Search results for: emergency circumstances
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1602

Search results for: emergency circumstances

642 Crash Statistics Comparison for Riyadh, Eastern Province, and Qaseem for 2016 and 2017

Authors: Hassan M. Al-Ahmadi

Abstract:

The fatality index (deaths/100 K population) due to road traffic accidents in the Kingdom of Saudi Arabia (KSA) is over 25, according to the World Health Organization Statistics (WHO) statistics, which is much higher than in the neighboring Arab regions. The KSA has implemented measures to mitigate traffic accidents by enforcing road safety regulations. As a result, there has been a slight decline in the frequency of road traffic accidents within the Kingdom. This study was based on the variations in the accidents for three provinces of KSA, i.e., Riyadh, Eastern Province (EP), & Qaseem, for 2016 and 2017 using ANOVA method. Data appropriateness for the ANOVA method was confirmed by the normality and the randomness of residuals. Additionally, the half-normal plot was used to identify the significant terms for the ANOVA analysis. The analysis revealed that the accidents in the EP were significantly higher than in the other two provinces during the analysis period. The monthly variation showed a spike in the accidents from month 7th to 9th month in the EP region and a slight drop in the accidents in the Qaseem and the Riyadh region during the same period, which was attributed to the increased leisure travels from the other regions to the EP. Furthermore, most of the accidents were found to occur in the age group of 18+ and 30+, and also the major reduction of accidents in 2017 as compared to 2016 was found to have occurred in the same group. These findings can be beneficial for developing strategies to further reduce the number of accidents.

Keywords: fatality index, emergency, road traffic accident, safety, leisure travels

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641 Early Intervention and Teletherapy during the COVID-19 Pandemic

Authors: Stephen Hernandez, Nikita Sharma

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The Coronavirus disease (COVID-19) emerged as a worldwide pandemic at the beginning of 2020. The pandemic and its impact reached the shores of the United States by the second week of March. Once infections started to grow in numbers, early intervention programs, including those providing home-based services, recognized that to reduce the spread of the virus, many traditional in-person therapeutic interventions were going to be impossible due to social distancing and self-quarantine requirements. Initially, infants, toddlers, and their families were left without any services from their educators and therapists, but within a few weeks of the public health emergency, various states, including New York, approved the use of teletherapy/virtual visits for early intervention service provision. This paper will detail the results of a survey from over 400 E.I. service providers about their experiences utilizing teletherapy to deliver services to children in early intervention programs. The survey questions focused on how did COVID-19 stay-at-home orders impact E.I. services for young children with special needs? Sub-questions included topics such as availability of the parents, the amount of time that babies remained engaged, as well as the perceived success of teletherapy as a viable option to provide service by both parent and professional. The results of this study found that therapists found teletherapy to be a viable manner of providing services and could be very effective on a case by case basis.

Keywords: early intervention, teletheraphy, telehealth, COVID-19

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640 Military Role of Russia beyond Its National Boundary

Authors: Nipuli Gajanayake

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The Russian military role beyond its national frontier has become a debatable hot topic in the international political arena. It’s advanced, and strategic responses in combating regional and international security problems have always been a factor to debate and criticize. Under such critical circumstances, Russia is attentive to play its military role according to the provisions of the Military Doctrine of the Russian Federation. Most importantly, the legal basis of the doctrine has also consisted with the generally recognized principles and norms of international law. Therefore, Russian international military assistances are pledged to accomplish international peace and security. The expansion of Russian military participation in the United Nations Peacekeeping operations, and military- political, and technical cooperation have largely evident the great effort of Russia in maintaining and restoring international peace and security. Moreover, the conflict management diplomacy and the development of dialogue with nation states to confront military risks and threats can also identify as a part of preserving international peace and security. In addition, Russia strives to strengthen the system of collective security with regional and international organizations through the legal framework of the Collective Security Treaty Organization (CSTO). Maintaining cooperative ties with the Commonwealth of Independent States (CIS), the Organization for Security and Cooperation in Europe (OSCE) and the Shanghai Cooperation Organization (SCO) have highlighted the Russian deliberation on maintaining regional peace and security. Nevertheless, the extension of cordial relations with nation states and providing of military assistances during tensions and conflicts on their territories can also underscore as Russians commitments on maintaining international peace and security. Observing and recognizing the disparity between the West portrayed terms like ‘illegal Russian interventions’ and the comprehensive reality behind the ‘Russian military assistances’ are important to understand. However, a lopsided vision or a perspective towards the Russian international military role would not present a clear understanding about its valued and also dedicated hard work on maintaining international peace and security.

Keywords: collective security, diplomacy, international military role of Russia, international peace and security

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639 Application to Monitor the Citizens for Corona and Get Medical Aids or Assistance from Hospitals

Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge

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It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.

