Search results for: safe%20behaviours
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1678

Search results for: safe%20behaviours

658 I Post Therefore I Am! Construction of Gendered Identities in Facebook Communication of Pakistani Male and Female Users

Authors: Rauha Salam

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In Pakistan, over the past decade, the notion of what counts as a true ‘masculine and feminine’ behaviour has become more complicated with the inspection of social media. Given its strong religious and socio-cultural norms, patriarchal values are entrenched in the local and cultural traditions of the Pakistani society and regulate the social value of gender. However, the increasing use of internet among Pakistani men and women, especially in the form of social media uses by the youth, is increasingly becoming disruptive and challenging to the strict modes of behavioural monitoring and control both at familial and state level. Facebook, being the prime social media communication platform in Pakistan, provide its users a relatively ‘safe’ place to embrace how they want to be perceived by their audience. Moreover, the availability of an array of semiotic resources (e.g. the videos, audios, visuals and gifs) on Facebook makes it possible for the users to create a virtual identity that allows them to describe themselves in detail. By making use of Multimodal Discourse Analysis, I aimed to investigate how men and women in Pakistan construct their gendered identities multimodally (visually and linguistically) through their Facebook posts and how these semiotic modes are interconnected to communicate specific meanings. In case of the female data, the analysis showed an ambivalence as females were found to be conforming to the existing socio-cultural norms of the society and they were also employing social media platforms to deviate from traditional gendered patterns and to voice their opinions simultaneously. Similarly, the male data highlighted the reproduction of the prevalent cultural models of masculinity. However, there were instances in the data that showed a digression from the standard norms and there is a (re)negotiation of the traditional patriarchal representations.

Keywords: Facebook, Gendered Identities, Multimodal Discourse Analysis, Pakistan

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657 Modeling and Temperature Control of Water-cooled PEMFC System Using Intelligent Algorithm

Authors: Chen Jun-Hong, He Pu, Tao Wen-Quan

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Proton exchange membrane fuel cell (PEMFC) is the most promising future energy source owing to its low operating temperature, high energy efficiency, high power density, and environmental friendliness. In this paper, a comprehensive PEMFC system control-oriented model is developed in the Matlab/Simulink environment, which includes the hydrogen supply subsystem, air supply subsystem, and thermal management subsystem. Besides, Improved Artificial Bee Colony (IABC) is used in the parameter identification of PEMFC semi-empirical equations, making the maximum relative error between simulation data and the experimental data less than 0.4%. Operation temperature is essential for PEMFC, both high and low temperatures are disadvantageous. In the thermal management subsystem, water pump and fan are both controlled with the PID controller to maintain the appreciate operation temperature of PEMFC for the requirements of safe and efficient operation. To improve the control effect further, fuzzy control is introduced to optimize the PID controller of the pump, and the Radial Basis Function (RBF) neural network is introduced to optimize the PID controller of the fan. The results demonstrate that Fuzzy-PID and RBF-PID can achieve a better control effect with 22.66% decrease in Integral Absolute Error Criterion (IAE) of T_st (Temperature of PEMFC) and 77.56% decrease in IAE of T_in (Temperature of inlet cooling water) compared with traditional PID. In the end, a novel thermal management structure is proposed, which uses the cooling air passing through the main radiator to continue cooling the secondary radiator. In this thermal management structure, the parasitic power dissipation can be reduced by 69.94%, and the control effect can be improved with a 52.88% decrease in IAE of T_in under the same controller.

Keywords: PEMFC system, parameter identification, temperature control, Fuzzy-PID, RBF-PID, parasitic power

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656 Thermal Proprieties of Date Palm Wood

Authors: K. Almi, S. Lakel, A. Benchabane, A. Kriker

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Several researches are focused on natural resources for the production of biomaterials intended for technical applications. Date palm wood present one of the world’s most important natural resource. Its use as insulating materials will help to solve the severe environmental and recycling problems which other artificial insulating materials caused. This paper reports the results of an experimental investigation on the thermal proprieties of date palm wood from Algeria. A study of physical, chemical, and mechanical properties is also carried out. The goal is to use this natural material in the manufacture of thermal insulation materials for buildings. The local natural resources used in this study are the date palm fibers from Biskra oasis in Algeria. The results have shown that there is no significant difference in the morphological proprieties of the four types of residues. Their chemical composition differed slightly; with the lowest amounts of cellulose and lignin content belong to Petiole. Water absorption study proved that Rachis has a low value of sorption whereas Petiole and Fibrillium have a high value of sorption what influenced their mechanical properties. It is seen that the Rachis and leaflets exhibit high tensile strength values compared to the other residue. On the other hand, the low value of the bulk density of Petiole and Fibrillium leads to a high value of specific tensile strength and young modulus. It was found that the specific young modulus of Petiole and Fibrillium was higher than that of Rachis and Leaflets and that of other natural fibers or even artificial fibers. Compared to the other materials date palm wood provide a good thermal proprieties thus, date palm wood will be a good candidate for the manufacturing efficient and safe insulating materials.

