Search results for: safe grade elevation

Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

Procedia PDF Downloads 158

Authors: Nurcan Tugrul, Funda Demir, Hilal Ozkan, Nur Olgun, Emek Derun

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Geopolymers are aluminosilicate-containing materials. The raw materials of the geopolymerization can be natural material such as kaolinite, metakaolin (calcined kaolinite), clay, diatomite, rock powder or can also be industrial by-products such as fly ash, silica fume, blast furnace slag, rice-husk ash, mine tailing, red mud, waste slag, etc. Reactivity of raw materials in geopolymer production is very important for achieving high reaction grade. Fly ash used in geopolymer production has been calcined to obtain tetrahedral SiO₂ and Al₂O₃ structures. In this study, fly ash calcined at different temperatures (700, 800 and 900 °C), and Al₂O₃ addition (Al₂O₃ at min (0%) and max (100%)) were used to produce geopolymers. HCl dissolution method was applied to determine the geopolymerization percentage of samples and Fourier Transform Infrared (FTIR) Spectroscopy was used to find out the optimum calcination temperature for geopolymerization. According to obtained results, the highest geopolymerization percentage (0% alumina added geopolymer equal to 35.789%; 100% alumina added geopolymer equal to 40.546%) was obtained in samples using fly ash calcined at 800 °C.

Keywords: geopolymer, fly ash, Al₂O₃ addition, calcination

Procedia PDF Downloads 171

Authors: Shivani Jha, Klaus Baier, Rafiq Azzam, Ramakar Jha

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In India, generally people migrate from rural area to the urban area for better infra-structural facilities, high standard of living, good job opportunities and advanced transport/communication availability. In fact, unplanned urban development due to migration of people causes seriou damage to the land use, water pollution and available water resources. In the present work, an attempt has been made to use satellite data of different years for urban change detection of Chennai metropolitan city along with pattern analysis to generate future scenario of urban development using buffer zoning in GIS environment. In the analysis, SRTM (30m) elevation data and IRS-1C satellite data for the years 1990, 2000, and 2014, are used. The flow accumulation, aspect, flow direction and slope maps developed using SRTM 30 m data are very useful for finding suitable urban locations for industrial setup and urban settlements. Normalized difference vegetation index (NDVI) and Principal Component Analysis (PCA) have been used in ERDAS imagine software for change detection in land use of Chennai metropolitan city. It has been observed that the urban area has increased exponentially in Chennai metropolitan city with significant decrease in agriculture and barren lands. However, the water bodies located in the study regions are protected and being used as freshwater for drinking purposes. Using buffer zone analysis in GIS environment, it has been observed that the development has taken place in south west direction significantly and will do so in future.

Keywords: urban change, satellite data, the Chennai metropolis, change detection

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Authors: Aminul Haque, Quazi Zahangir Hossain, Dilshad Sharmin Chowdhury

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The human migration is getting growing concern around the world, and recurrent disasters and climate change impact have great influence on migration. Bangladesh is one of the disaster prone countries that/and has greater susceptibility to stress migration by recurrent disasters and climate change. The study was conducted to investigate the factors that have a strong influence on current migration and changing pattern of life and livelihood means of the southwest coastal part of Bangladesh. Moreover, the study also revealed a strong relationship between disasters and migration and appropriate policy concern. To explore this relation, both qualitative and quantitative methods were applied to a questionnaire survey at household level and simple random sampling technique used in the sampling process along with different secondary data sources for understanding policy concern and practices. The study explores the most influential driver of migration and its relationship with social, economic and environmental drivers. The study denotes that, the environmental driver has a greater effect on the intention of permanent migration (t=1.481, p-value=0.000) at the 1 percent significance level. The significant number of respondents denotes that abrupt pattern of cyclone, flood, salinity intrusion and rainfall are the most significant environmental driver to make a decision on permanent migration. The study also found that the temporary migration pattern has 2-fold increased compared to last ten (10) years. It also appears from the study that environmental factors have a great implication on the changing pattern of the occupation of the study area and it has reported that about 76% of the respondent now in the changing modality of livelihood compare to their traditional practices. The study bares that the migration has foremost impact on children and women by increasing hardship and creating critical social security. The exposure-route of permanent migration is not smooth indeed, these migrations creating urban and conflict in Chittagong hill tracks of Bangladesh. The study denotes that there is not any safeguard of the stress migrant on existing policy and not have any measures for safe migration and resettlement rather considering the emergency response and shelter. The majority of (98%) people believes that migration is not to be the adoption strategies, but contrary to this young group of respondent believes that safe migration could be the adaptation strategy which could bring a positive result compare to the other resilience strategies. On the other hand, the significant number of respondents uttered that appropriate policy measure could be an adaptation strategy for being the formation of a resilient community and reduce the migration by meaningful livelihood options with appropriate protection measure.