Keywords: blockchain, deep learning, NLP, monitoring system

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638 The Bone Remodeling of Mandible in Bruxers

Authors: Eni Rahmi, Rasmi Rikmasari, Taufik Soemarsongko

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Background: One of the bad habits that requires a treatment and viewed as a risk factor of the temporomandibular disorder is bruxism. Bruxism defined as an awake and/or asleep parafunctional activities include grinding, gnashing, bracing or clenching of the teeth. In particular circumstances such as an increased frequency of episode, duration and the intensity of masseter contractions, caused phenomenon with pathological consequences, i.e., mandibular remodeling. The remodeling in mandibular angle was associated with the masseter and pterygoid medial muscles attachment which in its insertion area. The aim of this study was to compare the mandibular remodeling between bruxers and non-bruxers with ramus height, gonial angle and bigonial width as parameters, and to identify correlation among those parameters in bruxers, using panoramic radiographic. Methods: This study was conducted on 35 bruxers (10 phasic bruxism patients, 6 tonic bruxism patients, and 19 mixed bruxism patients) and 20 non-bruxers as control group. The data were obtained by using questionary, clinical examination, and radiographic measurement. Panoramic radiograph measurement was done using soft CBCT EPX Impla (E-Woo Korea). The data was analyzed by using Paired T-Test to see differences between parameters in both group and Pearson Correlation Test to evaluate correlation among parameters. Result: There was significant differences between bruxers and non-bruxers in ramus heights (p=0,04), bigonial widths (p=0,001), and gonial angles(p=0,015). The bruxers showed increased ramus heights and bigonial widths, in other hand, the gonial angles decreased. This study also found that there was highly correlation among ramus height, gonial angles, and bigonial widths. Conclusion: the bone remodeling occurred on inferior and posterior border of mandibular angle in bruxism patient, indicated by the form and size differences between bruxers (phasic bruxism, tonic bruxism, and mixed bruxism) with non-bruxers, which shown by panoramic radiograph.

Keywords: bruxism, ramus height, gonial angle, bigonial width

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637 Effect of Climate Change Rate in Indonesia against the Shrinking Dimensions of Granules and Plasticity Index of Soils

Authors: Muhammad Rasyid Angkotasan

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The soil is a dense granules and arrangement of the pores that are related to each other, so that the water can flow from one point which has higher energy to a point that has lower energy. The flow of water through the pores of the porous ground is urgently needed in water seepage estimates in ground water pumping problems, investigate for underground construction, as well as analyzing the stability of the construction of Weirs. Climate change resulted in long-term changes in the distribution of weather patterns are statistically throughout the period start time of decades to millions of years. In other words, changes in the average weather circumstances or a change in the distribution of weather events, on average, for example, the number of extreme weather events that increasingly a lot or a little. Climate change is limited to a particular regional or can occur in all regions of the Earth. Geographical location between two continents and two oceans and is located around the equator is klimatologis factor is the cause of flooding and drought in Indonesia. This caused Indonesia' geographical position is on a hemisphere with a tropical monsoon climate is very sensitive to climatic anomaly El Nino Southern Oscillation (ENSO). ENSO causes drought occurrence in sea surface temperature conditions in the Pacific Equator warms up to the middle part of the East (El Nino). Based on the analysis of the climate of the last 30 years show that there is a tendency, the formation of a new pattern of climate causes the onset of climate change. The impact of climate change on the occurrence of the agricultural sector is the bergesernya beginning of the dry season which led to the above-mentioned pattern planting due to drought. The impact of climate change (drought) which is very extreme in Indonesia affect the shrinkage dimensions grain land and reduced the value of a percentage of the soil Plasticity Index caused by climate change.

Keywords: climate change, soil shrinkage, plasticity index, shrinking dimensions

Procedia PDF Downloads 239
636 Exploring the Issue of Occult Hypoperfusion in the Pre-Hospital Setting

Authors: A. Fordham, A. Hudson

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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

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635 Distributed Real-time Framework for Experimental Multi Aerial Robotic Systems

Authors: Samuel Knox, Verdon Crann, Peyman Amiri, William Crowther

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There exists a shortage of open-source firmware for allowing researchers to focus on implementing high-level planning and control strategies for multi aerial robotic systems in simulation and experiment. Within this body of work, practical firmware is presented, which performs all supplementary tasks, including communications, pre and post-experiment procedures, and emergency safety measures. This allows researchers to implement high-level planning and control algorithms for path planning, traffic management, flight formation and swarming of aerial robots. The framework is built in Python using the MAVSDK library, which is compatible with flight controllers running PX4 firmware and onboard computers based on Linux. Communication is performed using Wi-Fi and the MQTT protocol, currently implemented using a centralized broker. Finally, a graphical user interface (GUI) has been developed to send general commands and monitor the agents. This framework enables researchers to prepare customized planning and control algorithms in a modular manner. Studies can be performed experimentally and in simulation using PX4 software in the loop (SITL) and the Gazebo simulator. An example experimental use case of the framework is presented using novel distributed planning and control strategies. The demonstration is performed using off-the-shelf components and minimal setup.

Keywords: aerial robotics, distributed framework, experimental, planning and control

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634 Use of a New Multiplex Quantitative Polymerase Chain Reaction Based Assay for Simultaneous Detection of Neisseria Meningitidis, Escherichia Coli K1, Streptococcus agalactiae, and Streptococcus pneumoniae

Authors: Nastaran Hemmati, Farhad Nikkhahi, Amir Javadi, Sahar Eskandarion, Seyed Mahmuod Amin Marashi

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Neisseria meningitidis, Escherichia coli K, Streptococcus agalactiae, and Streptococcus pneumoniae cause 90% of bacterial meningitis. Almost all infected people die or have irreversible neurological complications. Therefore, it is essential to have a diagnostic kit with the ability to quickly detect these fatal infections. The project involved 212 patients from whom cerebrospinal fluid samples were obtained. After total genome extraction and performing multiplex quantitative polymerase chain reaction (qPCR), the presence or absence of each infectious factor was determined by comparing with standard strains. The specificity, sensitivity, positive predictive value, and negative predictive value calculated were 100%, 92.9%, 50%, and 100%, respectively. So, due to the high specificity and sensitivity of the designed primers, they can be used instead of bacterial culture that takes at least 24 to 48 hours. The remarkable benefit of this method is associated with the speed (up to 3 hours) at which the procedure could be completed. It is also worth noting that this method can reduce the personnel unintentional errors which may occur in the laboratory. On the other hand, as this method simultaneously identifies four common factors that cause bacterial meningitis, it could be used as an auxiliary method diagnostic technique in laboratories particularly in cases of emergency medicine.

