Search results for: drift term

Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki

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Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.

Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions

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Authors: Fatima Homor

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The new era in business has started, according to my research paper findings, corporate social responsibility leads organizations to an incomparable advantage phase, where competition is secondary and financial growth is a result. Those who join later, lose their active advantage and cause passive disadvantage for their organizations. The main purpose of this presentation is to state the obvious and shed the light of the advantages of doing good, while doing well for multinational enterprises, extremely low fluctuation (preventing one of the highest costs), significantly lower marketing budget, enhanced reputation causing customer and supplier loyalty, employee commitment results in higher motivation level leading to better quality at each stages, Corporate Social Responsibility brings Unique Selling Proposition incomparable to others. The paper is based on a large research work conducted for the University of Liverpool Masters in Business Administration program, with the title of Corporate Social Responsibility for Multinational Enterprises to gain incomparable advantage. The research is based on both recent secondary data, but most importantly on 25 interviews with Chief Executive Officers at Multinational Enterprises and / or the Human Resources / corporate communications directors. The direct gains on Corporate Social Responsibility are analyzed when it is embedded into the core of the business. It is evident that project based Corporate Social Responsibility is not effective neither from the supported topic, Non-governmental Organizations point of view nor from the organization’s long-term sustainability point of view. Surveys have been conducted, data compared and consequences drawn. Corporate Social Responsibility must be started inside of the business to strengthen it. First, commit employees. It must come from the Chief Executive Officer. It must be related to the business profile. It has to be long term. They will commit customers. B-corps are coming (e.g. Unilever); the phenomenon of social enterprises has become a leading one.

Keywords: B-corps, embedded into core business, first inside, unique advantage

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Authors: Moh’d Anwer Al-Shboul

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The year 2011 was a challenging year for Jordanian economy, which felt a variety of effects from the Arab Spring which took place in neighboring countries. Since February, 5th 2012, the Arab Gas Supply Pipeline, which carries natural gas from Egypt through the Sinai Peninsula and to Jordan and Israel, has been attacked more than 39 times. Jordan imported about 80 percent of its necessity of natural gas (about 250 million cubic feet of natural gas per day) from Egypt to generate particularly electricity, with the reminder of being produced locally. Jordan has utilized multiple alternatives to address the interruption of available natural gas supply from Egypt. The Jordanian distributed power plants now rely on the use of heavy fuel oil and diesel for electricity generation, in this case, it costs Jordan about four times than natural gas. The substitution of Egyptian natural gas supplies by fuel oil and diesel, coupled with the 32 percent rise in global fuel prices, has increased Jordan’s energy import bill by over 50 percent in 2011, reaching more than 16 percent of the 2011 GDP. The increase in the cost of electricity generation pushed the Jordanian economy to borrow from multiple internal and external resource channels, thus increasing the public debt. The Jordanian government’s short-term solution to the reduced natural gas supply from Egypt was alternatively purchasing the necessary quantities from some Gulf countries such as Qatar and/or Saudi Arabia, which can be imported with two possible methods. The first method is to rent a ship equipped with a liquefied natural gas (LNG) terminal, which is currently operating. The second method requires equipping the Aqaba port with an LNG terminal, which also currently is operating. In the long-term, a viable solution to depending on importing expensive and often unreliable natural gas supplies from surrounding countries is to depend more heavily on renewable supply energy, including solar, wind, and water energy.

Keywords: energy supply resources, Arab spring, liquefied natural gas, pipeline, Jordan

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Authors: Wisam Ismail, Brendan Wooler, Penelope McManus

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Introduction: The public perception of implants has been damaged in the wake of recent negative publicity and increasingly we are finding patients wanting to avoid them. Planned lipo-modelling to enhance the volume of a Latissimus dorsi flap is a viable alternative to silicone implants and maintains a Totally Autologous Technique (TAT). Here we demonstrate that when compared to an Implant Assisted Technique (IAT), a TAT offers patients many benefits that offset the requirement of more operations initially, with reduced short and long term complications, reduced symmetrisation surgery and reduced revision rates. Methods. Data was collected prospectively over 7 years. The minimum follows up was 3 years. The technique was generally standardized in the hand of one surgeon. All flaps were extended LD flaps (ELD). Lipo-modelling was performed using standard techniques. Outcome measures were unplanned secondary procedures, complication rates, and contralateral symmetrisation surgery rates. Key Results Were: Lower complication rates in the TAT group (18.5% vs. 33.3%), despite higher radiotherapy rates (TAT=49%, IAT=36.8%), TAT was associated with lower subsequent symmetrisation rates (30.6% vs. 50.9%), IAT had a relative risk of 3.1 for subsequent unplanned procedure, Autologous patients required an average of 1.76 sessions of lipo-modelling, Conclusions: Using lipo-modelling to enable totally autologous LD reconstruction offers significant advantages over an implant assisted technique. We have shown a lower subsequent unplanned procedure rate, lower revision surgery, and less contralateral symmetrisation surgery. We anticipate that a TAT will be supported by patient satisfaction surveys and long-term patient-reported cosmetic outcome data and intended to study this.