Keywords: composite materials, date palm fiber, natural fibers, tensile tests, thermal proprieties

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655 Ecological Concerns in Food Systems: An Ethnographical Approach on Vegan Impact in Governmentality

Authors: Jessica Gonzalez

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Veganism, along with different types of vegetarianism, consists in the abstinence of animal products. Far from being only an alimentary regulation, it stands as a political posture against the food industry generating itself a set of beliefs, prohibitions, and attitudes that compel the individual to a reevaluation of his obligations towards the environment. Veganism defends animal rights and at the same time reinforces a different conception of natural resources embodying it in alimentary restrictions. These practices emerge in the context of alimentary modernity, which is characterized by bringing new concerns to the consumer. An increased skepticism towards the government ability to protect food supply; a notable distrust toward the market guaranties on providing safe food with sustainable techniques and the desire to react to the neoliberal forms of exploitation are some of its consequences of this phenomenon. This study aims to approach the concept of governmentality as a coproduced system of legitimized practices and knowledge, formed by the interaction of the different actors that are involved. In a scenario where the State seems to retreat from centralized regulation of food production giving up importance to citizens, dietary consultants, farmers, and stockbreeders, veganism plays its role on the conformation of distinctive forms of environmentalism, nature rights and responses to ecological crisis. The ethnographic method allows observing the mechanisms of interaction of consumers and discourses with the mainstream food system, providing evidence about the means of generation of new conceptions about nature and the environment. The paper focuses on how the dietary restrictions, consumption patterns and public discourses of vegans in Barcelona impact local consumption, demonstrating its relevance as a mechanism that associates particular concerns about food with political economy.

Keywords: animal rights, environmentalism, food system, governmentality, veganism

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654 Designing Urban Spaces Differently: A Case Study of the Hercity Herstreets Public Space Improvement Initiative in Nairobi, Kenya

Authors: Rehema Kabare

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As urban development initiatives continue to emerge and are implemented amid rapid urbanization and climate change effects in the global south, the plight of women is only being noticed. The pandemic exposed the atrocities, violence and unsafety women and girls face daily both in their homes and in public urban spaces. This is a result of poorly implemented and managed urban structures, which women have been left out of during design and implementation for centuries. The UN Habitat’s HerCity toolkit provides a unique opportunity to change course for both governments and civil society actors where women and girls are onboarded onto urban development initiatives, with their designs and ideas being the focal point. This toolkit proves that when women and girls design, they design for everyone. The HerCity HerStreets, Public Space Improvement Initiative, resulted in a design that focused on two aspects: Streets are a shared resource, and Streets are public spaces. These two concepts illustrate that for streets to be experienced effectively as cultural spaces, they need to be user-friendly, safe and inclusive. This report demonstrates how the HerCity HerStreets as a pilot project can be a benchmark for designing urban spaces in African cities. The project focused on five dimensions to improve the air quality of the space, the space allocation to street vending and bodaboda (passenger motorcycle) stops parking and the green coverage. The process displays how digital tools such as Minecraft and Kobo Toolbox can be utilized to improve citizens’ participation in the development of public spaces, with a special focus on including vulnerable groups such as women, girls and youth.

Keywords: urban space, sustainable development, gender and the city, digital tools and urban development

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653 Incorporating Circular Economy into Passive Design Strategies in Tropical Nigeria

Authors: Noah G. Akhimien, Eshrar Latif

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The natural environment is in need for an urgent rescue due to dilapidation and recession of resources. Passive design strategies have proven to be one of the effective ways to reduce CO2 emissions and to improve building performance. On the other hand, there is a huge drop in material availability due to poor recycling culture. Consequently, building waste pose environmental hazard due to unrecycled building materials from construction and deconstruction. Buildings are seen to be material banks for a circular economy, therefore incorporating circular economy into passive housing will not only safe guide the climate but also improve resource efficiency. The study focuses on incorporating a circular economy in passive design strategies for an affordable energy and resource efficient residential building in Nigeria. Carbon dioxide (CO2) concentration is still on the increase as buildings are responsible for a significant amount of this emission globally. Therefore, prompt measures need to be taken to combat the effect of global warming and associated threats. Nigeria is rapidly growing in human population, resources on the other hand have receded greatly, and there is an abrupt need for recycling even in the built environment. It is necessary that Nigeria responds to these challenges effectively and efficiently considering building resource and energy. Passive design strategies were assessed using simulations to obtain qualitative and quantitative data which were inferred to case studies as it relates to the Nigeria climate. Building materials were analysed using the ReSOLVE model in order to explore possible recycling phase. This provided relevant information and strategies to illustrate the possibility of circular economy in passive buildings. The study offers an alternative approach, as it is the general principle for the reworking of an economy on ecological lines in passive housing and by closing material loops in circular economy.

Keywords: building, circular, efficiency, environment, sustainability

Procedia PDF Downloads 239
652 Ventriculo-Gallbladder Shunt: Case Series and Literature Review

Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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651 Exposure Assessment to Airborne Particulate Matter in Agriculture

Authors: K. Rumchev, S. Gilbey

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Airborne particulate matter is a known hazard to human health, with a considerable body of evidence linking agricultural dust exposures to adverse human health effects in exposed populations. It is also known that agricultural workers are exposed to high levels of soil dust and other types of airborne particulate matter within the farming environment. The aim of this study was to examine exposure to agricultural dust among farm workers during the seeding season. Twenty-one wheat-belt farms consented to participate in the study with 30 workers being monitored for dust exposure whilst seeding or undertaking seeding associated tasks. Each farm was visited once and farmers’ were asked to wear a personal air sampler for a 4-hour sampling period. Simultaneous, real-time, tractor cabin air quality monitoring was also undertaken. Data for this study was collected using real-time aerosol dust monitors to determine in-tractor cabin PM exposure to five size fractions (total, PM10, respirable, PM2.5 and PM1), and personal sampling was undertaken to establish individual exposure to inhalable and respirable dust concentrations. The study established a significant difference between personal exposures and simultaneous real-time in-cabin exposures for both inhalable and respirable fractions. No significant difference was shown between in-cabin and personal inhalable dust concentrations during seeding and spraying tasks, although both in-cabin and personal concentrations were two times greater for seeding than spraying. Future research should focus on educating and providing farm owners and workers with more information on adopting safe work practices to minimise harmful exposures to agricultural dust.

