spectra could not separate the analyzed plant extracts according to the detected antiplasmodial bioactivity. Application of supervised Orthogonal Projections to Latent Structures–Discriminant Analysis (OPLS-DA) to the 1H NMR profiles resulted in a discrimination pattern that could be correlated to bioactivity. A contribution plot generated from the OPLS-DA scoring plot illustrated the classes of compounds responsible for the observed grouping. Given the preliminary in vitro results, Tabernaemontana elegans Stapf. (Apocynaceae) and Vangueria infausta Burch. subsp. infausta (Rubiaceae) were subjected to further phytochemical investigations. Two indole alkaloids, dregamine and tabernaemontanine possessing antiplasmodial activity were isolated from T. elegans. Two compounds were isolated from V. infausta subsp. infausta and identified as friedelin (IC50 = 3.01 µg/ml) and morindolide (IC50 = 18.5 µg/ml). While these compounds have been previously identified, this is the first account of their occurrence in the genus Vangueria and their antiplasmodial activity. Based on the results of the study, metabolomics can be used to globally identify classes of plant secondary metabolites that are responsible for antiplasmodial activity.

Keywords: ethnopharmacology, Malaria, medicinal plants, metabolomics

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Authors: S. Jabeen

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Though Pakistan has a rich cultural history and a diverse population; its global image is tarnished with labels of Muslim ‘fundamentalism’ and ‘extremism.’ Cultural policy is a tool that can be used by the government of Pakistan to ameliorate this image, but instead, this fundamentalist reputation is reinforced in the 2005 draft of Pakistan’s cultural policy. With its stern focus on a homogenized cultural identity, this 2005 draft bases itself largely on forced participation from the largely Muslim public and leaves little or no benefits to them or cultural minorities in Pakistan. The effects of this homogenized ‘Muslim’ identity linger ten years later where the study and celebration of the cultural heritage of Pakistan in schools and educational festivals focus entirely on creating and maintaining a singular ‘Islamic’ cultural identity. The current lack of inclusion has many adverse effects that include the breeding of extremist mindsets through the usurpation of minority rights and lack of safe cultural public spaces. This paper argues that Pakistan can improve social inclusivity and boost its global image through cultural policy. The paper sets the grounds for research by surveying the effectiveness of different cultural policies across nations with differing socioeconomic status. Then, by sampling two public literary festivals in Pakistan as case studies, the National Youth Peace Festival hosted with a nationalistic agenda using public funds and the Lahore Literary Festival (LLF) that aims to boost the cultural literacy scene of Lahore using both private and public efforts, this paper looks at the success of the private, more inclusive LLF. A revision of cultural policy is suggested that combines public and private efforts to host cultural festivals for the sake of cultural celebration and human development, without a set nationalistic agenda. Consequently, this comparison which is grounded in the human capabilities approach, recommends revising the 2005 draft of the Cultural Policy to improve human capabilities in order to support cultural diversity and ultimately contribute to economic growth in Pakistan.

Keywords: cultural policy, festivals, human capabilities, Pakistan

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Authors: Sinan Bilgen, Bekir Ozer Ay, Nilay Sezer Uzol

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After decades of conventional shapes, irregular forms with complex geometries are getting more popular for form generation of tall buildings all over the world. This trend has recently brought out diverse building forms such as twisting tall buildings. This study investigates both the aerodynamic and design features of twisting tall buildings through comparative analyses. Since twisting a tall building give rise to additional complexities related with the form and structural system, lateral load effects become of greater importance on these buildings. The aim of this study is to analyze the inherent characteristics of these iconic forms by comparing the wind loads on twisting tall buildings with those on their prismatic twins. Through a case study research, aerodynamic analyses of an existing twisting tall building and its prismatic counterpart were performed and the results have been compared. The prismatic twin of the original building were generated by removing the progressive rotation of its floors with the same plan area and story height. Performance-based measures under investigation have been evaluated in conjunction with the architectural design. Aerodynamic effects have been analyzed by both wind tunnel tests and computational methods. High frequency base balance tests and pressure measurements on 3D models were performed to evaluate wind load effects on a global and local scale. Comparisons of flat and real surface models were conducted to further evaluate the effects of the twisting form without façade texture contribution. Comparisons highlighted that, the twisting form under investigation shows better aerodynamic behavior both for along wind but particularly for across wind direction. Compared to the prismatic counterpart; twisting model is superior on reducing vortex-shedding dynamic response by disorganizing the wind vortices. Consequently, despite the difficulties arisen from inherent complexity of twisted forms, they could still be feasible and viable with their attractive images in the realm of tall buildings.