Keywords: breast, Latissimus dorsi, lipomodelling, reconstruction

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Authors: Ebipatei Victoria Tunyan, T. A. Cao, Cheol Young Ock

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Detecting subjectively biased statements is a vital task. This is because this kind of bias, when present in the text or other forms of information dissemination media such as news, social media, scientific texts, and encyclopedias, can weaken trust in the information and stir conflicts amongst consumers. Subjective bias detection is also critical for many Natural Language Processing (NLP) tasks like sentiment analysis, opinion identification, and bias neutralization. Having a system that can adequately detect subjectivity in text will boost research in the above-mentioned areas significantly. It can also come in handy for platforms like Wikipedia, where the use of neutral language is of importance. The goal of this work is to identify the subjectively biased language in text on a sentence level. With machine learning, we can solve complex AI problems, making it a good fit for the problem of subjective bias detection. A key step in this approach is to train a classifier based on BERT (Bidirectional Encoder Representations from Transformers) as upstream model. BERT by itself can be used as a classifier; however, in this study, we use BERT as data preprocessor as well as an embedding generator for a Bi-LSTM (Bidirectional Long Short-Term Memory) network incorporated with attention mechanism. This approach produces a deeper and better classifier. We evaluate the effectiveness of our model using the Wiki Neutrality Corpus (WNC), which was compiled from Wikipedia edits that removed various biased instances from sentences as a benchmark dataset, with which we also compare our model to existing approaches. Experimental analysis indicates an improved performance, as our model achieved state-of-the-art accuracy in detecting subjective bias. This study focuses on the English language, but the model can be fine-tuned to accommodate other languages.

Keywords: subjective bias detection, machine learning, BERT–BiLSTM–Attention, text classification, natural language processing

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Authors: Teklay Tesfay, Gebreyesus Brhane Tesfahunegn, Abadi Berhane, Selemawit Girmay

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Adjusting the proper sowing date of a crop at a particular location with a changing climate is an essential management option to maximize crop yield. However, determining the optimum sowing date for rainfed maize production through field experimentation requires repeated trials for many years in different weather conditions and crop management. To avoid such long-term experimentation to determine the optimum sowing date, crop models such as AquaCrop are useful. Therefore, the overall objective of this study was to evaluate the performance of AquaCrop model in simulating maize productivity under varying sowing dates. A field experiment was conducted for two consecutive cropping seasons by deploying four maize seed sowing dates in a randomized complete block design with three replications. Input data required to run this model are stored as climate, crop, soil, and management files in the AquaCrop database and adjusted through the user interface. Observed data from separate field experiments was used to calibrate and validate the model. AquaCrop model was validated for its performance in simulating the green canopy and aboveground biomass of maize for the varying sowing dates based on the calibrated parameters. Results of the present study showed that there was a good agreement (an overall R2 =, Ef= d= RMSE =) between measured and simulated values of the canopy cover and biomass yields. Considering the overall values of the statistical test indicators, the performance of the model to predict maize growth and biomass yield was successful, and so this is a valuable tool help for decision-making. Hence, this calibrated and validated model is suggested to use for determining optimum maize crop sowing date for similar climate and soil conditions to the study area, instead of conducting long-term experimentation.

Keywords: AquaCrop model, calibration, validation, simulation

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Authors: Abdulmajeed Almansour

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Learning a foreign language with the assistant of technological tools has become an interest of learners and educators. Increased use of smartphones among undergraduate students has made them popular for not only social communication but also for entertainment and educational purposes. Smartphones have provided remarkable advantages in language learning process. Learning vocabulary is an important part of learning a language. The use of smartphone applications for English vocabulary learning provides an opportunity for learners to improve vocabulary knowledge beyond the classroom wall anytime anywhere. Recently, various smartphone applications were created specifically for vocabulary learning. This paper aims to explore the use of smartphone application Memrise designed for vocabulary learning to enhance academic vocabulary among undergraduate students. It examines whether the use of a Memrise smartphone application designed course enhances the academic vocabulary learning among ESL learners. The research paradigm used in this paper followed a mixed research model combining quantitative and qualitative research. The study included two hundred undergraduate students randomly assigned to the experimental and controlled group during the first academic year at the Faculty of English Language, Imam University. The research instruments included an attitudinal questionnaire and an English vocabulary pre-test administered to students at the beginning of the semester whereas post-test and semi-structured interviews administered at the end of the semester. The findings of the attitudinal questionnaire revealed a positive attitude towards using smartphones in learning vocabulary. The post-test scores showed a significant difference in the experimental group performance. The results from the semi-structure interviews showed that there were positive attitudes towards Memrise smartphone application. The students found the application enjoyable, convenient and efficient learning tool. From the study, the use of the Memrise application is seen to have long-term and motivational benefits to students. For this reason, there is a need for further research to identify the long-term optimal effects of learning a language using smartphone applications.

Keywords: second language vocabulary learning, academic vocabulary, mobile learning technologies, smartphone applications

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Authors: Mohammad Yousefikia, Sara Moridpour, Ehsan Mazloumi

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Perceiving track geometry deterioration decisively influences the optimization of track maintenance operations. The effective management of this deterioration and increasingly utilized system with limited financial resources is a significant challenge. This paper provides a review of degradation models relevant for railroad tracks. Furthermore, due to the lack of long term information on the condition development of tram infrastructures, presents the methodology which will be used to derive degradation models from the data of Melbourne tram network.

Keywords: deterioration modeling, asset management, railway, tram

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Authors: Ransford Kwaku Afeadie

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Purpose – The health challenges that characterises most of the migrants’ urban slums raise a lot of concern for their well-being. Health-seeking behaviour becomes an important step towards maintaining a healthy life. The importance of contextual issues is necessary to help meet specific community health needs and programmes. Therefore, this study aims to bridge the knowledge gap by investigating health-seeking behaviour disparity among rural-urban labour migrant slum dwellers before and after migration to the urban slums of Madina in the Greater Accra Region, Ghana. Design/methodology/approach – The author used explanatory sequential approach of research investigation. Questionnaire and interview guides were used to collect data from the respondents; however, in the absence of an existing reliable sampling frame, the various communities were selected by the use of cluster sampling proportional to size. At the second stage, a simple random sampling was used to select the various household heads. A total of 241 questionnaires were retrieved from the respondents representing a response rate of 100%. The author used the purposive sampling technique to conduct eight in-depth interviews and six key informants’ interviews. Findings – The author found various discrepancies in many of the activities that could fulfill substantial health-seeking behaviour in the slum as compared to migrant’s places of origin. The reason for coming to the slum amidst many settlements needs and low education background are the factors that accounted for this. This study, therefore, contradicts the proposition held by the health belief model. It is, therefore, important to note that contextual issues are key, in this case, rural-urban migrant slums present a different dynamic that must be taken into account when designing health programmes for such settings. Originality/value – Many, if not all the, studies on health-seeking behaviour have focused on urban slums without taking into account urban migrants’ slums. Such a failure to take into account the variations of the health needs of migrants’ urban slum settings can eventually lead to a mismatch of health programmes meant to address their challenges. Therefore, this study brings to the fore such variations that must be taken into account when designing health programmes. The study also indicates that even with the same people, there were disparities in terms of health-seeking behaviour in the slum and at places of origin.

