Search results for: sick building syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4790

Search results for: sick building syndrome

3710 A Preliminary Research on Constituted Rules of Settlement Housing Alterations of Chinese New Village in Malaysia: A Study of Ampang New Village, Selangor

Authors: Song Hung Chi, Lee Chun Benn

Abstract:

Follow by the “A Research on Types of Settlement Housing Alterations of Chinese New Village in Malaysia- A Study in Ampang New Village, Selangor” preliminary informed that the main factors for expansion and enlargement suitably due to the needs of user's life and restoration purpose. The alterations behavior generally derived at the rear position of main house with different types of derivatives, the averages expansion area are not exceeding of 100㎡, while building materials used were wooden, wooden structure, and zinc which are non-permanent building materials. Therefore, a subsequent studies taken in this paper, further to analyze the drawing with summarize method, to explore the derived forms and the constituted rules of housing alterations in Ampang Village, as a more complete presentation of housing alterations in New Village. Firstly, classified the existing housing alterations into three types by using summarize method, which are Type 1, Additional of Prototype House; Type 2, Expansion of Prototype House; and Type 3, Diffusion of Additional. The results shows that the derivative mode of alterations can be divided into the use of "continuous wall" or "non-continuous wall," this will affects the structural systems and roof styles of alterations, and formed the different layers of interior space with "stages" and "continuity". On the aspects of spatial distribution, sacrificial area as a prescriptive function of space, it was mostly remains in the original location which in the center of living area after alterations. It is an important characteristic in a New Village house, reflecting the traditional Ethics of Hakka Chinese communities in the settlement. In addition, wooden as the main building materials of constituted rules for the prototype house, although there were appeared other building materials, such as cement, brick, glass, metal and zinc after alterations, but still mostly as "wooden house" pattern. Result show because of the economy of village does not significantly improve, and also forming the similarity types in alterations and constructions of the additional building with the existing. It did not significantly improve on the quality of living, but only increased the area of usage space.

Keywords: Ampang new village, derived forms, constituted rules, alterations

Procedia PDF Downloads 309
3709 A Case Series on Isolated Lead aVR ST-Segment Elevation Clinical Significance and Outcome

Authors: Fae Princess Bermudez

Abstract:

Background: One of the least significant leads on a 12-lead electrocardiogram is the augmented right lead (aVR), as it is not as specific compared to the other leads. In this case series, the value of lead aVR, which is more often than not ignored, is highlighted. Three cases of aVR ST segment elevation on 12-lead electrocardiogram are described, with the end outcome of demise of all three patients. The importance of immediate revascularization is described to improve prognosis in this group of patients. Objectives: This case series aims to primarily present under-reported cases of isolated aVR ST-segrment elevation myocardial infarction (STEMI), their course and outcome. More specific aims are to identify the criteria in determination of isolated aVR STEMI, know its clinical significance, and determine appropriate management for patients with this ECG finding. Method: A short review of previous studies, case reports, articles and guidelines from 2011-2016 was done. The author reviewed available literature, sorted out those that proved to be significant for the presented cases, and described them in conjunction with the aforementioned cases. Findings: Based on the limited information on these rare or under-reported cases, it was found that isolated aVR STEMI had a poorer prognosis that led to significant mortality and morbidity of patients. The significance of aVR ST-elevation was that of an occlusion of the left coronary artery or a severe three-vessel disease in the presence of an Acute Coronary Syndrome. Guidelines from American Heart Association/American College of Cardiology Foundation in 2013 already recognized ST-elevation of lead aVR in isolation as a STEMI; hence, recommended that patients with this particular ECG finding should undergo reperfusion strategies to improve prognosis. Conclusion: The indispensability of isolated aVR ST-segment elevation on ECG should alert physicians, especially Emergency physicians, to the high probability of Acute Coronary Syndrome with a very poor prognosis. If this group of patients is not promptly managed, demise may ensue, with cardiogenic shock as the most probable cause. With this electrocardiogram finding, physicians must be quick to make clinical decisions to increase chances of survival of this group of patients.

Keywords: AVR ST-elevation, diffuse ST-segment depression, left coronary artery infarction, myocardial infarction

Procedia PDF Downloads 192
3708 The Destruction of Memory: Ataturk Cultural Centre

Authors: Birge Yildirim Okta

Abstract:

This paper aims to narrate the story of Atatürk Cultural Center in Taksim Square, which was demolished in 2018, and discuss its architectonic as a social place of memory and its existence and demolishment as the space of politics. Focusing on the timeline starting from early republican period till today, the paper uses narrative discourse analysis to research Atatürk Cultural Center as a place of memory and a space of politics in its existence. After the establishment of Turkish Republic, one of most important implementation in Taksim Square, reflecting the internationalist style, was the construction of Opera Building in Prost Plan. The first design of the opera building belonged to Aguste Perret, which could not be implemented due to economic hardship during World War II. Later the project was designed by architects Feridun Kip and Rüknettin Güney in 1946 but could not be completed due to 1960 military coup. Later the project was shifted to another architect Hayati Tabanlıoglu, with a change in its function as a cultural center. Eventually, the construction of the building was completed in 1969 in a completely different design. AKM became a symbol of republican modernism not only with its modern architectural style but also with it is function as the first opera building of the republic, reflecting the western, modern cultural heritage by professional groups, artists and the intelligentsia. In 2005, Istanbul’s council for the protection of cultural heritage decided to list AKM as a grade 1 cultural heritage, ending a period of controversy which saw calls for the demolition of the center as it was claimed it ended its useful lifespan. In 2008 the building was announced to be closed for repairs and restoration. Over the following years, the building was demolished piece by piece silently while Taksim mosque has been built just in front of Atatürk Cultural Center. Belonging to the early republican period, AKM was a representation of a cultural production of a modern society for the emergence and westward looking, secular public space in Turkey. Its erasure from Taksim scene under the rule of the conservative government, Justice and Development Party and the construction of Taksim mosque in front of AKM’s parcel is also representational. The question of governing the city through space has always been an important aspect for governments, those holding political power since cities are the chaotic environments that are seen as a threat for the governments, carrying the tensions of proletariat or the contradictory groups. The story of AKM as a dispositive or a regulatory apparatus demonstrates how space itself is becoming a political medium, to transform the socio-political condition. The article aims to discuss the existence and demolishment of Atatürk Cultural Center by discussing the constructed and demolished building as a place of memory and a space of politics.

Keywords: space of politics, place of memory, atatürk cultural center, taksim square

Procedia PDF Downloads 64
3707 Building Information Models Utilization for Design Improvement of Infrastructure

Authors: Keisuke Fujioka, Yuta Itoh, Masaru Minagawa, Shunji Kusayanagi

Abstract:

In this study, building information models of the underground temporary structures and adjacent embedded pipes were constructed to show the importance of the information on underground pipes adjacent to the structures to enhance the productivity of execution of construction. Next, the bar chart used in actual construction process were employed to make the Gantt chart, and the critical pass analysis was carried out to show that accurate information on the arrangement of underground existing pipes can be used for the enhancement of the productivity of the construction of underground structures. In the analyzed project, significant construction delay was not caused by unforeseeable existence of underground pipes by the management ability of the construction manager. However, in many cases of construction executions in the developing countries, the existence of unforeseeable embedded pipes often causes substantial delay of construction. Design change based on uncertainty on the position information of embedded pipe can be also important risk for contractors in domestic construction. So CPM analyses were performed by a project-management-software to the situation that influence of the tasks causing construction delay was assumed more significant. Through the analyses, the efficiency of information management on underground pipes and BIM analysis in the design stage for workability improvement was indirectly confirmed.

Keywords: building-information modelling, construction information modelling, design improvement, infrastructure

Procedia PDF Downloads 293
3706 Effectiveness of Dry Needling with and without Ultrasound Guidance in Patients with Knee Osteoarthritis and Patellofemoral Pain Syndrome: A Systematic Review and Meta-Analysis

Authors: Johnson C. Y. Pang, Amy S. N. Fu, Ryan K. L. Lee, Allan C. L. Fu

Abstract:

Dry needling (DN) is one of the puncturing methods that involves the insertion of needles into the tender spots of the human body without the injection of any substance. DN has long been used to treat the patient with knee pain caused by knee osteoarthritis (KOA) and patellofemoral pain syndrome (PFPS), but the effectiveness is still inconsistent. This study aimed to conduct a systematic review and meta-analysis to assess the intervention methods and effects of DN with and without ultrasound guidance for treating pain and dysfunctions in people with KOA and PFPS. Design: This systematic review adhered to the PRISMA reporting guidelines. The registration number of the study protocol published in the PROSPERO database was CRD42021221419. Six electronic databases were searched manually through CINAHL Complete (1976-2020), Cochrane Library (1996-2020), EMBASE (1947-2020), Medline (1946-2020), PubMed (1966-2020), and Psychinfo (1806-2020) in November 2020. Randomized controlled trials (RCTs) and controlled clinical trials were included to examine the effects of DN on knee pain, including KOA and PFPS. The key concepts included were: DN, acupuncture, ultrasound guidance, KOA, and PFPS. Risk of bias assessment and qualitative analysis were conducted by two independent reviewers using the PEDro score. Results: Fourteen articles met the inclusion criteria, and eight of them were high-quality papers in accordance with the PEDro score. There were variations in the techniques of DN. These included the direction, depth of insertion, number of needles, duration of stay, needle manipulation, and the number of treatment sessions. Meta-analysis was conducted on eight articles. DN group showed positive short-term effects (from immediate after DN to less than 3 months) on pain reduction for both KOA and PFPS with the overall standardized mean difference (SMD) of -1.549 (95% CI=-0.588 to -2.511); with great heterogeneity (P=0.002, I²=96.3%). In subgroup analysis, DN demonstrated significant effects in pain reduction on PFPS (p < 0.001) that could not be found in subjects with KOA (P=0.302). At 3-month post-intervention, DN also induced significant pain reduction in both subjects with KOA and PFPS with an overall SMD of -0.916 (95% CI=-0.133 to -1.699, and great heterogeneity (P=0.022, I²=95.63%). Besides, DN induced significant short-term improvement in function with the overall SMD=6.069; 95% CI=8.595 to 3.544; with great heterogeneity (P<0.001, I²=98.56%) when analyzed was conducted on both KOA and PFPS groups. In subgroup analysis, only PFPS showed a positive result with SMD=6.089, P<0.001; while KOA showed statistically insignificant with P=0.198 in short-term effect. Similarly, at 3-month post-intervention, significant improvement in function after DN was found when the analysis was conducted in both groups with the overall SMD=5.840; 95% CI=9.252 to 2.428; with great heterogeneity (P<0.001, I²=99.1%), but only PFPS showed significant improvement in sub-group analysis (P=0.002, I²=99.1%). Conclusions: The application of DN in KOA and PFPS patients varies among practitioners. DN is effective in reducing pain and dysfunction at short-term and 3-month post-intervention in individuals with PFPS. To our best knowledge, no study has reported the effects of DN with ultrasound guidance on KOA and PFPS. The longer-term effects of DN on KOA and PFPS are waiting for further study.