Keywords: environmental driver, livelihood, migration, resilience

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Authors: Petr Homola, Roman Růžek

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Laser beam micro-drilling (LBMD) is one of the most important non-contact machining processes of materials that are difficult to machine by means oeqf conventional machining methods used in various industries. The paper is focused on LBMD knock-down effect on Ti-6Al-4V (Grade 5) titanium alloy sheets properties. Two various process configurations were verified with a focus on laser damages in back-structure parts affected by the process. The effects of the LBMD on the material properties were assessed by means of tensile and fatigue tests and fracture surface analyses. Fatigue limit of LBMD configurations reached a significantly lower value between 15% and 30% of the static strength as compared to the reference raw material with 58% value. The farther back-structure configuration gives a two-fold fatigue life as compared to the closer LBMD configuration at a given stress applied.

Keywords: fatigue, fracture surface, laser beam micro-drilling, titanium alloy

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Authors: Yunita Ratih Wijayanti, Dwi Rahmawati, Turniningtyas Ayu Rahmawati

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Gresik is one of the districts in East Java Province, Indonesia. Gresik Regency has three major rivers, namely Bengawan Solo River, Brantas River, and Lamong River. Lamong River is a tributary of Bengawan Solo River. Flood disasters that occur in Gresik Regency are often caused by the overflow of the Lamong River. The losses caused by the flood were very large and certainly detrimental to the affected people. Therefore, to be able to minimize the impact caused by the flood, it is necessary to take preventive action. However, before taking preventive action, it is necessary to have information regarding potential inundation areas and water levels at various points. For this reason, a flood simulation model is needed. In this study, the simulation was carried out using the Geographic Information System (GIS) method with the help of Global Mapper software. The approach used in this simulation is to use a topographical approach with Digital Elevation Models (DEMs) data. DEMs data have been widely used for various researches to analyze hydrology. The results obtained from this flood simulation are the distribution of flood inundation and water level. The location of the inundation serves to determine the extent of the flooding that occurs by referring to the 50-100 year flood plan, while the water level serves to provide early warning information. Both will be very useful to find out how much loss will be caused in the future due to flooding in Gresik Regency so that the Gresik Regency Regional Disaster Management Agency can take precautions before the flood disaster strikes.

Keywords: flood hazard, simulation model, potential inundation, global mapper, Gresik Regency

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Authors: M. K. Deore

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The thick films of undoped and Al2O3 doped- ZnO were prepared by screen printing technique. AR grade (99.9 % pure) Zinc Oxide powder were mixed mechanochemically in acetone medium with Aluminium Chloride (AlCl2) material in various weight percentages such as 0.5, 1, 3 and 5 wt % to obtain Al2O3 - ZnO composite. The prepared materials were sintered at 1000oC for 12h in air ambience and ball milled to ensure sufficiently fine particle size. The electrical, structural and morphological properties of the films were investigated. The X-ray diffraction analysis of pure and doped ZnO shows the polycrystalline nature. The surface morphology of the films was studied by SEM. The final composition of each film was determined by EDAX analysis. The gas response of undoped and Al2O3- doped ZnO films were studied for different gases such as CO, H2, NH3, and H2S at operating temperature ranging from 50 oC to 450 o C. The pure film shows the response to H2S gas (500ppm) at 300oC while the film doped with 3 wt.% Al2O3 gives the good response to H2S gas(ppb) at 350oC. The selectivity, response and recovery time of the sensor were measured and presented.