Keywords: health-seeking behaviour, rural–urban migration, urban slums, health belief model

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Authors: Matthew Pleshaw, Caroline Lynch, Caleb Eaton, Ali Kiapour

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The problem addressed in this proposal is that of the lacking comfort and safety of inpatient rooms, specifically at Boston Children’s Hospital, with the implementation of a system that will allow inpatient children to feel more comfortable in the unfamiliar environment of a hospital. The focus is that of advancing and enhancing the healing process for children in a long-term inpatient stay at the hospital, though a combination of announcing a clinician or hospital staff’s arrival utilizing RFID (Fig. 1), and improving communication between clinicians, parents/guardians, patients, etc. by integrating a mobile application.

Keywords: Pediatrics, Hospital, RFID, Technology

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Authors: Eunjung Lee

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This research investigates the intricate connection between cultural differences and online consumer behaviors by integrating Hofstede's Cultural Dimensions theory with analysis methodologies such as text mining, data mining, and topic analysis. Our aim is to provide a comprehensive understanding of how national cultural differences influence individuals' behaviors when engaging with online reviews. To ensure the relevance of our investigation, we systematically analyze and interpret the cultural nuances influencing online consumer behaviors, especially in the context of online reviews. By anchoring our research in Hofstede's Cultural Dimensions theory, we seek to offer valuable insights for marketers to tailor their strategies based on the cultural preferences of diverse global consumer bases. In our methodology, we employ advanced text mining techniques to extract insights from a diverse range of online reviews gathered globally for a specific product or service like Netflix. This approach allows us to reveal hidden cultural cues in the language used by consumers from various backgrounds. Complementing text mining, data mining techniques are applied to extract meaningful patterns from online review datasets collected from different countries, aiming to unveil underlying structures and gain a deeper understanding of the impact of cultural differences on online consumer behaviors. The study also integrates topic analysis to identify recurring subjects, sentiments, and opinions within online reviews. Marketers can leverage these insights to inform the development of culturally sensitive strategies, enhance target audience segmentation, and refine messaging approaches aligned with cultural preferences. Anchored in Hofstede's Cultural Dimensions theory, our research employs sophisticated methodologies to delve into the intricate relationship between cultural differences and online consumer behaviors. Applied to specific cultural dimensions, such as individualism vs. collectivism, masculinity vs. femininity, uncertainty avoidance, and long-term vs. short-term orientation, the study uncovers nuanced insights. For example, in exploring individualism vs. collectivism, we examine how reviewers from individualistic cultures prioritize personal experiences while those from collectivistic cultures emphasize communal opinions. Similarly, within masculinity vs. femininity, we investigate whether distinct topics align with cultural notions, such as robust features in masculine cultures and user-friendliness in feminine cultures. Examining information-seeking behaviors under uncertainty avoidance reveals how cultures differ in seeking detailed information or providing succinct reviews based on their comfort with ambiguity. Additionally, in assessing long-term vs. short-term orientation, the research explores how cultural focus on enduring benefits or immediate gratification influences reviews. These concrete examples contribute to the theoretical enhancement of Hofstede's Cultural Dimensions theory, providing a detailed understanding of cultural impacts on online consumer behaviors. As online reviews become increasingly crucial in decision-making, this research not only contributes to the academic understanding of cultural influences but also proposes practical recommendations for enhancing online review systems. Marketers can leverage these findings to design targeted and culturally relevant strategies, ultimately enhancing their global marketing effectiveness and optimizing online review systems for maximum impact.

Keywords: comparative analysis, cultural dimensions, marketing intelligence, national culture, online consumer behavior, text mining

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Authors: Sarthak Kumar Jena, Chandra Sekhar Mishra, Prabina Rajib

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Purpose: This paper aims to derive undervaluation signal from the insiders trading of Indian companies where the ownership is complex and concentrated, investors protection is weak, and the insider rules and regulations are not stringent like developed country. This study examines the relationship between insider trading with short term and long term abnormal return. The study also examines the relationship between insider trading and the actual share repurchase by the firm. Methodology: A sample of 78 companies over the period 2008-2013 are analyzed in the study due to not availability of insider data in Indian context. For preliminary analysis T-test and Wilcoxon rank sum test is used to find the difference between the insider trading before and after the share repurchase announcement. Tobit model is used to find out whether insider trading influence shares repurchase decisions or not. Return on the basis of market model and buy hold are calculated in the previous year and the following year of share repurchase announcement. Findings: The paper finds that insider trading around share repurchase is more than control firms and there is positive and significant difference in insider buying between the previous year of share buyback announcement and the following year of buyback announcement. Insider buying before share repurchase announcement has a positive influence on share repurchase decisions. We find insider buying has a positive and significant relationship with announcement return, whereas insider selling has a negative significant relationship with announcement return. Actual share repurchase and program completion also depend on insider trading before share repurchase. Research limitation: The study is constrained by the small sample size, so the results should be viewed by keeping this limitation in mind. Originality: The paper is to our best knowledge the first study based on Indian context to extend the insider trading literature to share repurchase event and examine insider trading to find out undervaluation signal associated with insider buying.