Keywords: cerebrospinal fluid, meningitis, quantitative polymerase chain reaction, simultaneous detection, diagnosis testing

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633 Normative Reflections on the International Court of Justice's Jurisprudence on the Protection of Human Rights in Times of War

Authors: Roger-Claude Liwanga

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This article reflects on the normative aspects of the jurisprudence on the protection of human rights in times of war that the International Court of Justice (ICJ) developed in 2005 in the Case Concerning Armed Activities on the Territory of the Congo (Democratic Republic of Congo v. Uganda). The article focuses on theories raised in connection with the Democratic Republic of Congo (DRC)'s claim of the violation of human rights of its populations by Uganda as opposed to the violation of its territorial integrity claims. The article begins with a re-visitation of the doctrine of state extraterritorial responsibility for violations of human rights by suggesting that a state's accountability for the breach of its international obligations is not territorially confined but rather transcends the State's national borders. The article highlights the criteria of assessing the State's extraterritorial responsibility, including the circumstances: (1) where the concerned State has effective control over the territory of another State in the context of belligerent occupation, and (2) when the unlawful actions committed by the State's organs on the occupied territory can be attributable to that State. The article also analyzes the ICJ's opinions articulated in DRC v. Uganda with reference to the relationship between human rights law and humanitarian law, and it contends that the ICJ had revised the traditional interaction between these two bodies of law to the extent that human rights law can no longer be excluded from applying in times of war as both branches are complementary rather than exclusive. The article correspondingly looks at the issue of reparations for victims of human rights violations. It posits that reparations for victims of human rights violations should be integral (including restitution, compensation, rehabilitation, satisfaction, and guarantees of non-repetition). Yet, the article concludes by emphasizing that reparations for victims were not integral in DRC v. Uganda because: (1) the ICJ failed to set a reasonable timeframe for the negotiations between the DRC and Uganda on the amount of compensation, resulting in Uganda paying no financial reparation to the DRC since 2005; and (2) the ICJ did not request Uganda to domestically prosecute the perpetrators of human rights abuses.

Keywords: human rights law, humanitarian law, civilian protection, extraterritorial responsibility

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632 Predicting Dose Level and Length of Time for Radiation Exposure Using Gene Expression

Authors: Chao Sima, Shanaz Ghandhi, Sally A. Amundson, Michael L. Bittner, David J. Brenner

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In a large-scale radiologic emergency, potentially affected population need to be triaged efficiently using various biomarkers where personal dosimeters are not likely worn by the individuals. It has long been established that radiation injury can be estimated effectively using panels of genetic biomarkers. Furthermore, the rate of radiation, in addition to dose of radiation, plays a major role in determining biological responses. Therefore, a better and more accurate triage involves estimating both the dose level of the exposure and the length of time of that exposure. To that end, a large in vivo study was carried out on mice with internal emitter caesium-137 (¹³⁷Cs). Four different injection doses of ¹³⁷Cs were used: 157.5 μCi, 191 μCi, 214.5μCi, and 259 μCi. Cohorts of 6~7 mice from the control arm and each of the dose levels were sacrificed, and blood was collected 2, 3, 5, 7 and 14 days after injection for microarray RNA gene expression analysis. Using a generalized linear model with penalized maximum likelihood, a panel of 244 genes was established and both the doses of injection and the number of days after injection were accurately predicted for all 155 subjects using this panel. This has proven that microarray gene expression can be used effectively in radiation biodosimetry in predicting both the dose levels and the length of exposure time, which provides a more holistic view on radiation exposure and helps improving radiation damage assessment and treatment.

Keywords: caesium-137, gene expression microarray, multivariate responses prediction, radiation biodosimetry

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631 Analysis and Identification of Trends in Electric Vehicle Crash Data

Authors: Cody Stolle, Mojdeh Asadollahipajouh, Khaleb Pafford, Jada Iwuoha, Samantha White, Becky Mueller

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Battery-electric vehicles (BEVs) are growing in sales and popularity in the United States as an alternative to traditional internal combustion engine vehicles (ICEVs). BEVs are generally heavier than corresponding models of ICEVs, with large battery packs located beneath the vehicle floorpan, a “skateboard” chassis, and have front and rear crush space available in the trunk and “frunk” or front trunk. The geometrical and frame differences between the vehicles may lead to incompatibilities with gasoline vehicles during vehicle-to-vehicle crashes as well as run-off-road crashes with roadside barriers, which were designed to handle lighter ICEVs with higher centers-of-mass and with dedicated structural chasses. Crash data were collected from 10 states spanning a five-year period between 2017 and 2021. Vehicle Identification Number (VIN) codes were processed with the National Highway Traffic Safety Administration (NHTSA) VIN decoder to extract BEV models from ICEV models. Crashes were filtered to isolate only vehicles produced between 2010 and 2021, and the crash circumstances (weather, time of day, maximum injury) were compared between BEVs and ICEVs. In Washington, 436,613 crashes were identified, which satisfied the selection criteria, and 3,371 of these crashes (0.77%) involved a BEV. The number of crashes which noted a fire were comparable between BEVs and ICEVs of similar model years (0.3% and 0.33%, respectively), and no differences were discernable for the time of day, weather conditions, road geometry, or other prevailing factors (e.g., run-off-road). However, crashes involving BEVs rose rapidly; 31% of all BEV crashes occurred in just 2021. Results indicate that BEVs are performing comparably to ICEVs, and events surrounding BEV crashes are statistically indistinguishable from ICEV crashes.