Keywords: thick films, ZnO-Al2O3, H2S gas, sensitivity, selectivity, response and recovery time

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Authors: Ajay Kadam, Ramesh Kagalkar

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The proposed research objective is to add to a framework for programmed recognition of sound. In this framework the real errand is to distinguish any information sound stream investigate it & anticipate the likelihood of diverse sounds show up in it. To create and industrially conveyed an adaptable sound web crawler a flexible sound search engine. The calculation is clamor and contortion safe, computationally productive, and hugely adaptable, equipped for rapidly recognizing a short portion of sound stream caught through a phone microphone in the presence of frontal area voices and other predominant commotion, and through voice codec pressure, out of a database of over accessible tracks. The algorithm utilizes a combinatorial hashed time-recurrence group of stars examination of the sound, yielding ordinary properties, for example, transparency, in which numerous tracks combined may each be distinguished.

Keywords: fingerprinting, pure tone, white noise, hash function

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Authors: C. C. Kruger, P. Van Tonder

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Concrete deteriorates over time and the deterioration can be escalated due to multiple factors. When deteriorations are beneath the concrete’s surface, they could be unknown, even more so when they are located at high elevations. Establishing the severity of such defects could prove difficult and therefore the need to find efficient, safe and economical methods to find these defects becomes ever more important. Current methods using thermography to find defects require equipment such as scaffolding to reach these higher elevations. This could become time- consuming and costly. The risks involved with personnel scaffold or abseil to such heights are high. Accordingly, by combining the technologies of a thermal camera and a Remotely Piloted Aerial System it could be used to find better diagnostic methods. The data could then be constructed into a 3D thermal model to easy representation of the results

Keywords: concrete, infrared thermography, 3D thermal models, diagnostic

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Authors: Florin Leon

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This paper describes a simulator of traffic scenarios tailored to facilitate autonomous driving model training for urban environments. With the rising prominence of self-driving vehicles, the need for diverse datasets is very important. The proposed simulator provides a flexible framework that allows the generation of custom scenarios needed for the validation and enhancement of trajectory prediction algorithms. Its controlled yet dynamic environment addresses the challenges associated with real-world data acquisition and ensures adaptability to diverse driving scenarios. By providing an adaptable solution for scenario creation and algorithm testing, this tool proves to be a valuable resource for advancing autonomous driving technology that aims to ensure safe and efficient self-driving vehicles.

Keywords: autonomous driving, car simulator, machine learning, model training, urban simulation environment

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Authors: Aman Patidar, Dipankar Sarkar, Manish Pal

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Due to rapid development, increase in the traffic load, higher traffic volume and seasonal variation in temperature, asphalt pavement shows distresses like rutting, fatigue and thermal cracking etc. because of this pavement fails during service life so that bitumen needs to be modified with some additive. In this study VG30 grade bitumen modify with addition of nanosilica with 1% to 5% (increment of 1%) by weight of bitumen. Hot mix asphalt (HMA) have higher mixing, laying and rolling temperatures which leads to higher consumption of fuel. To address this issue, a nano material named ZycoTherm which is chemical warm mix asphalt (WMA) additive is added to bitumen. Nanosilica modification (NSMB) results in the increase in stability compared to unmodified bitumen (UMB). WMA modified mix shows slightly higher stability than UMB and NSMB in a lower bitumen content. The Retained stability and tensile strength ratio (TSR) is more than 75% and 80% respectively for both mixes. Nanosilica with WMA has more resistant to temperature susceptibility, moisture susceptibility and short term aging than NSMB.

Keywords: HMA, nanosilica, NSMB, temperature, TSR, UMB, WMA

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Authors: Zubair Ahmad

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Specific activities of the natural radionuclides 238U, 232Th and 40K were measured by using γ - ray spectrometric technique in soil samples collected from the city of Dhanbad, which is located near coal mines. Mean activity values for 238U, 232Th and 40K were found to be 60.29 Bq/kg, 64.50 Bq/kg and 481.0 Bq/kg, respectively. Mean radium equivalent activity, absorbed dose rate, outdoor dose, external hazard index, internal hazard index, for the area under study were determined as 189.53 Bq/kg, 87.21 nGy/h, 0.37 mSv/y, 0.52 and 0.64, respectively. The annual effective dose to the general public was found 0.44 mSv/y. This value lies well below the limit of 1 mSv/y as recommended by International Commission on Radiological Protection. Measured values were found safe for environment and public health.