Keywords: insider trading, buyback, open market share repurchase, signalling

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Authors: Autumn Rooms Cypres, Barbara Driver

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The purpose of this study is to extend discussions about innovations and career politics. Research questions that grounded this effort were: How does an academic learn the unspoken rules of the academy? What happens politically to an academic’s career when their research speaks against the grain of society? Do professors perceive signals that it is time to move on to another institution or even to another career? Epistemology and Methods: This qualitative investigation was focused on examining perceptions of academics. Therefore an open-ended field study, based on Grounded Theory, was used. This naturalistic paradigm (Lincoln & Guba,1985) was selected because it tends to understand information in terms of whole, of patterns, and in relations to the context of the environment. The technique for gathering data was the process of semi-structured, in-depth interviewing. Twenty five academics across the United States were interviewed relative to their career trajectories and the politics and opportunities they have encountered in relation to their research efforts. Findings: The analysis of interviews revealed four themes: Academics are beholden to 2 specific networks of power that influence their sense of job security; the local network based on their employing university and the national network of scholars who share the same field of research. The fights over what counts as research can and does drift from the intellectual to the political, and personal. Academic were able to identify specific instances of shunning and or punishment from their colleagues related directly to the dissemination of research that spoke against the grain of the local or national networks. Academics identified specific signals from both of these networks indicating that their career was flourishing or withering. Implications: This research examined insights from those who persevered when the fights over what and who counts drifted from the intellectual to the political, and the personal. Considerations of why such drifts happen were offered in the form of a socio-political construct called Fit, which included thoughts on hegemony, discourse, and identity. This effort reveals the importance of understanding what professional capital is relative to job security. It also reveals that fear is an enmeshed and often unspoken part of the culture of Academia. Further research to triangulate these findings would be helpful within international contexts.

Keywords: politics, academia, job security, context

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Authors: Ons Triki, Fathi Abid

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Along with the increase in the use of leasing contracts in corporate finance, multiple studies aim to model the credit risk of the lease in order to cover the losses of the lessor of the asset if the lessee goes bankrupt. In the current research paper, a convertible lease contract is elaborated in a continuous time stochastic universe aiming to ensure the financial stability of the firm and quickly recover the losses of the counterparties to the lease in case of default. This work examines the term structure of the lease rates taking into account the credit default risk and the capital structure of the firm. The interaction between the lessee's capital structure and the equilibrium lease rate has been assessed by applying the competitive lease market argument developed by Grenadier (1996) and the endogenous structural default model set forward by Leland and Toft (1996). The cumulative probability of default was calculated by referring to Leland and Toft (1996) and Yildirim and Huan (2006). Additionally, the link between lessee credit risk and lease rate was addressed so as to explore the impact of convertible lease financing on the term structure of the lease rate, the optimal leverage ratio, the cumulative default probability, and the optimal firm value by applying an endogenous conversion threshold. The numerical analysis is suggestive that the duration structure of lease rates increases with the increase in the degree of the market price of risk. The maximal value of the firm decreases with the effect of the optimal leverage ratio. The results are indicative that the cumulative probability of default increases with the maturity of the lease contract if the volatility of the asset service flows is significant. Introducing the convertible lease contract will increase the optimal value of the firm as a function of asset volatility for a high initial service flow level and a conversion ratio close to 1.

Keywords: convertible lease contract, lease rate, credit-risk, capital structure, default probability

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Authors: Stephanie Wall, Guido Wimmers

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The construction and operation of buildings greatly contribute to environmental degradation through resource and energy consumption and greenhouse gas emissions. The design of the envelope system affects the environmental impact of a building in two major ways; 1) high thermal performance and air tightness can significantly reduce the operational energy of the building and 2) the material selection for the envelope largely impacts the embodied energy of the building. Life cycle assessment (LCA) is a scientific methodology that is used to systematically analyze the environmental load of processes or products, such as buildings, over their life. The paper will discuss the results of a comparative LCA of different envelope designs and the long-term monitoring of the Wood Innovation Research Lab (WIRL); a Passive House (PH), industrial building under construction in Prince George, Canada. The WIRL has a footprint of 30m x 30m on a concrete raft slab foundation and consists of shop space as well as a portion of the building that includes a two-story office/classroom space. The lab building goes beyond what was previously thought possible in regards to energy efficiency of industrial buildings in cold climates due to their large volume to surface ratio, small floor area, and high air change rate, and will be the first PH certified industrial building in Canada. These challenges were mitigated through the envelope design which utilizes solar gains while minimizing overheating, reduces thermal bridges with thick (570mm) prefabricated truss walls filled with blown in mineral wool insulation and a concrete slab and roof insulated with EPS rigid insulation. The envelope design results in lower operational and embodied energy when compared to buildings built to local codes or with steel. The LCA conducted using Athena Impact Estimator for Buildings identifies project specific hot spots as well illustrates that for high-efficiency buildings where the operational energy is relatively low; the embodied energy of the material selection becomes a significant design decision as it greatly impacts the overall environmental footprint of the building. The results of the LCA will be reinforced by long-term monitoring of the buildings envelope performance through the installation of temperature and humidity sensors throughout the floor slab, wall and roof panels and through detailed metering of the energy consumption. The data collected from the sensors will also be used to reinforce the results of hygrothermal analysis using WUFI®, a program used to verify the durability of the wall and roof panels. The WIRL provides an opportunity to showcase the use of wood in a high performance envelope of an industrial building and to emphasize the importance of considering the embodied energy of a material in the early stages of design. The results of the LCA will be of interest to leading researchers and scientists committed to finding sustainable solutions for new construction and high-performance buildings.