Keywords: aerodynamic tests, motivation for twisting, tall buildings, twisted forms, wind excitation

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Authors: M.Younus, M. Athar Khan, Asif Adrees

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The present research endeavour was made to investigate the Public Health impact of Salmonellosis through consuming the meat and eggs of the carrier’s birds and to see the prevalence of Salmonella enteritidis and Salmonella typhimurium from poultry feed, poultry meat, and poultry eggs and their role in the chain of transmission of salmonellae to human beings and causing food poisoning. The ultimate objective was to generate data to improve the quality of poultry products and human health awareness. Salmonellosis is one of the most wide spread food borne zoonoses in all the continents of the world. The etiological agents Salmonella enteritidis and Salmonella typhimurium not only produce the disease but during the convalescent phase (after the recovery of disease) remain carriers for indefinite period of time. The carrier state was not only the source of spread of disease with in the poultry but also caused typhoid fever in humans. The chain of transmission started from poultry feed to poultry meat and ultimately to humans as dead end hosts. In this experiment a total number of 200 samples of human stool and blood were collected randomly (100 samples of human stool and 100 samples of human blood) of 100 patients suspected from food poisoning patients from different hospitals of Lahore area for the identification of Salmonella enteritidis and Salmonella typhimurium through PCR method in order to see the public health impact of Salmonellosis through consuming the meat and eggs of the carrier birds. On the average 14 and 10 stool samples were found positive against Salmonella enteritidis and Salmonella typhimurium from each of the 25 patients from each hospital respectively in case of suspected food poisoning patients. Similarly on an average 5% and 6% blood samples were found positive from 25 patients of each hospital respectively. There was a significant difference (P< 0.05) in the sero positivity of stool and blood samples of suspected food poisoning patients as far as Salmonella enteritidis and Salmonella typhimurium was concerned. However there was no significant difference (P<0.05) between the hospitals.

Keywords: salmonella, zoonosis, food, transmission, eggs

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Authors: Daeung Jung

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Background: In case of patients with missing teeth, multiple implant restoration has been widely used and is inevitable. To increase its survival rate, it is important to understand the influence of different implant designs on inter-implant crestal bone resorption. There are several implant systems designed to minimize loss of crestal bone, and the Astra Tech and Brånemark Implant are two of them. Aim/Hypothesis: The aim of this 10-year study was to compare the height of inter-implant bone crest in two implant systems; the Astra Tech and the Brånemark implant system. Material and Methods: In this retrospective study, 40 consecutively treated patients were utilized; 23 patients with 30 sites for Astra Tech system and 17 patients with 20 sites for Brånemark system. The implant restoration was comprised of splinted crown in partially edentulous patients. Radiographs were taken immediately after 1st surgery, at impression making, at prosthetics setting, and annually after loading. Lateral distance from implant to bone crest, inter-implant distance was gauged, and crestal bone height was measured from the implant shoulder to the first bone contact. Calibrations were performed with known length of thread pitch distance for vertical measurement, and known diameter of abutment or fixture for horizontal measurement using ImageJ. Results: After 10 years, patients treated with Astra Tech implant system demonstrated less inter-implant crestal bone resorption when implants had a distance of 3mm or less between them. In cases of implants that had a greater than 3 mm distance between them, however, there appeared to be no statistically significant difference in crestal bone loss between two systems. Conclusion and clinical implications: In the situation of partially edentulous patients planning to have more than two implants, the inter-implant distance is one of the most important factors to be considered. If it is impossible to make sure of having sufficient inter-implant distance, the implants with less micro gap in the fixture-abutment junction, less traumatic 2nd surgery approach, and the adequate surface topography would be choice of appropriate options to minimize inter-implant crestal bone resorption.

Keywords: implant design, crestal bone loss, inter-implant distance, 10-year retrospective study

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Authors: Weber-Lewerenz Bianca