Keywords: agriculture, air quality, Australia, particulate matter

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650 The Effect of Vitamin D Supplements and Aerobic Exercise on Hunger and Serum Insulin Levels in Adolescents With Metabolic Syndrome

Authors: Vahab Behmanesh

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Metabolic syndrome is defined as having at least three of the five metabolic risk factors, including abdominal obesity, high blood pressure, high triglycerides, low HDL, and insulin resistance. Lifestyle changes towards reducing physical activity, unhealthy eating habits Especially the high-fat and high-carbohydrate diet is directly related to metabolic syndrome, and due to the epidemic of overweight and sedentary life, metabolic syndrome is a serious problem worldwide. On the other hand, vitamin D deficiency is considered as one of the most common problems in the world, which is related to the dysfunction of beta cells and insulin resistance, and therefore, vitamin D deficiency is considered as a factor in the occurrence of metabolic syndrome. 40 subjects (age: 16.12 ± 4.4 years and body mass index 25.61 ± 4.4 kg/m2) were randomly assigned to groups of aerobic exercise and placebo, aerobic exercise and vitamin D and placebo (no exercise) were divided. Vitamin D was taken at a dose of 50,000 units per week in a double-blind format for eight weeks, and the daily aerobic exercise program was performed for 50 to 60 minutes, three doses per week, with an intensity of 50-60% of the maximum heart rate. From one-way analysis of variance, Factorial variance analysis (2x2) repeated measurement and correlated t-test were used for data analysis. Aerobic exercise and vitamin D intake reduced all metabolic risk indicators and blood insulin (P < 0.05). However, the subjective feeling of hunger did not change significantly (P < 0.05). Regarding waist circumference and blood glucose, the effect of exercise combined with vitamin D consumption was greater than the corresponding effect in the vitamin D group (P < 0.05). Aerobic exercises and vitamin D intake are safe and effective for improving cardiometabolic health, Imam adds vitamin D to the exercise program has more benefits for weight and blood sugar control, which suggests prescribing it for patients with metabolic syndrome.

Keywords: vitamin D, aerobic exercise, metabolic control, adolescents

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649 Inter-Departmental Survey to Check the Impact of Bio-Safety Training Sessions among Lab Employees

Authors: Noorulaine Maqsood, Saeed Khan

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Background: Concern regarding incident reporting and bio-safety training in clinical laboratories in Pakistan has increased remarkably in the last few years due to rapid increase in diagnosis and research on infectious organisms. In order to ensure the safety of employees, this issue needs to be addressed immediately. Bio-safety training sessions and lectures are necessary for the protection of laboratory workers in order to ensure safe practices and minimize the count of incident reporting in the lab. Objective: To carry out an inter-departmental survey in lab regarding the awareness of bio-safety practices among lab employees before and after conducting bio-safety training sessions. Methodology: We conducted a 30 questions survey of laboratory workers in June 2013 (before training session) to gather information related to bio-safety awareness. Afterwards, we conducted another survey after training sessions and workshops related to bio-safety. Result: The survey regarding bio-safety level showed that before the training session 32% of the participants were aware of bio-safety level being used in their lab whereas after the session this percentage increased to 72%. 48% of the participants had information about the proper usage of PPE which increased to 76%. Awareness regarding proper management of hazardous waste increased from 32% to 64%. The incident reporting practice, sample handling and hand hygiene awareness was previously reported to be 40%, 65%, and 52% that increased to 80%, 85% and 88% respectively after the training session was completed. Conclusion: The first survey results showed lack of awareness that suggest nearly all senior scientists, faculty, medical technologist, lab attendant and housekeeping staff working in laboratories are required to have bio-safety training, and required inspection at least twice a year by a bio-safety officer and also required to renew their bio-safety training. After the training session, significant changes in awareness level and attitude of the participants regarding biosafety practices were observed. Therefore, such bio-safety sessions should be carried out regularly in clinical laboratories.