Keywords: battery-electric vehicles, transportation safety, infrastructure crashworthiness, run-off-road crashes, ev crash data analysis

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630 Risk Assessment of Oil Spill Pollution by Integration of Gnome, Aloha and Gis in Bandar Abbas Coast, Iran

Authors: Mehrnaz Farzingohar, Mehran Yasemi, Ahmad Savari

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The oil products are imported and exported via Rajaee’s tanker terminal. Within loading and discharging in several cases the oil is released into the berths and made oil spills. The spills are distributed within short time and seriously affected Rajaee port’s environment and even extended areas. The trajectory and fate of oil spills investigated by modeling and parted by three risk levels base on the modeling results. First GNOME (General NOAA Operational Modeling Environment) applied to trajectory the liquid oil. Second, ALOHA (Areal Location Of Hazardous Atmosphere) air quality model, is integrated to predict the oil evaporation path within the air. Base on the identified zones the high risk areas are signed by colored dots which their densities calculated and clarified on a map which displayed the harm places. Wind and water circulation moved the pollution to the East of Rajaee Port that accumulated about 12 km of coastline. Approximately 20 km of north east of Qeshm Island shore is covered by the three levels of risky areas. Since the main wind direction is SSW the pollution pushed to the east and the highest risk zones formed on the crests edges hence the low risk appeared on the concavities. This assessment help the management and emergency systems to monitor the exposure places base on the priority factors and find the best approaches to protect the environment.

Keywords: oil spill, modeling, pollution, risk assessment

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629 Collective Problem Solving: Tackling Obstacles and Unlocking Opportunities for Young People Not in Education, Employment, or Training

Authors: Kalimah Ibrahiim, Israa Elmousa

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This study employed the world café method alongside semi-structured interviews within a 'conversation café' setting to engage stakeholders from the public health and primary care sectors. The objective was to collaboratively explore strategies to improve outcomes for young people not in education, employment, or training (NEET). The discussions were aimed at identifying the underlying causes of disparities faced by NEET individuals, exchanging experiences, and formulating community-driven solutions to bolster preventive efforts and shape policy initiatives. A thematic analysis of the qualitative data gathered emphasized the importance of community problem-solving through the exchange of ideas and reflective discussions. Healthcare professionals reflected on their potential roles, pinpointing a significant gap in understanding the specific needs of the NEET population and the unclear distribution of responsibilities among stakeholders. The results underscore the necessity for a unified approach in primary care and the fostering of multi-agency collaborations that focus on addressing social determinants of health. Such strategies are critical not only for the immediate improvement of health outcomes for NEET individuals but also for informing broader policy decisions that can have long-term benefits. Further research is ongoing, delving deeper into the unique challenges faced by this demographic and striving to develop more effective interventions. The study advocates for continued efforts to integrate insights from various sectors to create a more holistic and effective response to the needs of the NEET population, ensuring that future strategies are informed by a comprehensive understanding of their circumstances and challenges.

Keywords: multi-agency working, primary care, public health, social inequalities

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628 Keyword Advertising: Still Need Construction in European Union; Perspective on Interflora vs. Marks and Spencer

Authors: Mohammadbagher Asghariaghamashhadi

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Internet users normally are automatically linked to an advertisement sponsored by a bidder when Internet users enter any trademarked keyword on a search engine. This advertisement appears beside the search results. Through the process of keyword advertising, advertisers can connect with many Internet users and let them know about their goods and services. This concept has generated heated disagreements among legal scholars, trademark proprietors, advertisers, search engine owners, and consumers. Therefore, use of trademarks in keyword advertising has been one of the most debatable issues in trademark law for several years. This entirely new way of using trademarks over the Internet has provoked a discussion concerning the core concepts of trademark law. In respect to legal issues, European Union (EU) trademark law is mostly governed by the Trademark Directive and the Community Trademark Regulation. Article 5 of the directive and Article 9 of the trademark regulation determine the circumstances in which a trademark owner holds the right to prohibit a third party’s use of his/her registered sign. Harmonized EU trademark law proved to be ambiguous on whether using of a trademark is amounted to trademark infringement or not. The case law of the European Court of Justice (ECJ), with reference to this legislation, is mostly unfavorable to trademark owners. This ambivalence was also exhibited by the case law of EU Member States. European keyword advertisers simply could not tell which use of a competitor‘s trademark was lawful. In recent years, ECJ has continuously expanded the scope and reach of trademark protection in the EU. It is notable that Inconsistencies in the Court’s system of infringement criteria clearly come to the fore and this approach has been criticized by analysts who believe that the Court should have adopted a more traditional approach to the analysis of trademark infringement, which was suggested by its Advocate General, in order to arrive at the same conclusion. Regarding case law of keyword advertising within Europe, one of the most disputable cases is Interflora vs. Marks and Spencer, which is still on-going. This study examines and critically analyzes the decisions of the ECJ, the high court of England, and the Court of Appeals of England and address critically keyword advertising issue within European trademark legislation.