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Digitization is developing fast and has become a powerful tool for digital planning, construction, and operations. Its transformation bears high potentials for companies, is critical for success, and thus, requires responsible handling. This study provides an assessment of calls made in the sustainable development goals by the United Nations (SDGs), White Papers on AI by international institutions, EU-Commission and German Government requesting for the consideration and protection of values and fundamental rights, the careful demarcation between machine (artificial) and human intelligence and the careful use of such technologies. The study discusses digitization and the impacts of artificial intelligence (AI) in construction engineering from an ethical perspective by generating data via conducting case studies and interviewing experts as part of the qualitative method. This research evaluates critically opportunities and risks revolving around corporate digital responsibility (CDR) in the construction industry. To the author's knowledge, no study has set out to investigate how CDR in construction could be conceptualized, especially in relation to the digitization and AI, to mitigate digital transformation both in large, medium-sized, and small companies. No study addressed the key research question: Where can CDR be allocated, how shall its adequate ethical framework be designed to support digital innovations in order to make full use of the potentials of digitization and AI? Now is the right timing for constructive approaches and apply ethics-by-design in order to develop and implement a safe and efficient AI. This represents the first study in construction engineering applying a holistic, interdisciplinary, inclusive approach to provide guidelines for orientation, examine benefits of AI and define ethical principles as the key driver for success, resources-cost-time efficiency, and sustainability using digital technologies and AI in construction engineering to enhance digital transformation. Innovative corporate organizations starting new business models are more likely to succeed than those dominated by conservative, traditional attitudes.

Keywords: construction engineering, digitization, digital transformation, artificial intelligence, ethics, corporate digital responsibility, digital innovation

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Authors: Praveen Vayalamkuzhi, Veeraragavan Amirthalingam

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Studies on safety on highways are becoming the need of the hour as over 400 lives are lost every day in India due to road crashes. In order to evaluate the factors that lead to different levels of crash severity, it is necessary to investigate the level of safety of highways and their relation to crashes. In the present study, an attempt is made to identify the factors that contribute to road crashes and to quantify their effect on the severity of road crashes. The study was carried out on a four-lane divided rural highway in India. The variables considered in the analysis includes components of horizontal alignment of highway, viz., straight or curve section; time of day, driveway density, presence of median; median opening; gradient; operating speed; and annual average daily traffic. These variables were considered after a preliminary analysis. The major complexities in the study are the heterogeneous traffic and the speed variation between different classes of vehicles along the highway. To quantify the impact of each of these factors, statistical analyses were carried out using Logit model and also negative binomial regression. The output from the statistical models proved that the variables viz., horizontal components of the highway alignment; driveway density; time of day; operating speed as well as annual average daily traffic show significant relation with the severity of crashes viz., fatal as well as injury crashes. Further, the annual average daily traffic has significant effect on the severity compared to other variables. The contribution of highway horizontal components on crash severity is also significant. Logit models can predict crashes better than the negative binomial regression models. The results of the study will help the transport planners to look into these aspects at the planning stage itself in the case of highways operated under heterogeneous traffic flow condition.

Keywords: geometric design, heterogeneous traffic, road crash, statistical analysis, level of safety

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Authors: Aamna Tufail, Kajal Kotecha, Iordanis Toursounidis, Ravinder Pabla

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Introduction/Aims: Acute Myeloid Leukaemia (AML) is a part of leukaemic group of hematopoietic disorders with a varying range of presentations, including oro-facial manifestations. Early recognition and management are essential for favourable outcomes. Materials and Methods: We present our experience, clinical presentation, and clinical photographs of a patient with previously undiagnosed AML who presented with oral symptoms to the emergency department of our hospital. An analysis of clinical characteristics, diagnostic investigations, and management modalities was performed. Results/Statistics: A 58-year-old man presented to A&E reporting an 11-day history of right sided facial swelling, acute TMJ symptoms, and oral discomfort. A dentist ruled out acute dental causes one day post onset of symptoms. Initial assessment was anatomically inconsistent and did not reveal a routine oral or maxillofacial etiology. Detailed clinical examination demonstrated fever, generalised pallor, swelling and erythema of right nasolabial region, bilateral masseteric tenderness, intraoral palatal ecchymosis, palatal ulceration, buccal and labial petechiae, cervical lymphadenopathy, and haematoma on dorsum of right hand overlying right 2nd metacarpal joint. Suspecting a systemic medical cause, we requested haematological investigations, which revealed neutropenia, thrombocytopenia, and anaemia. Flow cytometry confirmed CD34 + AML. Oral discomfort was managed symptomatically. The patient was referred to a tertiary care centre for acute haematologic care, where he was treated with IV antibiotics and continuing cycles of chemotherapy. Conclusions/Clinical Relevance: Oro-facial manifestations may be the first clinical sign of AML. Awareness of its features is vital in early diagnosis. In this context, dentists and oral medicine specialists can play an important role in detecting clinical signs of haematological disorders such as AML.

Keywords: acute myeloid leukaemia, oral symptoms, ulceration, diagnosis, management

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