Keywords: coal city Dhanbad, gamma-ray spectroscopy, natural radioactivity, soil samples

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Authors: Palwinder Singh

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Beyond the conventional mode of working with anti-inflammatory agents through enzyme inhibition, herein, an alternate substrate of cyclooxygenase-2 was developed. Proline centered pentapeptide iso-conformational to arachidonic acid exhibited appreciable selectivity for COX-2 overcoming acetic acid and formalin induced pain in rats to almost 80% and was treated as a substrate by the enzyme. Remarkably, COX-2 metabolized the pentapeptide into small fragments consisting mainly of di- and tri-peptides that ensured the safe breakdown of the peptide under in-vivo conditions. The kinetic parameter Kcat/Km for COX-2 mediated metabolism of peptide 6.3 x 105 M-1 s-1 was quite similar to 9.5 x 105 M-1 s-1 for arachidonic acid. Evidenced by the dynamic molecular studies and the use of Y385F COX-2, it was observed that the breakage of the pentapeptide has probably taken place through H-bond activation of the peptide bond by the side chains of Y385 and S530.

Keywords: small peptides, anti-inflammatory agents, cyclooxygenase-2, unnatural substrates

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Authors: Barbara Montwill

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The last three decades of continuing increase in the farming of aquatic animals worldwide placed a biosecurity in a different perspective. An introduction of new countries, technologies, species to aquaculture, increased movement of animals are a few factors the might be associated with biosecurity risks. Most farms depend on trade for various inputs such as broodstock, post-larvae/fingerlings and feed. These inputs represent potential pathways by which pathogens can enter farming operations and create conditions for emergence of new or reoccurrence of diseases and production loses. Farm biosecurity should be considered an essential component of a national aquatic animal biosecurity program and together with adequate import and export controls can lead to the development of successful aquaculture industry as a reliable source of safe seafood product. This presentation would describe some biosecurity management approaches to minimize the negative impact of aquatic diseases on production and preserve the power of antibiotics.

Keywords: aquaculture, biosecurity, antibiotics, antibiotics residues

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Authors: Martina Holenko Dlab, Natasa Hoic-Bozic, Ivica Boticki

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This paper presents technologically innovative and scalable mobile learning solution within the SCOLLAm project (“Opening up education through Seamless and COLLAborative mobile learning on tablet computers”). The main research method applied during the development of the SCOLLAm mobile learning system is design-based research. It assumes iterative refinement of the system guided by collaboration between researches and practitioners. Following the identification of requirements, a multiplatform mobile learning system SCOLLAm [in]Form was developed. Several experiments were designed and conducted in the first and second grade of elementary school. SCOLLAm [in]Form system was used to design learning activities for math classes during which students practice calculation. System refinements were based on experience and interaction data gathered during class observations. In addition to implemented improvements, the data were used to outline possible improvements and deficiencies of the system that should be addressed in the next phase of the SCOLLAm [in]Form development.

Keywords: adaptation, collaborative learning, educational technology, mobile learning, tablet computers

Procedia PDF Downloads 263

Authors: Sherif A. Abu El-Magd, Ahmed M. Sefelnasr, Ahmed M. Masoud

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Groundwater modeling is the way and tool for assessing and managing groundwater resources efficiently. The present work was carried out in the ancient Egyptian archeological site (Abydos) fromDynastyIandII.Theareaislocated about 13km west of the River Nilecourse, Upper Egypt. The main problem in this context is that the ground water level rise threatens and damages fragile carvings and paintings of the ancient buildings. The main objective of the present work is to identify the sources of the groundwater recharge in the site, further more, equally important there is to control the ground water level rise. Numerical modeling combined with field water level measurements was implemented to understand the ground water recharge sources. However, building a conceptual model was an important step in the groundwater modeling to phase to satisfy the modeling objectives. Therefore, boreholes, crosssections, and a high-resolution digital elevation model were used to construct the conceptual model. To understand the hydrological system in the site, the model was run under both steady state and transient conditions. Then, the model was calibrated agains the observation of the water level measurements. Finally, the results based on the modeling indicated that the groundwater recharge is originating from an indirect flow path mainly from the southeast. Besides, there is a hydraulic connection between the surface water and groundwater in the study site. The decision-makers and archeologyists could consider the present work to understand the behavior of groundwater recharge and water table level rise.