Keywords: ECJ, Google, Interflora, keyword advertising, Marks and Spencer, trademark infringement

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627 Flood Disaster Prevention and Mitigation in Nigeria Using Geographic Information System

Authors: Dinebari Akpee, Friday Aabe Gaage, Florence Fred Nwaigwu

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Natural disasters like flood affect many parts of the world including developing countries like Nigeria. As a result, many human lives are lost, properties damaged and so much money is lost in infrastructure damages. These hazards and losses can be mitigated and reduced by providing reliable spatial information to the generality of the people through about flood risks through flood inundation maps. Flood inundation maps are very crucial for emergency action plans, urban planning, ecological studies and insurance rates. Nigeria experience her worst flood in her entire history this year. Many cities were submerged and completely under water due to torrential rainfall. Poor city planning, lack of effective development control among others contributes to the problem too. Geographic information system (GIS) can be used to visualize the extent of flooding, analyze flood maps to produce flood damaged estimation maps and flood risk maps. In this research, the under listed steps were taken in preparation of flood risk maps for the study area: (1) Digitization of topographic data and preparation of digital elevation model using ArcGIS (2) Flood simulation using hydraulic model and integration and (3) Integration of the first two steps to produce flood risk maps. The results shows that GIS can play crucial role in Flood disaster control and mitigation.

Keywords: flood disaster, risk maps, geographic information system, hazards

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626 Budd-Chiari Syndrome: Common Presentation, Rare Disease

Authors: Aadil Khan, Yasser Chomayil, P. P. Venugopalan

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Background: Budd-Chiari syndrome is caused by thrombosis of the hepatic veins and/or the thrombosis of the intrahepatic or suprahepatic IVC. The etiology remains idiopathic in 16% -35% of cases. Malignancy, rheumatological disorder, myeloproliferative disease, inheritable coagulopathy, infection or hyperestrogen state can be identified in many cases. Methodology: Review of case records of the patient presented to Aster Medcity, Emergency Department, Cochin. Introduction:17 years old female was presented to ED with fever, jaundice and abdominal distention since 1 week. O/E: Pallor+, icterus+. Abdomen- gross distension+, shifting dullness+, generalized anasarca+. USG abdomen showed hepatomegaly with mild coarse echotexture and moderate to gross ascites. CT abdomen and chest showed hepatomegaly with thrombosis of all three hepatic vein and moderate ascites suggestive of Budd-Chiari syndrome. Patient was taken for catheter vein thrombolysis. Venogram done the next day revealed almost > 50% opening of the right hepatic vein. Concurrent doppler showed colour and doppler signals in middle hepatic veins. She gradually improved and was discharged home on anticoagulant and adviced regular follow up. Conclusion: Being a rare disease in this young population, high suspicion is required when evaluating young patients with abdominal pain and jaundice.

Keywords: Budd-Chiari syndrome, rare disease, abdominal pain, India

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625 Hospital Beds: Figuring and Forecasting Patient Population Arriving at Health Care Research Institute, Illustrating Roemer's Law

Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

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Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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624 Platelet Transfusion Thresholds for Pediatrics; A Retrospective Study

Authors: Hessah Alsulami, Majedah Aldosari

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Introduction: Platelet threshold of 10x109 /L is recommended for clinically stable thrombocytopenic pediatric patients. Transfusions at a higher level (given the absence of research evidence, as determined by clinical circumstances, generally at threshold of 40x109 /L) may be required for patients with signs of bleeding, high fever, hyper-leukocytosis, rapid fall in platelet count, concomitant coagulation abnormality, critically ill patients, and those with impaired platelet function (including drug induced). Transfusions at a higher level may be also required for patients undergoing invasive procedures. Method: This study is a retrospective observational analysis of platelet transfusion thresholds in a single secondary pediatric hospital in Riyadh. From the blood bank database, the list of the patients who received platelet transfusions in the second half of 2018 was retrieved. Patients were divided into two groups; group A, those belong to the category of high platelet level for transfusion (such as those with bleeding, high fever, rapid fall in platelet count, impaired platelet function or undergoing invasive procedures) and group B, those who were not. Then we looked at the pre and post transfusion platelet levels for each group. The data was analyzed using GraphPad software and the data expressed as Mean ± SD. Result: A total of 112 of transfusion episodes in 61 patients (38% female) were analyzed. The age ranged from 24 days to 8 years. The distribution of platelet transfusion episodes was 64% (n=72) for group A and 36% (n= 40) for group B. The mean pre-transfusion platelet count was 46x103 ± (11x 103) for group A and 28x103 ± (6x103) for group B. the post-transfusion mean platelet count was 61 x 103 ± (14 x 103) and 60 x103 ± (24 x 103) for group A and B respectively. Among the groups the rise in the mean platelet count after transfusion was significant among stable patients (group B) compared to unstable patients (group A) (P < 0.001). Conclusion: The platelet count threshold for transfusion varied with the clinical condition and is higher among unstable patients’ group which is expected. For stable patients the threshold was higher than what it should be which means that the clinicians don’t follow the guidelines in this regard. The rise of platelet count after transfusion was higher among stable patients.