Keywords: biosafety practices, clinical laboratory, Pakistan, survey

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648 Experiences of Homophobia, Machismo and Misogyny in Tourist Destinations: A Netnography in a Facebook Community of LGBT Backpackers

Authors: Renan De Caldas Honorato, Ana Augusta Ferreira De Freitas

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Homosexuality is still criminalized in a large number of countries. In some of them, being gay or lesbian can even be punished by death. Added to this context, the experiences of social discrimination faced by the LGBT population, including homophobia, machismo and misogyny, cause numerous restrictions throughout their lives. The possibility of confronting these challenges in moments that should be pleasant, such as on a trip or on vacation, is unpleasant, to say the least. In the current scenario of intensifying the use of Social network sites (SNSs) to search for information, including in the tourist area, this work aims to analyze the sharing of tourist experiences with situations of confrontation and perceptions of homophobia, machismo and misogyny, and restrictions suffered in tourist destinations. The fieldwork is a community of LGBT backpackers based on Facebook. Netnography was the core method adopted. A qualitative approach was conducted and 463 publications posted from January to December 2020 were assessed through the computer-mediated discourse analysis (CMDA). The results suggest that these publications exist to identify the potential exposure to these offensive behaviors while traveling. Individuals affirm that the laws, positive or not, in relation to the LGBT public are not the only factors for a place to be defined as safe or not for gay travelers. The social situation of a country and its laws are quite different and this is the main target of these publications. The perception of others about the chosen destination is more important than knowing your rights and the legal status of each country and it also lessens uncertainty, even when they are never totally confident when choosing a travel destination. In certain circumstances, sexual orientation also needs to be protected from the judgment of hosts and residents. The systemic treatment of homophobic behavior and the construction of a more inclusive society are urgent.

Keywords: homophobia, hospitality, machismo, misogyny

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647 Evaluation of Entomopathogenic Fungi Strains for Field Persistence and Its Relationship to in Vitro Heat Tolerance

Authors: Mulue Girmay Gebreslasie

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Entomopathogenic fungi are naturally safe and eco-friendly biological agents. Their potential of host specificity and ease handling made them appealing options to substitute synthetic pesticides in pest control programs. However, they are highly delicate and unstable under field conditions. Therefore, the current experiment was held to search out persistent fungal strains by defining the relationship between invitro heat tolerance and field persistence. Current results on leaf and soil persistence assay revealed that strains of Metarhizium species, M. pingshaense (F2685), M. pingshaense (MS2) and M. brunneum (F709) exhibit maximum cumulative CFUs count, relative survival rate and least percent of CFUs reductions showed significant difference at 7 days and 28 days post inoculations (dpi) in hot seasons from sampled soils and leaves and in cold season from soil samples. Whereas relative survival of B. brongniartii (TNO6) found significantly higher in cold weather leaf treatment application as compared to hot season and found as persistent as other fungal strains, while higher deterioration of fungal conidia seen with M. pingshaense (MS2). In the current study, strains of Beauveria brongniartii (TNO6) and Cordyceps javanica (Czy-LP) were relatively vulnerable in field condition with utmost colony forming units (CFUs) reduction and least survival rates. Further, the relationship of the two parameters (heat tolerance and field persistence) was seen with strong linear positive correlations elucidated that heat test could be used in selection of field persistent fungal strains for hot season applications.

Keywords: integrated pest management, biopesticides, Insect pathology and microbial control, entomology

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646 Transit-Oriented Development as a Tool for Building Social Capital

Authors: Suneet Jagdev

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Rapid urbanization has resulted in informal settlements on the periphery of nearly all big cities in the developing world due to lack of affordable housing options in the city. Residents of these communities have to travel long distances to get to work or search for jobs in these cities, and women, children and elderly people are excluded from urban opportunities. Affordable and safe public transport facilities can help them expand their possibilities. The aim of this research is to identify social capital as another important element of livable cities that can be protected and nurtured through transit-oriented development, as a tool to provide real resources that can help these transit-oriented communities become self-sustainable. Social capital has been referred to the collective value of all social networks and the inclinations that arise from these networks to do things for each other. It is one of the key component responsible to build and maintain democracy. Public spaces, pedestrian amenities and social equity are the other essential part of Transit Oriented Development models that will be analyzed in this research. The data has been collected through the analysis of several case studies, the urban design strategies implemented and their impact on the perception and on the community´s experience, and, finally, how these focused on the social capital. Case studies have been evaluated on several metrics, namely ecological, financial, energy consumption, etc. A questionnaire and other tools were designed to collect data to analyze the research objective and reflect the dimension of social capital. The results of the questionnaire indicated that almost all the participants have a positive attitude towards this dimensions of building a social capital with the aid of transit-oriented development. Statistical data of the identified key motivators against against demographic characteristics have been generated based on the case studies used for the paper. The findings suggested that there is a direct relation between urbanization, transit-oriented developments, and social capital.

Keywords: better opportunities, low-income settlements, social capital, social inclusion, transit oriented development

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645 Comparative Study Between Two Different Techniques for Postoperative Analgesia in Cesarean Section Delivery

Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

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Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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644 Systematic Review and Meta-Analysis of Mid-Term Survival, and Recurrent Mitral Regurgitation for Robotic-Assisted Mitral Valve Repair

Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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643 Software Development for AASHTO and Ethiopian Roads Authority Flexible Pavement Design Methods