Keywords: numerical modeling, archeological site, groundwater recharge, egypt

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Authors: S. J. Yune, K. H. Park

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The purpose of this study was to examine the validity of the research process for enhancing the humanities competence of the medical students. The research process was developed to be operated as a core subject course of 3 semesters. Among them, the research process for enhancing humanities capacity consisted of humanities and societies (6 teams) and education-psychology (2teams). The subjects of this study were 88-second grade students and 22 professors who participated in the research process. Among them, 13 professors participated in the study of humanities and 37 students. In the validity test, the professors were more likely to have more validity in the research process than the students in all areas of logic (p = .001), influence (p = .037), process (p = .001). The validity of the professor was higher than that of the students. The professors highly evaluated the students' learning outcomes and showed the most frequency to the prize group. As a result of analyzing the agreement between the students and the professors through the Kappa coefficient, the agreement degree of communication and cooperation competence was moderate to .430. Problem-solving ability was .340, which showed a fair degree of agreement. However, other factors showed only a slight degree of agreement of less than .20.

Keywords: research process, medical school, humanities competence, validity verification

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Authors: Muhammad Mooneeb Ali

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Institutions, where religious knowledge is given are known as madrassas. They also give formal education along with religious education. This study will be a pioneer to explore if MALL can be beneficial for madrassa students or not in formal educational situations. For investigation, an experimental study was planned in Punjab where the sample size was 100 students, 10 each from 10 different madrassas of Punjab, who are studying at the intermediate level (i.e., 11th grade). The madrassas were chosen through a convenient sampling method, whereas the learners were chosen by a simple random sampling method. A pretest was conducted, and on the basis of the results, the learners were divided into two equal groups (experimental and controlled). After two months of treatment, a posttest was conducted, and the results of both groups were compared. The results indicated that the performance of the experimental group was significantly better than the control one. This indicates that MALL elevates the performance of Madrassa students.

Keywords: english language learners, madrassa students, formal education, mobile assisted language learning (MALL), Pakistan.

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Authors: Hua Tan, David Salamon

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In this study, γ-Al2O3 powders doped with various amounts of iron were sintered via SPS process. Two heating modes – auto and manual mode were applied to observe the role of electrical induction on heating. Temperature, electric current, and pulse pattern were experimented with grade iron γ-Al2O3 powders. Phase transformation of γ to α -Al2O3 serves as a direct indicator of internal temperature, independently on measured outside temperature. That pulsing in SPS is also able to induce internal heating due to its strong electromagnetic field when dopants are conductive metals (e.g., iron) is proofed during SPS. Density and microstructure were investigated to explain the mechanism of induction heating. In addition, the role of electric pulsing and strong electromagnetic field on internal heating (induction heating) were compared and discussed. Internal heating by iron doping within electrically nonconductive samples is able to decrease sintering temperature and save energy, furthermore it is one explanation for unique features of this material fabrication technology.