Keywords: platelet, transfusion, threshold, pediatric

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623 Planning and Strategies for Risks Prevention, Mitigating, and Recovery of Ancient Theatres Heritage: Investigation and Recommendations

Authors: Naif A. Haddad

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Greek, Hellenistic and Roman theatre heritage are exposed to multiple risks at varied times or simultaneously. There is no single reason why a theatre building becomes ‘at risk’, as each case has different circumstances which have led to the theatre building decay. There are complicated processes of destruction and distress that show divergence in theatre building materials' decay. Theatre modern use for cultural performances causes much of the risks concerning the physical structure and authenticity of theatre sites. In addition, there are some deterioration and deformations due to previous poor quality restorations and interventions through related excavation and conservation programmes as also risks to authenticity due to new additions. For preventive conservation, theatre natural and anthropogenic risks management can provide a framework for decision making. These risks to ancient theatre heritage may stem from exposure to one or more risk or synergy of many factors. We, therefore, need to link the theatre natural risks to the risks that come from anthropogenic factors associated with social and economic development. However, this requires a holistic approach, and systematic methodology for understanding these risks from various sources while incorporating specific actions, planning and strategies for each specific risk. Elaborating on recent relevant studies, and ERATO and ATHENA EU projects for ancient theaters and odea and general surveys, this paper attempts to discuss the main aspects of the ancient Greek, Hellenistic and Roman theatres risk related issues. Relevant case studies shall also be discussed and investigated to examine frameworks for risk mitigation, and related guidelines and recommendations that provide a systematic approach for sustainable management and planning in relation mainly to ‘compatible use’ of theatre sites.

Keywords: cultural heritage management, European ancient theatres projects, Anthropogenic risks mitigation, sustainable management and planning, preventive conservation, modern use, compatible use

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622 Speech Emotion Recognition: A DNN and LSTM Comparison in Single and Multiple Feature Application

Authors: Thiago Spilborghs Bueno Meyer, Plinio Thomaz Aquino Junior

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Through speech, which privileges the functional and interactive nature of the text, it is possible to ascertain the spatiotemporal circumstances, the conditions of production and reception of the discourse, the explicit purposes such as informing, explaining, convincing, etc. These conditions allow bringing the interaction between humans closer to the human-robot interaction, making it natural and sensitive to information. However, it is not enough to understand what is said; it is necessary to recognize emotions for the desired interaction. The validity of the use of neural networks for feature selection and emotion recognition was verified. For this purpose, it is proposed the use of neural networks and comparison of models, such as recurrent neural networks and deep neural networks, in order to carry out the classification of emotions through speech signals to verify the quality of recognition. It is expected to enable the implementation of robots in a domestic environment, such as the HERA robot from the RoboFEI@Home team, which focuses on autonomous service robots for the domestic environment. Tests were performed using only the Mel-Frequency Cepstral Coefficients, as well as tests with several characteristics of Delta-MFCC, spectral contrast, and the Mel spectrogram. To carry out the training, validation and testing of the neural networks, the eNTERFACE’05 database was used, which has 42 speakers from 14 different nationalities speaking the English language. The data from the chosen database are videos that, for use in neural networks, were converted into audios. It was found as a result, a classification of 51,969% of correct answers when using the deep neural network, when the use of the recurrent neural network was verified, with the classification with accuracy equal to 44.09%. The results are more accurate when only the Mel-Frequency Cepstral Coefficients are used for the classification, using the classifier with the deep neural network, and in only one case, it is possible to observe a greater accuracy by the recurrent neural network, which occurs in the use of various features and setting 73 for batch size and 100 training epochs.

Keywords: emotion recognition, speech, deep learning, human-robot interaction, neural networks

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621 Patient Outcomes Following Out-of-Hospital Cardiac Arrest

Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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620 Black Masculinity, Media Stereotyping And Its Influence on Policing in the United States: A Functionalist Perspective

Authors: Jack Santiago Monell

Abstract:

In America, misrepresentations of black males have been perpetuated throughout the history of popular culture. Because of these narratives, varying communities have developed biases and stereotypes about what black male masculinity represents and more importantly, how they respond to them. The researcher explored the perspectives of police officers in the following states, Maryland, Pennsylvania, and North Carolina. Because of the nature of police and community relations, and national attention to high profile cases, having officers provide context into how black males are viewed from their lens, was critical while expanding on the theoretical explanations to describe attitudes towards police confrontations. As one of the objectives was to identify specific themes relevant to why police officers may view African American males differently, hence, responding more aggressively, this proved to be the most beneficial method of initial analysis to identify themes. The following nodes (appearance, acting suspicious/ troublesome behavior, upbringing about black males, excessive force) were identified to analyze the transcripts to discern associations. The data was analyzed through NVivo 11, and several themes resulted to elaborate on the data received. In analyzing the data, four themes were identified: appearance, acting suspicious/ troublesome behavior, upbringing about black males, and excessive force. The data conveyed that continuous stereotypes about African American men will ultimately result in excessive use of force or pervasive shootings, albeit the men are armed or unarmed. African American males are consistently targeted because of their racial makeup and appearance over any other probable circumstances. As long as racial bias and stereotypical practices continue in policing, African American males will endlessly be unjustly targeted and at times, the victims of violent encounters with police officers in the United States.