Authors: Amare Setegn Enyew, Bikila Teklu Wodajo

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The primary aim of flexible pavement design is to ensure the development of economical and safe road infrastructure. However, failures can still occur due to improper or erroneous structural design. In Ethiopia, the design of flexible pavements relies on doing calculations manually and selecting pavement structure from catalogue. The catalogue offers, in eight different charts, alternative structures for combinations of traffic and subgrade classes, as outlined in the Ethiopian Roads Authority (ERA) Pavement Design Manual 2001. Furthermore, design modification is allowed in accordance with the structural number principles outlined in the AASHTO 1993 Guide for Design of Pavement Structures. Nevertheless, the manual calculation and design process involves the use of nomographs, charts, tables, and formulas, which increases the likelihood of human errors and inaccuracies, and this may lead to unsafe or uneconomical road construction. To address the challenge, a software called AASHERA has been developed for AASHTO 1993 and ERA design methods, using MATLAB language. The software accurately determines the required thicknesses of flexible pavement surface, base, and subbase layers for the two methods. It also digitizes design inputs and references like nomographs, charts, default values, and tables. Moreover, the software allows easier comparison of the two design methods in terms of results and cost of construction. AASHERA's accuracy has been confirmed through comparisons with designs from handbooks and manuals. The software can aid in reducing human errors, inaccuracies, and time consumption as compared to the conventional manual design methods employed in Ethiopia. AASHERA, with its validated accuracy, proves to be an indispensable tool for flexible pavement structure designers.

Keywords: flexible pavement design, AASHTO 1993, ERA, MATLAB, AASHERA

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642 Qualitative Study of Organizational Variables Affecting Nurses’ Resilience in Pandemic Condition

Authors: Zahra Soltani Shal

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Introduction: The COVID-19 pandemic marks an extraordinary global public health crisis unseen in the last century, with its rapid spread worldwide and associated mortality burden. Healthcare resilience during a pandemic is crucial not only for continuous and safe patients care but also for control of any outbreak. Aim: The present study was conducted to discover the organizational variables effective in increasing resilience and continuing the work of nurses in critical and stressful pandemic conditions. Method: The study population is nurses working in hospitals for patients with coronavirus. Sampling was done purposefully and information was collected from 15 nurses through In-depth semi-structured interviews. The interview was conducted to analyze the data using the framework analysis method consisting of five steps and is classified in the table. Results: According to the findings through semi-structural interviews, among organizational variables, organizational commitment (Affective commitment, continuous commitment, normative commitment) has played a prominent role in nurses' resilience. Discussion: despite the non-withdrawal of nurses and their resilience, due to the negative quality of their working life, the mentioned variable has affected their level of performance and ability and leads to fatigue and physical and mental exhaustion. Implications for practice: By equipping hospitals and improving the facilities of nurses, their organizational commitment can be increased and lead to their resilience in critical situations. Supervisors and senior officials at the hospitals should be responsible for nurses' health and safety. A clear and codified program in critical situations and comprehensive management is effective in improving the quality of the work-life of nurses. Creating an empathetic and interactive environment can help promote nurses' mental health.

Keywords: organizational commitment, quality of work life, nurses resilience, pandemic, coronavirus

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641 Demographic Impact on Wastewater: A Systemic Analysis of Human Impact on Wastewater Quality in Dhaka, Bangladesh

Authors: Dewan Hasin Mahtab, Farzana Sadia

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At present, wastewater treatment has become essential to maintain a constant supply of safe water as well as to protect the environment. Due to overpopulation and overconsumption, the water quality from various surface water sources is degrading every day. Being one of the megacities in the world, Dhaka City, is going through rapid industrialization and urbanization. The effluents from these industries and factories are mostly discharged directly into the rivers without any treatment. As such, the quality of water of Buriganga is being afflicted with a noisome problem of pollution. The water of the Buriganga River has become detrimental to humans, animals, and the environment. It has become crucial to conserve the environment so that we can save both ourselves and the environment. The first step towards it should be analyzing the wastewater to decide the further steps of the treatment process. Increased population and increased consumption both contribute to water pollution. Mohammadpur is a developing area of Dhaka City, and Kamrangirchar is one of the largest slum areas in Dhaka City. The total study area is 6.13 sq. Km of Dhaka city with a population of 4,73,310 people. Of them, 86.47% had their own latrine, 47% were directly connected to the drain, 55% had septic tanks, and 70.09% of them cleaned their septic tank once a year. The pH, Dissolved Oxygen, Chemical Oxygen Demand, Biochemical Oxygen Demand, Total Dissolved Solid, Total Suspended and total coliforms of wastewater from two samples of both Mohammadpur and Kamrangirchar was analyzed. The DO level from the water bodies of Kamrangirchar was found very low, making the water bodies inhabitable for aquatic plants and animals. The BOD and COD level was extremely high from samples collected from Mohammadpur. The total coliforms count was found too high during the wet season, making it a potential health concern in the wet season in these two areas.

Keywords: Dhaka, environmental conservation rule, sanitation, wastewater

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640 Pneumoperitoneum Creation Assisted with Optical Coherence Tomography and Automatic Identification

Authors: Eric Yi-Hsiu Huang, Meng-Chun Kao, Wen-Chuan Kuo

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For every laparoscopic surgery, a safe pneumoperitoneumcreation (gaining access to the peritoneal cavity) is the first and essential step. However, closed pneumoperitoneum is usually obtained by blind insertion of a Veress needle into the peritoneal cavity, which may carry potential risks suchas bowel and vascular injury.Until now, there remains no definite measure to visually confirm the position of the needle tip inside the peritoneal cavity. Therefore, this study established an image-guided Veress needle method by combining a fiber probe with optical coherence tomography (OCT). An algorithm was also proposed for determining the exact location of the needle tip through the acquisition of OCT images. Our method not only generates a series of “live” two-dimensional (2D) images during the needle puncture toward the peritoneal cavity but also can eliminate operator variation in image judgment, thus improving peritoneal access safety. This study was approved by the Ethics Committee of Taipei Veterans General Hospital (Taipei VGH IACUC 2020-144). A total of 2400 in vivo OCT images, independent of each other, were acquired from experiments of forty peritoneal punctures on two piglets. Characteristic OCT image patterns could be observed during the puncturing process. The ROC curve demonstrates the discrimination capability of these quantitative image features of the classifier, showing the accuracy of the classifier for determining the inside vs. outside of the peritoneal was 98% (AUC=0.98). In summary, the present study demonstrates the ability of the combination of our proposed automatic identification method and OCT imaging for automatically and objectively identifying the location of the needle tip. OCT images translate the blind closed technique of peritoneal access into a visualized procedure, thus improving peritoneal access safety.