Keywords: dry needling, knee osteoarthritis, patellofemoral pain syndrome, ultrasound guidance

Procedia PDF Downloads 118
3705 Applications of Building Information Modeling (BIM) in Knowledge Sharing and Management in Construction

Authors: Shu-Hui Jan, Shih-Ping Ho, Hui-Ping Tserng

Abstract:

Construction knowledge can be referred to and reused among involved project managers and job-site engineers to alleviate problems on a construction job-site and reduce the time and cost of solving problems related to constructability. This paper proposes a new methodology to provide sharing of construction knowledge by using the Building Information Modeling (BIM) approach. The main characteristics of BIM include illustrating 3D CAD-based presentations and keeping information in a digital format, and facilitation of easy updating and transfer of information in the 3D BIM environment. Using the BIM approach, project managers and engineers can gain knowledge related to 3D BIM and obtain feedback provided by job-site engineers for future reference. This study addresses the application of knowledge sharing management in the construction phase of construction projects and proposes a BIM-based Knowledge Sharing Management (BIMKSM) system for project managers and engineers. The BIMKSM system is then applied in a selected case study of a construction project in Taiwan to verify the proposed methodology and demonstrate the effectiveness of sharing knowledge in the BIM environment. The combined results demonstrate that the BIMKSM system can be used as a visual BIM-based knowledge sharing management platform by utilizing the BIM approach and web technology.

Keywords: construction knowledge management, building information modeling, project management, web-based information system

Procedia PDF Downloads 329
3704 Covid-19 Pandemic: Another Lesson Learned by a Military Hospital

Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

Abstract:

SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

Procedia PDF Downloads 163
3703 Development of Palm Kernel Shell Lightweight Masonry Mortar

Authors: Kazeem K. Adewole

Abstract:

There need to construct building walls with lightweight masonry bricks/blocks and mortar to reduce the weight and cost of cooling/heating of buildings in hot/cold climates is growing partly due to legislations on energy use and global warming. In this paper, the development of Palm Kernel Shell masonry mortar (PKSMM) prepared with Portland cement and crushed PKS fine aggregate (an agricultural waste) is demonstrated. We show that PKSMM can be used as a lightweight mortar for the construction of lightweight masonry walls with good thermal insulation efficiency than the natural river sand commonly used for masonry mortar production.

Keywords: building walls, fine aggregate, lightweight masonry mortar, palm kernel shell, wall thermal insulation efficacy

Procedia PDF Downloads 304
3702 Hygrothermal Interactions and Energy Consumption in Cold Climate Hospitals: Integrating Numerical Analysis and Case Studies to Investigate and Analyze the Impact of Air Leakage and Vapor Retarding

Authors: Amir E. Amirzadeh, Richard K. Strand

Abstract:

Moisture-induced problems are a significant concern for building owners, architects, construction managers, and building engineers, as they can have substantial impacts on building enclosures' durability and performance. Computational analyses, such as hygrothermal and thermal analysis, can provide valuable information and demonstrate the expected relative performance of building enclosure systems but are not grounded in absolute certainty. This paper evaluates the hygrothermal performance of common enclosure systems in hospitals in cold climates. The study aims to investigate the impact of exterior wall systems on hospitals, focusing on factors such as durability, construction deficiencies, and energy performance. The study primarily examines the impact of air leakage and vapor retarding layers relative to energy consumption. While these factors have been studied in residential and commercial buildings, there is a lack of information on their impact on hospitals in a holistic context. The study integrates various research studies and professional experience in hospital building design to achieve its objective. The methodology involves surveying and observing exterior wall assemblies, reviewing common exterior wall assemblies and details used in hospital construction, performing simulations and numerical analyses of various variables, validating the model and mechanism using available data from industry and academia, visualizing the outcomes of the analysis, and developing a mechanism to demonstrate the relative performance of exterior wall systems for hospitals under specific conditions. The data sources include case studies from real-world projects and peer-reviewed articles, industry standards, and practices. This research intends to integrate and analyze the in-situ and as-designed performance and durability of building enclosure assemblies with numerical analysis. The study's primary objective is to provide a clear and precise roadmap to better visualize and comprehend the correlation between the durability and performance of common exterior wall systems used in the construction of hospitals and the energy consumption of these buildings under certain static and dynamic conditions. As the construction of new hospitals and renovation of existing ones have grown over the last few years, it is crucial to understand the effect of poor detailing or construction deficiencies on building enclosure systems' performance and durability in healthcare buildings. This study aims to assist stakeholders involved in hospital design, construction, and maintenance in selecting durable and high-performing wall systems. It highlights the importance of early design evaluation, regular quality control during the construction of hospitals, and understanding the potential impacts of improper and inconsistent maintenance and operation practices on occupants, owner, building enclosure systems, and Heating, Ventilation, and Air Conditioning (HVAC) systems, even if they are designed to meet the project requirements.