Keywords: high performance envelope, life cycle assessment, long term monitoring, passive house, prefabricated panels

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Authors: Muhammad Naveed Ali, Hamad Bin Rashid, Muhammad Arif Khan, Abdul Basit, Hafiz Muhammad Arshad

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Abdominal defects are very common in pigeons. A new technique is known as intraabdominal mesh transplant that give better protection for herniorrhaphy. The aim of this study was to determine the performance of hernia mesh. In this study, an efficacy of two synthetic hernia mesh implants viz. conventional Prolene and a lightweight mesh monofilament polyester were assessed for the abdominal wall repair in pigeons. Twenty four healthy pigeons were selected and randomly distributed into three groups, A, B and C (n=8). In all groups, experimental laparotomy was performed; thereafter, abdominal muscles and peritoneum were sutured together, while, a 2 x 2 cm defect was created in the abdominal muscles. For onlay hernioplasty, the hernia mesh (Prolene mesh: group A; Polyester mesh: group B) was implanted over the external oblique muscles of the abdomen. In group C (control), the mesh was not implanted; instead, the laparotomy incision was closed after a herniorrhaphy. Post-operative pain wound healing, adhesion formation, histopathological findings and formation of hematoma, abscess and seroma were assessed as short-term complications. Post-operatively, pain at surgical site was significantly less (P < 0.001) in group B (Polyester mesh); wound healing was also significantly better and rapid in group B (P < 0.05) than in group A (Prolene mesh). Group B (Polyester mesh) also depicted less than 25% adhesions when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions or flimsy adhesions (n=2) in group B (Polyester mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. There were observed hematoma, seroma and abscess formations in birds treated by Prolene mesh only. Conclusively, the polyester mesh proved superior to the Prolene mesh regarding lesser adhesion, better in wound healing, and no short-term follow-up complications.

Keywords: adhesion, mesh, polyester, prolene

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Authors: Saeid Asghari

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The growing interest in sustainability and healthy lifestyles has stimulated the development of solutions that promote mindful consumption and healthier choices. One such solution is the use of transparent graded lanes in product packaging, which enables consumers to visually track their product consumption and encourages portion control. However, the extent to which this packaging affects consumer behavior, trust, and loyalty towards a product or brand, as well as the effectiveness of messaging on the graded lanes, remains unclear. The research aims to examine the impact of transparent graded lanes on consumer behavior, trust, and loyalty towards products or brands in the context of the Janbo chain supermarket in Tehran, Iran, focusing on Ketchup and edible oils containers. A representative sample of 720 respondents is selected using quota sampling based on sex, age, and financial status. The study assesses the effect of messaging on the graded lanes in enhancing consumer recall and recognition of the product at the time of purchase, increasing repeat purchases, and fostering long-term relationships with customers. Furthermore, the potential outcomes of using transparent graded lanes, including the promotion of healthy consumption habits and the reduction of food waste, are also considered. The findings and results can inform the development of effective messaging strategies for graded lanes and suggest ways to enhance consumer engagement with product packaging. Moreover, the study's outcomes can contribute to the broader discourse on sustainable consumption and healthy lifestyles, highlighting the potential role of packaging innovations in promoting these values. We used four theories (social cognitive theory, self-perception theory, nudge theory, and marketing and consumer behavior) to examine the effect of these transparent graded lanes on consumer behavior. The conceptual model integrates the use of transparent graded lanes, consumer behavior, trust and loyalty, messaging, and promotion of healthy consumption habits. The study aims to provide insights into how transparent graded lanes can promote mindful consumption, increase consumer recognition and recall of the product, and foster long-term relationships with customers. Findings suggest that the use of transparent graded lanes on Ketchup and edible oils containers can have a positive impact on consumer behavior, trust, and loyalty towards a product or brand, as well as promote mindful consumption and healthier choices. The messaging on the graded lanes is also found to be effective in promoting recall and recognition of the product at the time of purchase and encouraging repeat purchases. However, the impact of transparent graded lanes may be limited by factors such as cultural norms, personal values, and financial status. Broadly speaking, the investigation provides valuable insights into the potential benefits and challenges of using transparent graded lanes in product packaging, as well as effective strategies for promoting healthy consumption habits and building long-term relationships with customers.

Keywords: packaging customer behavior, purchase, brand loyalty, healthy consumption

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Authors: Nicolas Bae, Theodore L. Karavasilis

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Increasingly, a large number of new and existing tall buildings are required to improve their resilient performance against strong winds and earthquakes to minimize direct, as well as indirect damages to society. Those advent stationary functions of tall building structures in metropolitan regions can be severely hazardous, in socio-economic terms, which also increase the requirement of advanced seismic performance. To achieve these progressive requirements, the seismic reinforcement for some old, conventional buildings have become enormously costly. The methods of increasing the buildings’ resilience against wind or earthquake loads have also become more advanced. Up to now, vibration control devices, such as the passive damper system, is still regarded as an effective and an easy-to-install option, in improving the seismic resilience of buildings at affordable prices. The main purpose of this paper is to examine 1) the optimization of the shape of visco plastic brace damper (VPBD) system which is one of hybrid damper system so that it can maximize its energy dissipation capacity in tall buildings against wind and earthquake. 2) the verification of the seismic performance of the visco plastic brace damper system in tall buildings; up to forty-storey high steel frame buildings, by comparing the results of Non-Linear Response History Analysis (NLRHA), with and without a damper system. The most significant contribution of this research is to introduce the optimized hybrid damper system that is adequate for high rise buildings. The efficiency of this visco plastic brace damper system and the advantages of its use in tall buildings can be verified since tall buildings tend to be affected by wind load at its normal state and also by earthquake load after yielding of steel plates. The modeling of the prototype tall building will be conducted using the Opensees software. Three types of modeling were used to verify the performance of the damper (MRF, MRF with visco-elastic, MRF with visco-plastic model) 22-set seismic records used and the scaling procedure was followed according to the FEMA code. It is shown that MRF with viscous, visco-elastic damper, it is superior effective to reduce inelastic deformation such as roof displacement, maximum story drift, roof velocity compared to the MRF only.