Keywords: pneumoperitoneum, optical coherence tomography, automatic identification, veress needle

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639 Genotoxic and Cytotoxic Effects of Salvia officinals Extracts on Rat Bone Marrow

Authors: Mohammed A. Alshehri

Abstract:

Salvia officinalis is an aromatic plant member of the mint (Labiatae) family. It is popular kitchen herb. Not surprise to find that the name of this herb related to cure, in Latin language Salvia means to cure where officinalis means medicinal which answer why the sage has a top place in the list of medicinal plants. The aim of the present study was to assess the genetic damage and cytological changes caused by exposure of the test organism (Rattusrattus) to Salvia officinals. For this purpose, adult female rats, weighing 200–250 g, were used as donors. A total of 36 adult Wister male rats were randomly assigned to five groups: the experimental groups (rats were intraperitonealy injected with Salvia officinalis pure extract at (0.1, 0.2, 0.5, 0.1mg/kg body weight, the same dose was administered once a day. Control group (rats were injected intraperitonealy physiological saline. And positive control were injected with Cyclophosphamide. On the 21st days following Salvia officinalis pure extract exposure, rats were sacrificed, and samples of bone marrow were collected. Following that, we performed a micronuclei (MN) test using MNNCE (Micro-nucleated normocromatic erythrocytes) and MNPCE (Micronucleated polychromatic erythrocytes), NDI (Nuclear division index), and cytological parameters using NDCI (nuclear division cytotoxicity index), necrotic, and apoptotic cells in rat's bone marrow samples. Results showed that there was a no significant increase in the frequency of micro-nucleatedas well as in cytological parameters in bone marrow cells. In light of these results, if Salvia officinalis pure extract may considered to be safe from the stand point of genotoxicity and cytotoxicity effects.

Keywords: Salvia officinalis, micronucleus, NDI, NDCI, toxicity, chromosomal aberrations

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638 Feasibility of Solar Distillation as Household Water Supply in Saline Zones of Bangladesh

Authors: Md. Rezaul Karim, Md. Ashikur Rahman, Dewan Mahmud Mim

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Scarcity of potable water as the result of rapid climate change and saltwater intrusion in groundwater has been a major problem in the coastal regions over the world. In equinoctial countries like Bangladesh, where sunlight is available for more than 10 hours a day, Solar Distillation provides a promising sustainable way for safe drinking water supply in coastal poor households with negligible major cost and difficulty of construction and maintenance. In this paper, two passive type solar stills- a Conventional Single Slope Solar still (CSS) and a Pyramid Solar Sill (PSS) is used and relationship is established between distill water output corresponding to four different factors- temperature, solar intensity, relative humidity and wind speed for Gazipur, Bangladesh. Comparison is analyzed between the two different still outputs for nine months period (January- September) and efficiency is calculated. Later a thermal mathematical model is developed and the distilled water output for Khulna, Bangladesh is computed. Again, difference between the output of the two cities- Gazipur and Khulna is demonstrated and finally an economic analysis is prepared. The distillation output has a positive correlation with temperature and solar intensity, inverse relation with relative humidity and wind speed has nugatory consequence. The maximum output of Conventional Solar Still is obtained 3.8 L/m2/day and Pyramid still is 4.3 L/m2/day for Gazipur and almost 15% more efficiency is found for Pyramid still. Productivity in Khulna is found almost 20% more than Gazipur. Based on economic analysis, taking 10 BDT, per liter, the net profit, benefit cost ratio, payback period all indicates that both stills are feasible but pyramid still is more feasible than Conventional Still. Finally, for a 3-4 member family, area of 4 m2 is suggested for Conventional Still and 3m2 for Pyramid Solar Still.

Keywords: solar distillation, household water supply, saline zones, Bangladesh

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637 Epidemiological Study on Prevalence of Bovine Trypanosomosis and Tsetse Fly Density in Some Selected of Pastoral Areas of South Omo Zone