Keywords: hygrothermal analysis, building enclosure, hospitals, energy efficiency, optimization and visualization, uncertainty and decision making

Procedia PDF Downloads 54
3701 Understanding the Heterogeneity of Polycystic Ovarian Syndrome: The Influence of Ethnicity and Body Mass

Authors: Hamza Ikhlaq, Stephen Franks

Abstract:

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. The aetiology behind PCOS is poorly understood but influencing ethnic, environmental, and genetic factors have been recognised. However, literature examining the impact of ethnicity is scarce. We hypothesised Body Mass Index (BMI) and ethnicity influence the clinical, metabolic, and biochemical presentations of PCOS, with an interaction between these factors. Methods: A database of 1081 women with PCOS and a control group of 72 women were analysed. BMIs were grouped using the World Health Organisation classification into normal weight, overweight and obese groups. Ethnicities were classified into European, South Asian, and Afro-Caribbean groups. Biochemical and clinical presentations were compared amongst these groups, and statistical analyses were performed to assess significance. Results: This study revealed ethnicity significantly influences biochemical and clinical presentations of PCOS. A greater proportion of South Asian women are impacted by menstrual cycle disturbances and hirsutism than European and Afro-Caribbean women. South Asian and Afro-Caribbean women show greater measures of insulin resistance and weight gain when compared to their European peers. Women with increased BMI are shown to have an increased prevalence of PCOS phenotypes alongside increased levels of insulin resistance and testosterone. Furthermore, significantly different relationships between the waist-hip ratio and measures of insulin and glucose control for Afro-Caribbean women were identified compared to other ethnic groups. Conclusions: The findings of this study show ethnicity significantly influence the phenotypic and biochemical presentations of PCOS, with an interaction between body habitus and ethnicity found. Furthermore, we provide further data on the influences of BMI on the manifestations of PCOS. Therefore, we highlight the need to consider these factors when reviewing diagnostic criteria and delivering clinical care for these groups.

Keywords: PCOS, ethnicity, BMI, clinical

Procedia PDF Downloads 94
3700 Feasibility Study for Implementation of Geothermal Energy Technology as a Means of Thermal Energy Supply for Medium Size Community Building

Authors: Sreto Boljevic

Abstract:

Heating systems based on geothermal energy sources are becoming increasingly popular among commercial/community buildings as management of these buildings looks for a more efficient and environmentally friendly way to manage the heating system. The thermal energy supply of most European commercial/community buildings at present is provided mainly by energy extracted from natural gas. In order to reduce greenhouse gas emissions and achieve climate change targets set by the EU, restructuring in the area of thermal energy supply is essential. At present, heating and cooling account for approx... 50% of the EU primary energy supply. Due to its physical characteristics, thermal energy cannot be distributed or exchange over long distances, contrary to electricity and gas energy carriers. Compared to electricity and the gas sectors, heating remains a generally black box, with large unknowns to a researcher and policymaker. Ain literature number of documents address policies for promoting renewable energy technology to facilitate heating for residential/community/commercial buildings and assess the balance between heat supply and heat savings. Ground source heat pump (GSHP) technology has been an extremely attractive alternative to traditional electric and fossil fuel space heating equipment used to supply thermal energy for residential/community/commercial buildings. The main purpose of this paper is to create an algorithm using an analytical approach that could enable a feasibility study regarding the implementation of GSHP technology in community building with existing fossil-fueled heating systems. The main results obtained by the algorithm will enable building management and GSHP system designers to define the optimal size of the system regarding technical, environmental, and economic impacts of the system implementation, including payback period time. In addition, an algorithm is created to be utilized for a feasibility study for many different types of buildings. The algorithm is tested on a building that was built in 1930 and is used as a church located in Cork city. The heating of the building is currently provided by a 105kW gas boiler.

Keywords: GSHP, greenhouse gas emission, low-enthalpy, renewable energy

Procedia PDF Downloads 198
3699 Determination of Medians of Biochemical Maternal Serum Markers in Healthy Women Giving Birth to Normal Babies

Authors: Noreen Noreen, Aamir Ijaz, Hamza Akhtar

Abstract:

Background: Screening plays a major role to detect chromosomal abnormalities, Down syndrome, neural tube defects and other inborn diseases of the newborn. Serum biomarkers in the second trimester are useful in determining risk of most common chromosomal anomalies; these test include Alpha-fetoprotein (AFP), Human chorionic gonadotropin (hCG), Unconjugated Oestriol (UEȝ)and inhibin-A. Quadruple biomarkers are worth test in diagnosing the congenital pathology during pregnancy, these procedures does not form a part of routine health care of pregnant women in Pakistan, so the median value is lacking for population in Pakistan. Objective: To determine median values of biochemical maternal serum markers in local population during second trimester maternal screening. Study settings: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi. Methods: Cross-Sectional study for estimation of reference values. Non-probability consecutive sampling, 155 healthy pregnant women, of 30-40 years of age, will be included. As non-parametric statistics will be used, the minimum sample size is 120. Result: Total 155 women were enrolled into this study. The age of all women enrolled ranged from 30 to39 yrs. Among them, 39 per cent of women were less than 34 years. Mean maternal age 33.46±2.35 SD and maternal body weight were 54.98±2.88. Median value of quadruple markers calculated from 15-18th week of gestation that will be used for calculation of MOM for screening of trisomy21 in this gestational age. Median value at 15 week of gestation were observed hCG 36650 mIU/ml, AFP 23.3 IU/ml, UEȝ 3.5 nmol/L, InhibinA 198 ng/L, at 16 week of gestation hCG 29050 mIU/ml, AFP 35.4 IU/ml, UEȝ 4.1 nmol/L, InhibinA 179 ng/L, at 17 week of gestation hCG 28450 mIU/ml, AFP 36.0 IU/ml, UEȝ 6.7 nmol/L, InhibinA 176 ng/L and at 18 week of gestation hCG 25200 mIU/ml, AFP 38.2 IU/ml, UEȝ 8.2 nmol/L, InhibinA 190 ng/L respectively.All the comparisons were significant (p-Value <0.005) with 95% confidence Interval (CI) and level of significance of study set by going through literature and set at 5%. Conclusion: The median values for these four biomarkers in Pakistani pregnant women can be used to calculate MoM.

Keywords: screening, down syndrome, quadruple test, second trimester, serum biomarkers

Procedia PDF Downloads 162
3698 Mauriac Syndrome: A Rare Complicacation With an Easy Solution

Authors: Pablo Cid Galache, Laura Zamorano Bonilla

Abstract:

Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

Procedia PDF Downloads 39
3697 Neonatology Clinical Routine in Cats and Dogs: Cases, Main Conditions and Mortality

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

The neonatal care of cats and dogs represents a challenge to veterinarians due to the small size of the newborns and their physiological particularities. In addition, many Veterinary Medicine colleges around the world do not include neonatology in the curriculum, which makes it less likely for the veterinarian to have basic knowledge regarding neonatal care and worsens the clinical care these patients receive. Therefore, lack of assistance and negligence have become frequent in the field, which contributes towards the high mortality rates. This study aims at describing cases and the main conditions pertaining to the neonatology clinical routine in cats and dogs, highlighting the importance of specialized care in this field of Veterinary Medicine. The study included 808 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, between January 2018 and November 2019. Of these, 87.3% (705/808) were dogs and 12.7% (103/808) were cats. Among the neonates admitted, 57.3% (463/808) came from emergency c-sections due to dystocia, 8.7% (71/808) cane from vaginal deliveries with obstetric maneuvers due to dystocia, and 34% (274/808) were admitted for clinical care due to neonatal conditions. Among the neonates that came from emergency c-sections and vaginal deliveries, 47.3% (253/534) was born in respiratory distress due to severe hypoxia or persistent apnea and required resuscitation procedure, such as the Jen Chung acupuncture point (VG26), oxygen therapy with mask, pulmonary expansion with resuscitator, heart massages and administration of emergency medication, such as epinephrine. On the other hand, in the neonatal clinical care, the main conditions and alterations observed in the newborns were omphalophlebitis, toxic milk syndrome, neonatal conjunctivitis, swimmer puppy syndrome, neonatal hemorrhagic syndrome, pneumonia, trauma, low weight at birth, prematurity, congenital malformations (cleft palate, cleft lip, hydrocephaly, anasarca, vascular anomalies in the heart, anal atresia, gastroschisis, omphalocele, among others), neonatal sepsis and other local and systemic bacterial infections, viral infections (feline respiratory complex, parvovirus, canine distemper, canine infectious traqueobronchitis), parasitical infections (Toxocara spp., Ancylostoma spp., Strongyloides spp., Cystoisospora spp., Babesia spp. and Giardia spp.) and fungal infections (dermatophytosis by Microsporum canis). The most common clinical presentation observed was the neonatal triad (hypothermia, hypoglycemia and dehydration), affecting 74.6% (603/808) of the patients. The mortality rate among the neonates was 10.5% (85/808). Being knowledgeable about neonatology is essential for veterinarians to provide adequate care for these patients in the clinical routine. Adding neonatology to college curriculums, improving the dissemination of information on the subject, and providing annual training in neonatology for veterinarians and employees are important to improve immediate care and reduce the mortality rates.

Keywords: neonatal care, puppies, neonatal, conditions

Procedia PDF Downloads 210
3696 Seismic Directionality Effects on In-Structure Response Spectra in Seismic Probabilistic Risk Assessment

Authors: Sittipong Jarernprasert, Enrique Bazan-Zurita, Paul C. Rizzo

Abstract:

Currently, seismic probabilistic risk assessments (SPRA) for nuclear facilities use In-Structure Response Spectra (ISRS) in the calculation of fragilities for systems and components. ISRS are calculated via dynamic analyses of the host building subjected to two orthogonal components of horizontal ground motion. Each component is defined as the median motion in any horizontal direction. Structural engineers applied the components along selected X and Y Cartesian axes. The ISRS at different locations in the building are also calculated in the X and Y directions. The choice of the directions of X and Y are not specified by the ground motion model with respect to geographic coordinates, and are rather arbitrarily selected by the structural engineer. Normally, X and Y coincide with the “principal” axes of the building, in the understanding that this practice is generally conservative. For SPRA purposes, however, it is desirable to remove any conservatism in the estimates of median ISRS. This paper examines the effects of the direction of horizontal seismic motion on the ISRS on typical nuclear structure. We also evaluate the variability of ISRS calculated along different horizontal directions. Our results indicate that some central measures of the ISRS provide robust estimates that are practically independent of the selection of the directions of the horizontal Cartesian axes.