Keywords: African American males, police perceptions, masculinity, popular culture

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619 Improvement in Blast Furnace Performance Using Softening - Melting Zone Profile Prediction Model at G Blast Furnace, Tata Steel Jamshedpur

Authors: Shoumodip Roy, Ankit Singhania, K. R. K. Rao, Ravi Shankar, M. K. Agarwal, R. V. Ramna, Uttam Singh

Abstract:

The productivity of a blast furnace and the quality of the hot metal produced are significantly dependent on the smoothness and stability of furnace operation. The permeability of the furnace bed, as well as the gas flow pattern, influences the steady control of process parameters. The softening – melting zone that is formed inside the furnace contributes largely in distribution of the gas flow and the bed permeability. A better shape of softening-melting zone enhances the performance of blast furnace, thereby reducing the fuel rates and improving furnace life. Therefore, predictive model of the softening- melting zone profile can be utilized to control and improve the furnace operation. The shape of softening-melting zone depends upon the physical and chemical properties of the agglomerates and iron ore charged in the furnace. The variations in the agglomerate proportion in the burden at G Blast furnace disturbed the furnace stability. During such circumstances, it was analyzed that a w-shape softening-melting zone profile was formed inside the furnace. The formation of w-shape zone resulted in poor bed permeability and non-uniform gas flow. There was a significant increase in the heat loss at the lower zone of the furnace. The fuel demand increased, and the huge production loss was incurred. Therefore, visibility of softening-melting zone profile was necessary in order to pro-actively optimize the process parameters and thereby to operate the furnace smoothly. Using stave temperatures, a model was developed that predicted the shape of the softening-melting zone inside the furnace. It was observed that furnace operated smoothly during inverse V-shape of the zone and vice-versa during w-shape. This model helped to control the heat loss, optimize the burden distribution and lower the fuel rate at G Blast Furnace, TSL Jamshedpur. As a result of furnace stabilization productivity increased by 10% and fuel rate reduced by 80 kg/thm. Details of the process have been discussed in this paper.

Keywords: agglomerate, blast furnace, permeability, softening-melting

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618 Surpassing Antibiotic Resistance through Synergistic Effects of Polyethyleneimine-Silver Nanoparticle Complex Coated Mesoporous Silica Trio-Nanoconstructs

Authors: Ranjith Kumar Kankala, Wei-Zhi Lin, Chia-Hung Lee

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Antibiotic resistance in bacteria has become an emergency situation clinically. To improve the efficacy of antibiotics in resistant strains, advancement of nanoparticles is inevitable than ever. Herewith, we demonstrate a design by immobilizing tetracycline (TET) in copper substituted mesoporous silica nanoparticles (Cu-MSNs) through a pH-sensitive coordination link, enabling its release in the acidic environment. Subsequently, MSNs are coated with silver nanoparticles stabilized polyethyleneimine (PEI-SNP) to act against drug-resistant (MDR) bacterial strains. Silver ions released from SNP are capable of sensitizing the resistant strains and facilitate the generation of free radicals capable of damaging the cell components. In addition, copper ions in the framework are also capable of generating free radicals through Fenton-like reaction. Furthermore, the nanoparticles are well-characterized physically, and various antibacterial efficacious tests against isolated multidrug resistant bacterial strain were highly commendable. However, this formulation has no significant toxic effect on normal mammalian fibroblast cells accounting its high biocompatibility. These MSN trio-hybrids, i.e., SNP, tetracycline, and copper ions result in synergistic effects, and their advancement could bypass resistance and allow synergism for effective treatment of antibiotic clinically.

Keywords: antibiotic resistance, copper, mesoporous silica nanoparticles, Ph-sensitive release, polyethyleneimine, silver, tetracycline

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617 Documentation of Verbal and Written Head Injury Advice Given to All Adults Presenting Following a Head Injury

Authors: Rania Mustafa, Anfal Gadour

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Specialty area: Manchester University NHS Foundation Trust, Wythenshawe Hospital Accident and Emergency Department. About, Documentation of verbal and written head injury advice given to all adults presenting following a head injury. Our aim was to assess verbal & written head injury advice for an adult patient attending ED in Wythenshawe hospital during the period from January 2022 to May 2022, with a view to evaluating the NICE head injury guidelines concerning discharge advice and also to review the clinical notes to ensure that all adult patients presenting with a head injury are documented to have received both verbal & written head injury advice as per the NICE guidelines. Here we collected data from a random sample over a 1 month period. This data was furtherly filtered to include the adult patient >16 years and resulted in 54 patients with head injuries attending ED during this time period; then patient’s age, sex and hospital number were used to identify the discharge advice for the purpose of chart review and to assess the documentation of head injuries compliance with recommendation for NICE assessment. Data were checked between January 2022 up to May 2022 to allow more intervals for better assessment. Our finding indicates that documentation of verbal advice, 26% of patients were not recorded to have received this in January compared to only 3% in May & Written advice was not recorded in 44% of patients studied in January compared to 1% in May.

Keywords: head, injuries, advice, leaflets

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616 Exploring Causes of Homelessness and Shelter Entry: A Case Study Analysis of Shelter Data in New York

Authors: Lindsay Fink, Sarha Smith-Moyo, Leanne W. Charlesworth

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In recent years, the number of individuals experiencing homelessness has increased in the United States. This paper analyzes 2019 data from 16 different emergency shelters in Monroe County, located in Upstate New York. The data were collected through the County’s Homeless Management Information System (HMIS), and individuals were de-identified and de-duplicated for analysis. The purpose of this study is to explore the basic characteristics of the homeless population in Monroe County, and the dynamics of shelter use. The results of this study showed gender as a significant factor when analyzing the relationship between demographic variables and recorded reasons for shelter entry. Results also indicated that age and ethnicity did not significantly influence odds of re-entering a shelter, but did significantly influence reasons for shelter entry. Overall, the most common recorded cause of shelter entry in 2019 in the examined county was eviction by primary tenant. Recommendations to better address recurrent shelter entry and potential chronic homelessness include more consideration for the diversity existing within the homeless population, and the dynamics leading to shelter stays, including enhanced funding and training for shelter staff, as well as expanded access to permanent supportive housing programs.