Authors: Tekle Olbamo, Tegegn Tesfaye, Dikaso Unbushe, Belete Jorga

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Bovine trypanosomosis is a haemoprotozoan parasitic disease, mostly transmitted by the tsetse fly (Glossina species) and poses significant losses to the livestock industry in pastoral and agro-pastoral areas. Therefore, the current study was aimed to determine the prevalence of bovine trypanosomosis and its vectorial density in some selected tsetse suppression and non-tsetse suppression areas of South Omo Zonefrom December 2018- November 2019. Dark phase contrast buffy coat, hematocrit techniques, and thin blood smear method were used for determination of prevalence and packed cell volume of trypanosomosis infection, respectively. For entomological investigation, 96 NGU traps were deployed (64 traps in tsetse suppression areas, 32 traps in tsetse non-suppression areas) in vector breeding areas. The overall prevalence of bovine trypanosomosis was 11.05% (142/1284), and overall seasonal prevalence of disease was 14.33% (92/642) and 7.78% (50/642) for dry and wet seasons, respectively. There was a statistically significant difference (P <0.05) in disease prevalence between the two seasons. Trypanosomacongolensewas the dominant parasite species; 80% and 71.64%, followed by Trypanosomavivax. Overall mean packed cell volume indicated parasitaemic animals (23.57±3.13) had significantly lower PCV than aparasitaemic animals (27.80±4.95), and animals examined during dry season (26.22±4.37) had lower mean PCV than animals examined during wet season with the significant association. Entomological study result revealed a total of 2.64 F/T/D and 2.03 F/T/D respectively from tsetse suppression areas and tsetse non-suppression areas during dry season and 0.42 F/T/D and 0.56 F/T/D during the wet season. Glossinapallidipes was the only cyclical vectors collected and identified from current study areas along with numerous mechanical vectors of genus Tabanus, Stomoxys, and Haematopota. Therefore integrated and safe control and prevention effort should be engaged to uphold cattle production and productivity in the area.

Keywords: bovine trypanosomiasis, South Omo, tsetse fly density, epidemiological study

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636 Clinical Outcomes After Radiological Management of Varicoceles

Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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635 A Retrospective Study of Pain Management Strategies for Pediatric Hypospadias Surgery in a Tertiary Care Hospital in Western Rajasthan

Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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634 Mitigation of Profitable Problems: Level of Hotel Quality Management Program and Environmental Management Practices Towards Performance

Authors: Siti Anis Nadia Abu Bakar, Vani Tanggamani

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Over recent years, the quality and environmental management practices are the necessary tasks in hospitality industry in order to provide high quality services, a comfortable and safe environment for occupants as well as innovative nature and shareholders' satisfaction, its environmental and social added value sustainable. Numerous studies have observed and measured quality management program (QMProg) and environmental management practices (EMPrac) independently. This paper analyzed the level of QMProg, and EMPrac in hospitality industry, particularly on hotel performance, specifically in the context of Malaysia as hotel industry in Malaysia has contributed tremendously to the development in the Malaysia tourism industry.The research objectives are; (1) to analyze how the level of QMProg influences on firm performance; (2) to investigate the level of EMPrac and its influence on firm performance. This paper contributes to the literature by providing added-value to the service industry strategic decision-making processes by helping to predict the varying impacts of positive and negative corporate social responsibility (CSR) activities on financial performance in their respective industries. Further, this paper also contributes to develop more applicable CSR strategies. As a matter of fact, the findings of this paper has contributed towards an integrated management system that will assist a firm in implementation of their environmental strategy by creating a higher level of accountability for environmental performance. The best results in environmental systems have instigated managers to explore more options when dealing with problems, especially problems involving the reputation of their hotel. In conclusion, the results of the study infer that the best CSR strategies of the quality and environmental management practices influences hotel performance.

Keywords: corporate social responsibility (CSR), environmental management practices (EMPrac), performance (PERF), quality management program (QMProg)

Procedia PDF Downloads 364
633 Design of Sustainable Concrete Pavement by Incorporating RAP Aggregates

Authors: Selvam M., Vadthya Poornachandar, Surender Singh

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These Reclaimed Asphalt Pavement (RAP) aggregates are generally dumped in the open area after the demolition of Asphalt Pavements. The utilization of RAP aggregates in cement concrete pavements may provide several socio-economic-environmental benefits and could embrace the circular economy. The cross recycling of RAP aggregates in the concrete pavement could reduce the consumption of virgin aggregates and saves the fertile land. However, the structural, as well as functional properties of RAP-concrete could be significantly lower than the conventional Pavement Quality Control (PQC) pavements. This warrants judicious selection of RAP fraction (coarse and fine aggregates) along with the accurate proportion of the same for PQC highways. Also, the selection of the RAP fraction and its proportion shall not be solely based on the mechanical properties of RAP-concrete specimens but also governed by the structural and functional behavior of the pavement system. In this study, an effort has been made to predict the optimum RAP fraction and its corresponding proportion for cement concrete pavements by considering the low-volume and high-volume roads. Initially, the effect of inclusions of RAP on the fresh and mechanical properties of concrete pavement mixes is mapped through an extensive literature survey. Almost all the studies available to date are considered for this study. Generally, Indian Roads Congress (IRC) methods are the most widely used design method in India for the analysis of concrete pavements, and the same has been considered for this study. Subsequently, fatigue damage analysis is performed to evaluate the required safe thickness of pavement slab for different fractions of RAP (coarse RAP). Consequently, the performance of RAP-concrete is predicted by employing the AASHTO-1993 model for the following distresses conditions: faulting, cracking, and smoothness. The performance prediction and total cost analysis of RAP aggregates depict that the optimum proportions of coarse RAP aggregates in the PQC mix are 35% and 50% for high volume and low volume roads, respectively.