Keywords: tall steel building, seismic retrofit, viscous, viscoelastic damper, performance based design, resilience based design

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Authors: Ajay Kumar Sinha, Sharad Singh, Anukriti Sinha

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Passive energy dissipation method for earthquake protection of structures is undergoing developments for improved performance. Combined use of different types of damping mechanisms has shown positive results in the near past. Different supplemental damping methods like viscous damping, frictional damping and metallic damping are being combined together for optimum performance. The conventional method of connecting passive dampers to structures is a parallel connection between the damper unit and structural member. Researchers are investigating coupling effect of different types of dampers. The most popular choice among the research community is coupling of viscous dampers and frictional dampers. The series and parallel coupling of these damping units are being studied for relative performance of the coupled system on response control of structures against earthquake. In this paper an attempt has been made to couple Fluid Viscous Dampers and Frictional Dampers in series and parallel to form a single unit of damping system. The relative performance of the coupled units has been studied on three dimensional reinforced concrete framed structure. The current theories of structural dynamics in practice for viscous damping and frictional damping have been incorporated in this study. The time history analysis of the structural system with coupled damper units, uncoupled damper units as well as of structural system without any supplemental damping has been performed in this study. The investigations reported in this study show significant improved performance of coupled system. A higher natural frequency of the system outside the forcing frequency has been obtained for structural systems with coupled damper units as against the other cases. The structural response of the structure in terms of storey displacement and storey drift show significant improvement for the case with coupled damper units as against the cases with uncoupled units or without any supplemental damping. The results are promising in terms of improved response of the structure with coupled damper units. Further investigations in this regard for a comparative performance of the series and parallel coupled systems will be carried out to study the optimum behavior of these coupled systems for enhanced response control of structural systems.

Keywords: frictional damping, parallel coupling, response control, series coupling, supplemental damping, viscous damping

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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

Procedia PDF Downloads 109

Authors: Melissa Hachem, Maxime Loizeau, Nadine Saleh, Isabelle Momas, Lynda Bensefa-Colas

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Professional drivers are exposed inside their vehicles to high levels of air pollutants due to the considerable time they spend close to motor vehicle emissions. Little is known about ultrafine particles (UFP) or black carbon (BC) adverse respiratory health effects compared to the regulated pollutants. We aimed to study the short-term associations between UFP and BC concentrations inside vehicles and (1) the onset of mucosal irritation and (2) the acute changes in lung function of Parisian taxi drivers during a working day. An epidemiological study was carried out on 50 taxi drivers in Paris. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively. On the same day, the frequency and the severity of nose, eye, and throat irritations were self-reported by each participant and a spirometry test was performed before and after the work shift. Multivariate analysis was used to evaluate the associations between in-taxis UFP and BC concentrations and mucosal irritation and lung function, after adjustment for potential confounders. In-taxis UFP concentrations ranged from 17.9 to 37.9 × 103 particles/cm³ and BC concentrations from 2.2 to 3.9 μg/m³, during a mean of 9 ± 2 working hours. Significant dose-response relationships were observed between in-taxis UFP concentrations and both nasal irritation and lung function. The increase of in-taxis UFP (for an interquartile range of 20 × 103 particles/cm3) was associated to an increase in nasal irritation (adjusted OR = 6.27 [95% CI: 1.02 to 38.62]) and to a reduction in forced expiratory flow at 25–75% by −7.44% [95% CI: −12.63 to −2.24], forced expiratory volume in one second by −4.46% [95% CI: −6.99 to −1.93] and forced vital capacity by −3.31% [95% CI: −5.82 to −0.80]. Such associations were not found with BC. Incident throat and eye irritations were not related to in-vehicle particles exposure; however, they were associated with outdoor air quality (estimated by the Atmo index) and in-vehicle humidity, respectively. This study is the first to show a significant association, within a short-period of time, between in-vehicle UFP exposure and acute respiratory effects in professional drivers.

Keywords: black carbon, lung function, mucosal irritation, taxi drivers, ultrafine particles

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Authors: Asif Iqbal

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Working capital management has its effect on liquidity as well as on profitability of a firm. In this research we have selected a sample of 100 respondents whose firms are listed on Karachi stock exchange. We have studied the effect of different variable s of working capital management. We find that organizations throughout the world as well as in Pakistan have to give immense recognition to the working capital management as it is an effective thing from their long term perspective especially to their shareholders to have a firm confidence over the companies for investment purpose.

Keywords: working capital management, Karachi stock exchange, shareholders, capital management

Procedia PDF Downloads 577

Authors: Vincent Schlageter, Maroua Mestiri, Florian Denzinger, Hugo Raetzo, Michel Demierre