Keywords: chronic homelessness, homeless shelter stays, permanent supportive housing, shelter population dynamics

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615 Stomach Perforation, due to Chronic External Pressure

Authors: Angelis P. Barlampas

Abstract:

PURPOSE: The purpose of this paper is to demonstrate the important role of taking an appropriate and detailed history, in order to reach the best possible diagnostic conclusion. MATERIAL: A patient presented to the emergency department due to the sudden onset of continuous abdominal pain, during the last hour and with the clinical symptoms of an acute abdomen. During the clinical examination, signs of peritoneal irritation and diffuse abdominal tenderness were found. The rest of the clinical and laboratory tests did not reveal anything important. From the reported medical history, nothing of note was found, except for the report of a large liver cyst, for which he was advised not to take any further action, except from regular ultrasound examination . METHOD: A computed tomography examination was performed after per os administration of gastrografin, which revealed a hyperdense ascitic effusion, similar in density to that of gastrografin within the intestinal tract. The presence of a large cyst of the left hepatic lobe was confirmed, contacting and pushing against the stomach. In the area of the contact between the liver cyst and the pylorus, there were extraluminal air bubbles and local opacity of the peritoneal fat, with a small hyperdense effusion. Result : The above, as well as the absence of a history of stomach ulcer or recent trauma, or other pathology, argue in favor of acute pyloric perforation, due to mural necrosis, in response to chronic external pressure from the pre-existing large liver cyst.

Keywords: perforation, stomach, large liver cyst, CT abdomen, acute abdominal pain, intraperitoneal leakage, constrast leakage

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614 Examining the Influence of Organisational Culture on Middle Leadership in Primary Schools in Saudi Arabia and United Kingdom

Authors: Saeed Musaid Alzahrani

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Shared values, beliefs, norms and assumptions within the organisation can affect personal and team effectiveness. Organisational culture can also affect the performance of organisational members. The nature of middle leadership in a primary school is largely influenced by organizational culture. The effectiveness of middle leadership in primary schools and their performance is strongly determined by the circumstances in which they work and can be political or institutional. This study aims to examine the influence of organisational culture and government policy on the performance and effectiveness of middle managers, using the English and Saudi education systems as case studies. To examine how education policy conditions educational discourse, and answer the research questions, there is a need to collect qualitative data on middle manager’s perceptions and experiences in the English and Saudi Arabian contexts. The study involved a qualitative and interpretative approach. In-depth interviews with 6 middle managers and school supervisors in 3 English primary schools and 6 middle managers in 3 Saudi Arabian primary schools were conducted to answer the research questions. The study also included ethnographic tools such as observations of a sample of three primary schools in both England and Saudi Arabia where the researcher observed middle managers’ interactions with their peers. The sample of three enabled the study to identify trends and make comparisons between leadership approaches in both systems based on observations without the bias of prescriptions. The use of ethnographic tools not only makes the study empirical but also increases the reliability and validity of the findings by reducing prescriptive bias. The observations will be triangulated with the results of the interviews to draw comparisons and conclusions on whether middle managers act as leaders or as followers in their respective political contexts.

Keywords: education management, government education policies, middle managers, organisational culture

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613 Sex and Sexuality Communication in African Families: The Dynamics of Openness and Closedness

Authors: Victorine Mbong Shu

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Very little research exists on family sex and sexuality communication and identity formation and how communication is helping adolescents in forming their sexual identities in South Africa. This study is designed to explore the impact of sexual communication in African families and the dynamics that influence the openness or closedness of adolescent sexual identities. The primary objectives of this study are threefold; to understand how sexuality communication in African families impacts the closedness and/or openness of adolescent African identities; to explore the nature of African children's sexuality given the status of their families’ communications on sex; to describe how parental or adult sexual knowledge, attitudes, values of sex, etc. are translated to children in African families, if at all. This study seeks answers to challenges faced by African parents and caregivers of adolescent children in South Africa regarding sex-sexuality communication and their shifting identities in different spaces. Its outcome seeks to empower these families on how to continue to effectively communicate sex and sexuality at different stages and circumstances. Two sets of people are interviewed separately in order to explore issues of familial communication and how to understand how together with religion and culture, adolescents are socialised to form the social and gender identities that they take to adulthood. They were parents of adolescents and young adult children who spoke in retrospect on when they were adolescents. The results of this study will fill knowledge gaps considering the chosen theory of communication that gives clarity to the topic of sex and sexuality communication in African families in South Africa and the dynamics of privacy that influence identity formation. A subset of the 40 conversations, 5 female parents, 5 male parents, 5 young female adults, and 5 male young adults, was used for this analysis. The preliminary results revealed five emergent themes informed by research questions and the theoretical framework of this study: Open communication, Discomfort discussing sex and sexuality, The importance of sex communication to African parents, Factors influencing African families’ communication about sex and sexuality and Privacy and boundaries.

Keywords: sex, sexuality, communication, African families, adolescents

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