Keywords: spark plasma sintering, induction heating, alumina, microstructure

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Authors: Driss Haddouche

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Pastoral crisis in Algeria has its origins in rangeland degradation which are the main factor in any activity in the steppe zones. Indeed, faced with the increasing human and animal population on a living space smaller and smaller, there is an overuse of what remains of the steppe range lands, consequently the not sustainability of biomass production. Knowing the amount of biomass available, the practice of grazing options, taking into account the use of "Use Factor" factor remains an essential method for managing pastoral resources. This factor has three options: at 40% Conservative pasture; at 60 % the beginning of overgrazing; at 80% destructive grazing. Accessibility on the pasture is based on our field observations of a type any flock along a grazing cycle. The main purpose of these observations is to highlight the speed of herd grazing situation. Several individuals from the herd were timed to arrive at an average duration of about 5 seconds to move between two tufts of grass, separated by a distance of one meter. This gives a rate of 5 s/m (0.72 km/h) flat. This speed varies depending on the angle of the slope. Knowing the speed and slope of each pixel of the study area, given by the digital elevation model of Spot Image (MNE) and whose pitch is 15 meters, a map of pasture according to the distances is generated. Knowing the stocking and biomass available, the examination of the common Mécheria at regular distances (8.64 km or 12 hours of grazing, 17.28 km or 24 hours of grazing and 25.92 Km or 36 hours of grazing), offers three different options (conservation grazing resource: utilization at 40%; overgrazing statements for use at 60% and grazing destructive for use by more than 80%) for each distance traveled by sheep from the starting point is the town of Mécheria.

Keywords: pastoral crisis, biomass, animal charge, use factor, Algeria

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Authors: Ayoub. El Bourtali, Abdessamed.Najine, Amrou Moussa. Benmoussa

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One of the main goals of river engineering is river training, which is defined as controlling and predicting the behavior of a river. It is taking effective measurements to eliminate all related risks and thus improve the river system. In some rivers, the riverbed continues to erode and degrade; therefore, equilibrium will never be reached. Generally, river geometric characteristics and riverbed erosion analysis are some of the most complex but critical topics in river engineering and sediment hydraulics; riverbank erosion is the second answering process in hydrodynamics, which has a major impact on the ecological chain and socio-economic process. This study aims to integrate the new computer technology that can analyze erosion and hydraulic problems through computer simulation and modeling. Choosing the right model remains a difficult and sensitive job for field engineers. This paper makes use of the 5.0.4 version of the HEC-RAS model. The river section is adopted according to the gauged station and the proximity of the adjustment. In this work, we will demonstrate how 2D hydraulic modeling helped clarify the design and cover visuals to set up depth and velocities at riverbanks and throughout advanced structures. The hydrologic engineering center's-river analysis system (HEC-RAS) 2D model was used to create a hydraulic study of the erosion model. The geometric data were generated from the 12.5-meter x 12.5-meter resolution digital elevation model. In addition to showing eroded or overturned river sections, the model output also shows patterns of riverbank changes, which can help us reduce problems caused by erosion.

Keywords: 2D hydraulics model, erosion, floodplain, hydrodynamic, HEC-RAS, riverbed erosion, river morphology, resolution digital data, sediment

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Authors: Vasudha Govil, Suresh Singhal

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Introduction: Patients with oropharyngeal masses pose a challenge for an anaesthetist in terms of ventilation and tracheal intubation. Thus, preoperative assessment and preparation become an integral part of managing such anticipated difficult airway cases. Case report: A 45- year old female presented with growth in the oropharynx causing dysphagia and hoarseness of voice. Clinical examination and investigations predicted a difficult airway. It was managed with fibreoptic nasotracheal intubation with a successful perioperative outcome. Tracheostomy was kept as plan B in case of the CVCI situation. Conclusion: Careful preoperative examination and assessment is required to prepare oneself for difficult airway. Fibreoptic bronchoscope-guided nasotracheal intubation in a spontaneously breathing patient is a safe and successful airway management technique in difficult airway cases.

Keywords: airway, difficult, mass, oropharyngeal

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Authors: Lazgeen Mohammed

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The greatest advantage of acupuncture over western medicine is that it is safe . Unlike synthetic drugs, acupuncture has virtually no side effects, and the procedures for treating headaches are much less invasive. Migraine headaches are usually one-sided, pulsating or throbbing, and moderate or severe in intensity.. Some patients also experience auras, a neurological symptom that develops gradually over 5-20 minutes. The patient may see brief flashes or waves of light, or changes in their vision. Other common features of auras include vertigo, imbalance, confusion and numbness.Acupuncture had been used to treat 50 patients suffering from migraine ,topiramat (topamax) given to prevent the attacks, duration of treatment is 10 weeks , the patients were fallowed up for one year .Topiramat is called an anticonvulsant.Topiramat is also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. This medicine will only prevent migraine headaches or reduce the number of attacks. It will not treat a headache that has already begun.