Keywords: seismic, directionality, in-structure response spectra, probabilistic risk assessment

Procedia PDF Downloads 398
3695 Systems Integrated Approach to Improve the Design and Construction of Green Buildings

Authors: Saleh Hayat

Abstract:

Efficiency, productivity and sustainability are important factors for structure and the application of processes in green building. Various previous studies have addressed efficiency, productivity and sustainability separately. This research study aims to investigate the implications of these three factors taking together. Frequency analysis and the ranking techniques are carried out to explore the connection between these factors. The interconnection matrix has been developed and functional grouping is made based upon data from expert opinion and field professionals. The existence of a relationship, the type of relationship and the scaled impact have been drawn. Additionally, a system diagram has been developed to show the variable correlation. The results of expert opinion show that efficiency, productivity and sustainability have a stronger impact on green buildings.

Keywords: efficiency, green building, productivity, sustainability

Procedia PDF Downloads 122
3694 The Characteristics of Static Plantar Loading in the First-Division College Sprint Athletes

Authors: Tong-Hsien Chow

Abstract:

Background: Plantar pressure measurement is an effective method for assessing plantar loading and can be applied to evaluating movement performance of the foot. The purpose of this study is to explore the sprint athletes’ plantar loading characteristics and pain profiles in static standing. Methods: Experiments were undertaken on 80 first-division college sprint athletes and 85 healthy non-sprinters. ‘JC Mat’, the optical plantar pressure measurement was applied to examining the differences between both groups in the arch index (AI), three regional and six distinct sub-regional plantar pressure distributions (PPD), and footprint characteristics. Pain assessment and self-reported health status in sprint athletes were examined for evaluating their common pain areas. Results: Findings from the control group, the males’ AI fell into the normal range. Yet, the females’ AI was classified as the high-arch type. AI values of the sprint group were found to be significantly lower than the control group. PPD were higher at the medial metatarsal bone of both feet and the lateral heel of the right foot in the sprint group, the males in particular, whereas lower at the medial and lateral longitudinal arches of both feet. Footprint characteristics tended to support the results of the AI and PPD, and this reflected the corresponding pressure profiles. For the sprint athletes, the lateral knee joint and biceps femoris were the most common musculoskeletal pains. Conclusions: The sprint athletes’ AI were generally classified as high arches, and that their PPD were categorized between the features of runners and high-arched runners. These findings also correspond to the profiles of patellofemoral pain syndrome (PFPS)-related plantar pressure. The pain profiles appeared to correspond to the symptoms of high-arched runners and PFPS. The findings reflected upon the possible link between high arches and PFPS. The correlation between high-arched runners and PFPS development is worth further studies.

Keywords: sprint athletes, arch index, plantar pressure distributions, high arches, patellofemoral pain syndrome

Procedia PDF Downloads 324
3693 The Impact of Total Parenteral Nutrition on Pediatric Stem Cell Transplantation and Its Complications

Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

Abstract:

Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

Procedia PDF Downloads 137
3692 Development of a Program for the Evaluation of Thermal Performance Applying the Centre Scientifique et Techniques du Bâtiment Method Case Study: Classroom

Authors: Iara Rezende, Djalma Silva, Alcino Costa Neto

Abstract:

Considering the transformations of the contemporary world linked to globalization and climate changes caused by global warming, the environmental and energy issues have been increasingly present in the decisions of the world scenario. Thus, the aim of reducing the impacts caused by human activities there are the energy efficiency measures, which are also applicable in the scope of Civil Engineering. Considering that a large part of the energy demand from buildings is related to the need to adapt the internal environment to the users comfort and productivity, measures capable of reducing this need can minimize the climate changes impacts and also the energy consumption of the building. However, these important measures are currently little used by civil engineers, either because of the interdisciplinarity of the subject, the time required to apply certain methods or the difficult interpretation of the results obtained by computational programs that often have a complex and little applied approach. Thus, it was proposed the development of a Java application with a simpler and applied approach to evaluate the thermal performance of a building in order to obtain results capable of assisting the civil engineers in the decision making related to the users thermal comfort. The program was built in Java programming language and the method used for the evaluation was the Center Scientifique et Technique du Batiment (CSTB) method. The program was used to evaluate the thermal performance of a university classroom. The analysis was carried out from simulations considering the worst climatic situation of the building occupation. Thus, at the end of the process, the favorable result was obtained regarding the classroom comfort zone and the feasibility of using the program, thus achieving the proposed objectives.

Keywords: building occupation, CSTB method, energy efficiency measures, Java application, thermal comfort

Procedia PDF Downloads 120
3691 The Robotic Intervention in the Tourism Experience: The Customer Journey’s Touchpoints, Context, and Qualities

Authors: Aikaterini Manthiou, Phil Klaus, Kafia Ayadi

Abstract:

Tourism research has shown a growing need to comprehend the robotic tourism experience’s meaning and foundations while also offering guidance regarding future discussions and research. This paper aims to analyze the robotic tourism experience based on the basis of De Keyser et al.’s (2020) conceptualization. In order to develop three theoretical propositions, we explore the robotic tourism experience by means of the three building blocks: touchpoints, context, and qualities. The three building blocks should not be examined in isolation but as a system of interplaying factors impacting the customer journey and customer experience. The study discusses the theoretical and practical implications of these impacts, as well as providing future research directions.