Keywords: concrete pavement, RAP aggregate, performance prediction, pavement design

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632 Subsurface Exploration for Soil Geotechnical Properties and its Implications for Infrastructure Design and Construction in Victoria Island, Lagos, Nigeria

Authors: Sunday Oladele, Joseph Oluwagbeja Simeon

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Subsurface exploration, integrating methods of geotechnics and geophysics, of a planned construction site in the coastal city of Lagos, Nigeria has been carried out with the aim of characterizing the soil properties and their implication for the proposed infrastructural development. Six Standard Penetration Tests (SPT), fourteen Dutch Cone Penetrometer Tests (DCPT) and 2D Electrical Resistivity Imaging employing Dipole-dipole and Pole-dipole arrays were implemented on the site. The topsoil (0 - 4m) consists of highly compacted sandy lateritic clay(10 to 5595Ωm) to 1.25m in some parts and dense sand in other parts to 5.50m depth. This topsoil was characterized as a material of very high shear strength (≤ 150kg/m2) and allowable bearing pressure value of 54kN/m2 to 85kN/m2 and a safety factor of 2.5. Soft amorphous peat/peaty clay (0.1 to 11.4Ωm), 3-6m thick, underlays the lateritic clay to about 18m depth. Grey, medium dense to very dense sand (0.37 to 2387Ωm) with occasional gravels underlies the peaty clay down to 30m depth. Within this layer, the freshwater bearing zones are characterized by high resistivity response (83 to 2387Ωm), while the clayey sand/saline water intruded sand produced subdued resistivity output (0.37 to 40Ωm). The overall ground-bearing pressure for the proposed structure would be 225kN/m2. Bored/cast-in-place pile at 18.00m depth with any of these diameters and respective safe working loads 600mm/1,140KN, 800mm/2,010KN and 1000mm/3,150KN is recommended for the proposed multi-story structure.

Keywords: subsurface exploration, Geotechnical properties, resistivity imaging, pile

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631 Development of Muay Thai Competition Management for Promoting Sport Tourism in the next Decade (2015-2024)

Authors: Supasak Ngaoprasertwong

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The purpose of this research was to develop a model for Muay Thai competition management for promoting sport tourism in the next decade. Moreover, the model was appropriately initiated for practical use. This study also combined several methodologies, both quantitative research and qualitative research, to entirely cover all aspects of data, especially the tourists’ satisfaction toward Muay Thai competition. The data were collected from 400 tourists watching Muay Thai competition in 4 stadiums to create the model for Muay Thai competition to support the sport tourism in the next decade. Besides, Ethnographic Delphi Futures Research (EDFR) was applied to gather the data from certain experts in boxing industry or having significant role in Muay Thai competition in both public sector and private sector. The first step of data collection was an in-depth interview with 27 experts associated with Muay Thai competition, Muay Thai management, and tourism. The second step and the third step of data collection were conducted to confirm the experts’ opinions toward various elements. When the 3 steps of data collection were completely accomplished, all data were assembled to draft the model. Then the model was proposed to 8 experts to conduct a brainstorming to affirm it. According to the results of quantitative research, it found that the tourists were satisfied with personnel of competition at high level (x=3.87), followed by facilities, services, and safe high level (x=3.67). Furthermore, they were satisfied with operation in competition field at high level (x=3.62).Regarding the qualitative methodology including literature review, theories, concepts and analysis of qualitative research development of the model for Muay Thai competition to promote the sport tourism in the next decade, the findings indicated that there were 2 data sets as follows: The first one was related to Muay Thai competition to encourage the sport tourism and the second one was associated with Muay Thai stadium management to support the sport tourism. After the brain storming, “EE Muay Thai Model” was finally developed for promoting the sport tourism in the next decade (2015-2024).

Keywords: Muay Thai competition management, Muay Thai sport tourism, Muay Thai, Muay Thai for sport tourism management

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630 Development of Clinical Nursing Practice Guideline to Prevent Infection During Intubation in Suspected or Confirmed Covid-19 Patients

Authors: Sarinra Thongmee, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk, Krittaphon Prakobsaeng

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The purposes of this research and development was to develop and evaluation of clinical nursing practice guideline (CNPG) for the prevention of infection during intubation in patient withsuspected or confirmedCOVID-19 patient. This study was developed by using the evidence based practice model of Soukup (2000) as a conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patients with confirmed COVID-19, 2) development the CNPG, 3) apply the NPG to trial, and 4) evaluation of the NPG. Thesample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) CNPG, 2) the nurses anesthetist opinion questionnaire to the guideline, 3) the evaluation practice form, and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results found that this developed NPG consists of 4 sections: 1) NPG for Preventing Airborne Infection Prevention2) preparation of anesthetic and intubation equipments 3) roles and duties of the intubation team 4) guidelines for intubation in suspected or confirmed COVID-19patients. The result found that 1) provider: using NPG in providers revealed that nurse anesthetist had higher mean of knowledge scores than before using NPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% in all activities. The anesthetic team was not infected with COVID-19from intubation outside operating room.2) Client: the patient was safe, no complications from intubation. Summary CNPG to prevent infection in intubation of suspected or confirmedCOVID-19 patient was appropriate and applicable to practice.

Keywords: nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

Procedia PDF Downloads 133
629 Right Cerebellar Stroke with a Right Vertebral Artery Occlusion Following an Embolization of the Right Glomus Tympanicum Tumor

Authors: Naim Izet Kajtazi

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Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

Procedia PDF Downloads 63