Keywords: acpuncture, migraine, topiramat, headache

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: M. Jamuna Rani, K. Ramanathan

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A steam power plant is housed with various types of equipments like boiler, turbine, heat exchanger etc. These equipments are mainly connected with piping systems. Such a piping layout design depends mainly on stress analysis and flexibility. It will vary with respect to pipe geometrical properties, pressure, temperature, and supports. The present paper is to analyze the presence and effect of hangers and expansion joints in the piping layout/routing using CAESAR-II software. Main aim of piping stress analysis is to provide adequate flexibility for absorbing thermal expansion, code compliance for stresses and displacement incurred in piping system. The design is said to be safe if all these are in allowable range as per code. In this study, a sample problem is considered for analysis as per power piping ASME B31.1 code and the results thus obtained are compared.

Keywords: ASTM B31.1, hanger, expansion joint, CAESAR-II

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Authors: Bandar Alahmadi

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The fact that people tend to remember pictures better than texts, motivates researchers to develop graphical passwords as an alternative to textual passwords. Graphical passwords as such were introduced as a possible alternative to traditional text passwords, in which users prove their identity by clicking on pictures rather than typing alphanumerical text. In this paper, we present a scheme for graphical passwords that are resistant to shoulder surfing attacks and spyware attacks. The proposed scheme introduces a clicking technique to chosen images. First, the users choose a set of images, the images are then included in a grid where users can click in the cells around each image, the location of the click and the number of clicks are saved. As a result, the proposed scheme can be safe from shoulder surface and spyware attacks.

Keywords: security, password, authentication, attack, applications

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Authors: Nidhi Gadura

Abstract:

To ensure student success in a non majors biology course, a flipped classroom pedagogical approach is developed and implemented. All students are assigned online lectures to listen to before they come to class. A three hour lecture is split into one hour of online component, one hour of in class lecture and one hour of worksheets done by students in the classroom. This deviation from a traditional 3 hour in class lecture has resulted in increased student interest in science as well as better understanding of difficult scientific concepts. A pre and post survey was given to measure the interest rates and grades were used to measure the success rates. While the overall grade average did not change dramatically, students reported a better appreciation of biology. Also, students overwhelmingly like the use of worksheets in class to help them understand the concepts. They liked the fact that they could listen to lectures at their own pace on line and even repeat if needed. The flipped classroom approach turned out to work really well our non science majors and the author is ready to implement this in other classrooms.

Keywords: flipped classroom, non science majors, pedagogy, technological pedagogical model

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Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira

Abstract:

This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.

Keywords: neurology, intracranial pressure, medical education, simulation

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Authors: A-Reum Shin, Heon-Seock Cynn, Ji-Hyun Lee, Da-Eun Kim

Abstract:

Round shoulder posture (RSP) is a position of scapular protraction and elevation, which may appear as scapular winging, and humeral internal rotation. Flexed posture (FP) may also affect RSP because FP is characterized by hyperkyphosis, forward head posture, and height reduction. The aim of this study was to investigate the effect of scapular posterior tilting exercise with prone trunk extension on round shoulder posture, activities of lower trapezius and serratus anterior, flexed posture, and thoracic erector spinae activity in subjects with round shoulder posture. Fifteen subjects with round shoulder posture were recruited in this study. Activities of lower trapezius, serratus anterior and thoracic erector spinae were measured during both scapular posterior tilting exercise and scapular posterior tilting exercise with prone trunk extension using electromyography, and round shoulder posture and flexed posture were measured immediately after each exercises using caliper. When the prone trunk extension was applied, the round shoulder posture and flexed posture significantly decreased, activities of lower trapezius and thoracic erector spinae significantly increased (p < 0.05) compared with the scapular posterior tilting exercise alone. There was no significant difference in serratus anterior activity between two exercises. Thus, prone trunk extension could be effective method to improve round shoulder posture during scapular posterior tilting exercise in subjects with round shoulder posture.

Keywords: flexed posture, prone trunk extension, round shoulder posture, scapular posterior tilting

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Authors: Husham Bayazed

Abstract:

Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.

Keywords: immunity, metabolic disorders, cancer, COVID-19

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