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Precise landslide monitoring with differential global navigation satellite system (GNSS) is well known, but technical or economic reasons limit its application by geotechnical companies. This study demonstrates the reliability and the usefulness of Geomon (Infrasurvey Sàrl, Switzerland), a stand-alone and cost-effective rover network. The system permits deploying up to 15 rovers, plus one reference station for differential GNSS. A dedicated radio communication links all the modules to a base station, where an embedded computer automatically provides all the relative positions (L1 phase, open-source RTKLib software) and populates an Internet server. Each measure also contains information from an internal inclinometer, battery level, and position quality indices. Contrary to standard GNSS survey systems, which suffer from a limited number of beacons that must be placed in areas with good GSM signal, Geomon offers greater flexibility and permits a real overview of the whole landslide with good spatial resolution. Each module is powered with solar panels, ensuring autonomous long-term recordings. In this study, we have tested the system on several sites in the Swiss mountains, setting up to 7 rovers per site, for an 18 month-long survey. The aim was to assess the robustness and the accuracy of the system in different environmental conditions. In one case, we ran forced blind tests (vertical movements of a given amplitude) and compared various session parameters (duration from 10 to 90 minutes). Then the other cases were a survey of real landslides sites using fixed optimized parameters. Sub centimetric-accuracy with few outliers was obtained using the best parameters (session duration of 60 minutes, baseline 1 km or less), with the noise level on the horizontal component half that of the vertical one. The performance (percent of aborting solutions, outliers) was reduced with sessions shorter than 30 minutes. The environment also had a strong influence on the percent of aborting solutions (ambiguity search problem), due to multiple reflections or satellites obstructed by trees and mountains. The length of the baseline (distance reference-rover, single baseline processing) reduced the accuracy above 1 km but had no significant effect below this limit. In critical weather conditions, the system’s robustness was limited: snow, avalanche, and frost-covered some rovers, including the antenna and vertically oriented solar panels, leading to data interruption; and strong wind damaged a reference station. The possibility of changing the sessions’ parameters remotely was very useful. In conclusion, the rover network tested provided the foreseen sub-centimetric-accuracy while providing a dense spatial resolution landslide survey. The ease of implementation and the fully automatic long-term survey were timesaving. Performance strongly depends on surrounding conditions, but short pre-measures should allow moving a rover to a better final placement. The system offers a promising hazard mitigation technique. Improvements could include data post-processing for alerts and automatic modification of the duration and numbers of sessions based on battery level and rover displacement velocity.

Keywords: GNSS, GSM, landslide, long-term, network, solar, spatial resolution, sub-centimeter.

Procedia PDF Downloads 115

Authors: Mostafa Elbaba

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Because childhood renal diseases are grossly different compared to adult diseases, pediatric nephrology was founded as a specialty in 1965. Renal pathology specialty was introduced at the London Ciba Symposium in 1961. The history of renal pathology can be divided into two eras: one starting in the 1650s with the invention of the microscope, the second in the 1950s with the implementation of renal biopsy, and the presence of electron microscopy and immunofluorescence study. Prior to the 1950s, the study of diseased human kidneys was restricted to postmortem examination by gross pathology. In 1827, Richard Bright first described his triad of kidney disease, which was confirmed by morbid kidney changes at autopsy. In 1905 Friedrich Mueller coined the term “nephrosis” describing the inflammatory form of “degenerative” diseases, and later F. Munk added the term “lipoid nephrosis”. The most profound influence on renal diseases’ classification came from the publication of Volhard and Fahr in 1914. In 1899, Carl Max Wilhelm Wilms described Wilms' tumor of the kidneys in children. Chronic pyelonephritis was a popular renal diagnosis and the most common cause of uremia until the 1960s. Although kidney biopsy had been used early in the 1930s for renal tumors, the earliest reports of its use in the diagnosis of medical kidney disease were by Iversen and Brun in 1951, followed by Alwall in 1952, then by Pardo in 1953. The earliest intentional renal biopsies were done in 1944 by Nils Alwall, while the procedure was abandoned after the death of one of his 13 patients who biopsied. In 1950, Antonino Perez-Ara attempted renal biopsies, but his results were missed because of an unpopular journal publication. In the year 1951, Claus Brun and Poul Iverson developed the biopsy procedure using an aspiration technique. Popularizing renal biopsy practice is accredited to Robert Kark, who published his distinct work in 1954. He perfected the technique of renal biopsy in the prone position using the Vim-Silverman needle and used intravenous pyelography to improve the localization of the kidney.

Keywords: history, medicine, nephrology, pediatrics, pathology

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Authors: Anuradha Maharaj, Adrian Cashman

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The cross-cutting nature of water as a resource translates into the need for a better understanding of its movement, storage and loss at all points in the hydro-socioeconomic cycle. An integrated approach to addressing the issue of sustainability means quantitatively understanding: the linkages within this cycle, the role of water managers in resource allocation, and the critical factors influencing its scarcity. The Water Evaluation and Planning Tool (WEAP) is an integrative model that combines the catchment-scale hydrologic processes with a water management model, driven by environmental requirements and socioeconomic demands. The concept of demand priorities is included to represent the areas of greatest use within a given catchment. Located on Barbados’ West Coast, Speightstown and the surrounding areas encompass a well-developed tourist, residential and agricultural area. The main water resource for this area, and the rest of the island, is that of groundwater. The availability of groundwater in Barbados may be adversely affected by the projected changes in climate, such as reduced wet season rainfall. Economic development and changing sector priorities together with climate related changes have the potential to affect water resource abundance and by extension the allocation of resources for example in the Speightstown area. In order to investigate the potential impacts on the Speightstown area specifically, a WEAP Model of the study area was developed to estimate the present available water (baseline reference scenario 2000-2010). From this baseline scenario, it is envisioned that an exploration into projected changes in availability in the near term (2035-2045) and medium/long term (2065-2075) time frames will be undertaken. The generated estimations can assist water managers to better evaluate the status of and identify trends in water use and formulate adaptation measures to offset future deficits.

Keywords: water evaluation and planning system (WEAP), water availability, demand and supply, water allocation