Keywords: robotic tourism experience, robot, touchpoints, context, qualities

Procedia PDF Downloads 194
3690 Comparative Analysis of a Self-Supporting Wall of Granite Slabs in a Multi-Leaves Enclosure System

Authors: Miguel Angel Calvo Salve

Abstract:

Building enclosures and façades not only have an aesthetic component they must also ensure thermal comfort and improve the acoustics and air quality in buildings. The role of facades design, its assemblies, and construction are key in developing a greener future in architecture. This research and study focus on the design of a multi-leaves building envelope, with a self-supporting wall of granite slabs. The study will demonstrate the advantages of its use in compare with the hanging stone veneer in a vented cladding system. Using the Design of the School of Music and Theatre of the Atlantic Area in Spain as a case study where the multi-leaves enclosure system consists in a self-supported outer leaf of large granite slabs of 15cm. of thickness, a vent cavity with thermal isolation, a brick wall, and a series of internal layers. The methodology used were simulations and data collected in building. The advantages of the self-supporting wall of granite slabs in the outer leaf (15cm). compared with a hanging stone veneer in a vented cladding system can summarize the goals as follows: Using the stone in more natural way, by compression. The weight of the stone slabs goes directly to a strip-footing and don't overload the reinforced concrete structure of the building. The weight of the stone slabs provides an external aerial soundproofing, preventing the sound transmission to the structure. The thickness of the stone slabs is enough to provide the external waterproofing of the building envelope. The self-supporting system with minimum anchorages allows having a continuous and external thermal isolation without thermal bridges. The thickness of ashlars masonry provides a thermal inertia that balances the temperatures between day and night in the external thermal insulation layer. The absence of open joints gives the quality of a continuous envelope transmitting the sensations of the stone, the heaviness in the facade, the rhythm of the music and the sequence of the theatre. The main cost of stone due his bigger thickness is more than compensated with the reduction in assembly costs. Don´t need any substructure systems for hanging stone veneers.

Keywords: self-supporting wall, stone cladding systems, hanging veneer cladding systems, sustainability of facade systems

Procedia PDF Downloads 45
3689 Building Children's Capacity towards Sustainable Future: Making a Case for a Socio-Cultural Approach to Understanding Sustainability

Authors: Taiwo Frances Gbadegesin

Abstract:

Children’s capacity to contribute to social and economic status of a nation has been given more recognition than ever. Global policy priority aimed at ensuring sustainable development has been extended to the developing nations of the world. However, many developing countries have continued to puzzle out the extent and possibilities of exploring sustainability within their socio-economic environment. This paper considers ways in which the theoretical framework of Dahlberg, Moss and Pence (1999; 2007) and Moss (2007; 2012) that embraces meaning-making, social construction of childhood experiences and democratic perspectives can be used to understand children’s capacity for building a sustainable future. This paper presents data collected through interviews and observations from ECCE teachers and children in Lagos, Nigeria. A distinct finding is that children’s participation in building sustainable future is a consequence of the knowledge of the workings of their social, economic and cultural nuances and not a matter of economic wealth per se. It further argues that sustainability is situated within a complex network of local and global contexts. It thus challenges the present neo-liberal approach and advocates a democratic approach to preparing children for a sustainable society. It concludes that sustainability cannot be built on what may be seen as decontextualized responses by relevant stakeholders to the needs and experiences of the “whole child”.

Keywords: children, ECCE, sustainable development, Nigeria

Procedia PDF Downloads 345
3688 Carbon Footprint of Educational Establishments: The Case of the University of Alicante

Authors: Maria R. Mula-Molina, Juan A. Ferriz-Papi

Abstract:

Environmental concerns are increasingly obtaining higher priority in sustainability agenda of educational establishments. This is important not only for its environmental performance in its own right as an organization, but also to present a model for its students. On the other hand, universities play an important role on research and innovative solutions for measuring, analyzing and reducing environmental impacts for different activities. The assessment and decision-making process during the activity of educational establishments is linked to the application of robust indicators. In this way, the carbon footprint is a developing indicator for sustainability that helps understand the direct impact on climate change. But it is not easy to implement. There is a large amount of considering factors involved that increases its complexity, such as different uses at the same time (research, lecturing, administration), different users (students, staff) or different levels of activity (lecturing, exam or holidays periods). The aim of this research is to develop a simplified methodology for calculating and comparing carbon emissions per user at university campus considering two main aspects for carbon accountings: Building operations and transport. Different methodologies applied in other Spanish university campuses are analyzed and compared to obtain a final proposal to be developed in this type of establishments. First, building operation calculation considers the different uses and energy sources consumed. Second, for transport calculation, the different users and working hours are calculated separately, as well as their origin and traveling preferences. For every transport, a different conversion factor is used depending on carbon emissions produced. The final result is obtained as an average of carbon emissions produced per user. A case study is applied to the University of Alicante campus in San Vicente del Raspeig (Spain), where the carbon footprint is calculated. While the building operation consumptions are known per building and month, it does not happen with transport. Only one survey about the habit of transport for users was developed in 2009/2010, so no evolution of results can be shown in this case. Besides, building operations are not split per use, as building services are not monitored separately. These results are analyzed in depth considering all factors and limitations. Besides, they are compared to other estimations in other campuses. Finally, the application of the presented methodology is also studied. The recommendations concluded in this study try to enhance carbon emission monitoring and control. A Carbon Action Plan is then a primary solution to be developed. On the other hand, the application developed in the University of Alicante campus cannot only further enhance the methodology itself, but also render the adoption by other educational establishments more readily possible and yet with a considerable degree of flexibility to cater for their specific requirements.