Procedia PDF Downloads 354

Authors: Haruka Ando

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Undernutrition of children is a critical issue, especially for people in the remote areas of the Republic of Djibouti, since household food insecurity, inadequate child caring and feeding, unhealthy environment and lack of clean water, as well as insufficient maternal and child healthcare, are underlying causes which affect. Nomadic pastoralists living in the Dikhil region (Dikhil) are socio-economically and geographically more vulnerable due to displacement, which in turn worsens the situation of child stunting. A high prevalence of inappropriate complementary feeding among pastoral mothers might be a significant barrier to child growth. This study aims to identify health promotion intervention strategies that would support an increase in optimal complementary feeding among pastoral mothers of children aged 6-23 months in Dikhil. There are four objectives; to explore and to understand the existing practice of complementary feeding among pastoral mothers in Dikhil; to identify the barriers in appropriate complementary feeding among the mothers; to critically explore and analyse the strategies for an increase in complementary feeding among the mothers; to make pragmatic recommendations to address the barriers in Djibouti. This is an in-depth study utilizing a conceptual framework, the behaviour change wheel, to analyse the determinants of complementary feeding and categorize health promotion interventions for increasing optimal complementary feeding among pastoral mothers living in Dikhil. The analytical tool was utilized to appraise the strategies to mitigate the selected barriers against optimal complementary feeding. The data sources were secondary literature from both published and unpublished sources. The literature was systematically collected. The findings of the determinants including the barriers of optimal complementary feeding were identified: heavy household workload, caring for multiple children under five, lack of education, cultural norms and traditional eating habits, lack of husbands' support, poverty and food insecurity, lack of clean water, low media coverage, insufficient health services on complementary feeding, fear, poor personal hygiene, and mothers' low decision-making ability and lack of motivation for food choice. To mitigate selected barriers of optimal complementary feeding, four intervention strategies based on interpersonal communication at the community-level were chosen: scaling up mothers' support groups, nutrition education, grandmother-inclusive approach, and training for complementary feeding counseling. The strategies were appraised through the criteria of effectiveness and feasibility. Scaling up mothers' support groups could be the best approach. Mid-term and long-term recommendations are suggested based on the situation analysis and appraisal of intervention strategies. Mid-term recommendations include complementary feeding promotion interventions are integrated into the healthcare service providing system in Dikhil, and donor agencies advocate and lobby the Ministry of Health Djibouti (MoHD) to increase budgetary allocation on complementary feeding promotion to implement interventions at a community level. Moreover, the recommendations include a community health management team in Dikhil training healthcare workers and mother support groups by using complementary feeding communication guidelines and monitors behaviour change of pastoral mothers and health outcome of their children. Long-term recommendations are the MoHD develops complementary feeding guidelines to cover sector-wide collaboration for multi-sectoral related barriers.

Keywords: Afar, child food, child nutrition, complementary feeding, complementary food, developing countries, Djibouti, East Africa, hard-to-reach areas, Horn of Africa, nomad, pastoral, rural area, Somali, Sub-Saharan Africa

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Authors: Lucia Carrion Gordon, Jaime Santiago Sanchez Reinoso

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According to the relation of Digital Preservation and the Health field as a case of study, the architectural model help us to explain that definitions. .The principal goal of Data Preservation is to keep information for a long term. Regarding of Mediacal information, in order to perform a heart transplant, physicians need to preserve this organ in an adequate way. This approach between the two perspectives, the medical and the technological allow checking the similarities about the concepts of preservation. Digital preservation and medical advances are related in the same level as knowledge improvement.

Keywords: medical management, digital, data, heritage, preservation

Procedia PDF Downloads 423

Authors: Mohammad-Javad Eslami, Mahtab Zargham, Farshad Gholipour, Mohammadreza Hajian, Katayoun Bakhtiari, Sakineh Hajebrahimi, Melina Eghbal, Ziba Farajzadegan

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Introduction: To study the mid-term safety and functional outcomes of transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF) mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT). Methods: Between 2015 and 2020, we prospectively included women with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of the prolapse using PVDF mesh in two medical centers. We followed all patients for at least 12 months. We recorded the characteristics of vaginal and sexual symptoms, urinary incontinence, and prolapse stage pre- and postoperatively using International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system, respectively. Results: One hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%) patients. There was a significant improvement in patients’ vaginal symptoms, urinary incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully. The total rates of complications and de novo urinary symptoms were 21.3% and 7.4%, respectively. Significant pain was reported in 17 cases (15.7%). Conclusion: Our findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional success rates and acceptable complication rates in mid-term follow-up.

Keywords: stress urinary incontinence (SU, incontinence questionnaire-vaginal symptoms (ICIQ-VS), polyvinylidene fluoride (PVDF) mes, double trans-obturator technique (TOT)

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Authors: S. M. C. Kelly, M. Goulden

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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

Procedia PDF Downloads 139

Authors: Michel Soto Chalhoub

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Building designers in the Mediterranean region and other parts of the world utilize natural stone panels on the exterior façades as skin cover. This type of finishing is not only intended for aesthetic reasons but also environmental. The stone, since the earliest ages of civilization, has been used in construction and to-date some of the most appealing buildings owe their beauty to stone finishing. The stone also provides warmth in winter and freshness in summer as it moderates heat transfer and absorbs radiation. However, as structural codes became increasingly stringent about the dynamic performance of buildings, it became essential to study the performance of stone panels under cyclic loading – a condition that arises under the building is subjected to wind or earthquakes. The present paper studies the performance of stone panels using mechanical connectors when subjected to load reversal. In this paper, we present a theoretical model that addresses modes of failure in the steel connectors, by yield, and modes of failure in the stone, by fracture. Then we provide an experimental set-up and test results for rectangular stone panels of varying thickness. When the building is subjected to an earthquake, its rectangular panels within the structural system are subjected to shear deformations, which in turn impart stress into the stone cover. Rectangular stone panels, which typically range from 40cmx80cm to 60cmx120cm, need to be designed to withstand transverse loading from the direct application of lateral loads, and to withstand simultaneously in-plane loading (membrane stress) caused by inter-story drift and overall building lateral deflection. Results show correlation between the theoretical model which we derive from solid mechanics fundamentals and the experimental results, and lead to practical design recommendations. We find that for panel thickness below a certain threshold, it is more advantageous to utilize structural adhesive materials to connect stone panels to the main structural system of the building. For larger panel thicknesses, it is recommended to utilize mechanical connectors with special detailing to ensure a minimum level of ductility and energy dissipation.

Keywords: solid mechanics, cyclic loading, mechanical connectors, natural stone, seismic, wind, building skin

Procedia PDF Downloads 258