Keywords: building operations, built environment, carbon footprint, climate change, transport

Procedia PDF Downloads 273
3687 Modernism’s Influence on Architect-Client Relationship: Comparative Case Studies of Schroder and Farnsworth Houses

Authors: Omneya Messallam, Sara S. Fouad

Abstract:

The Modernist Movement initially flourished in France, Holland, Germany and the Soviet Union. Many architects and designers were inspired and followed its principles. Two of its most important architects (Gerrit Rietveld and Ludwig Mies van de Rohe) were introduced in this paper. Each did not follow the other’s principles and had their own particular rules; however, they shared the same features of the Modernist International Style, such as Anti-historicism, Abstraction, Technology, Function and Internationalism/ Universality. Key Modernist principles translated into high expectations, which sometimes did not meet the inhabitants’ aspirations of living comfortably; consequently, leading to a conflict and misunderstanding between the designer and their clients’ needs. Therefore, historical case studies (the Schroder and the Farnsworth houses) involving two Modernist pioneer architects have been chosen. This paper is an attempt to explore some of the influential factors affecting buildings design such as: needs, gender, and question concerning commonalities between both designers and their clients. The three aspects and two designers explored here have been chosen because they have been influenced the researchers to understand the impact of those factors on the design process, building’s performance, and the dweller’s satisfaction. This is a descriptive/ analytical research based on two historical comparative case studies that involve several steps such as: key evaluation questions (KEQs), observations, document analysis, etc. The methodology is based on data collation and finding validations. The research aims to state a manifest to regulate the relation between architects and their clients to reach the optimum building performance and functional interior design that suits their clients’ needs, reflects the architects’ character, and the school they belong to. At the end, through the investigation in this paper, the different needs between both the designers and the clients have been seen not only in the building itself but also it could convert the inhabitant’s life in various ways. Moreover, a successful relationship between the architect and their clients could play a significant role in the success of projects. In contrast, not every good design or celebrated building could end up with a successful relationship between the designer and their client or full-fill the inhabitant’s aspirations.

Keywords: architect’s character, building’s performance, commonalities, client’s character, gender, modernist movement, needs

Procedia PDF Downloads 133
3686 Scenarios of Digitalization and Energy Efficiency in the Building Sector in Brazil: 2050 Horizon

Authors: Maria Fatima Almeida, Rodrigo Calili, George Soares, João Krause, Myrthes Marcele Dos Santos, Anna Carolina Suzano E. Silva, Marcos Alexandre Da

Abstract:

In Brazil, the building sector accounts for 1/6 of energy consumption and 50% of electricity consumption. A complex sector with several driving actors plays an essential role in the country's economy. Currently, the digitalization readiness in this sector is still low, mainly due to the high investment costs and the difficulty of estimating the benefits of digital technologies in buildings. Nevertheless, the potential contribution of digitalization for increasing energy efficiency in the building sector in Brazil has been pointed out as relevant in the political and sectoral contexts, both in the medium and long-term horizons. To contribute to the debate on the possible evolving trajectories of digitalization in the building sector in Brazil and to subsidize the formulation or revision of current public policies and managerial decisions, three future scenarios were created to anticipate the potential energy efficiency in the building sector in Brazil due to digitalization by 2050. This work aims to present these scenarios as a basis to foresight the potential energy efficiency in this sector, according to different digitalization paces - slow, moderate, or fast in the 2050 horizon. A methodological approach was proposed to create alternative prospective scenarios, combining the Global Business Network (GBN) and the Laboratory for Investigation in Prospective Strategy and Organisation (LIPSOR) methods. This approach consists of seven steps: (i) definition of the question to be foresighted and time horizon to be considered (2050); (ii) definition and classification of a set of key variables, using the prospective structural analysis; (iii) identification of the main actors with an active role in the digital and energy spheres; (iv) characterization of the current situation (2021) and identification of main uncertainties that were considered critical in the development of alternative future scenarios; (v) scanning possible futures using morphological analysis; (vi) selection and description of the most likely scenarios; (vii) foresighting the potential energy efficiency in each of the three scenarios, namely slow digitalization; moderate digitalization, and fast digitalization. Each scenario begins with a core logic and then encompasses potentially related elements, including potential energy efficiency. Then, the first scenario refers to digitalization at a slow pace, with induction by the government limited to public buildings. In the second scenario, digitalization is implemented at a moderate pace, induced by the government in public, commercial, and service buildings, through regulation integrating digitalization and energy efficiency mechanisms. Finally, in the third scenario, digitalization in the building sector is implemented at a fast pace in the country and is strongly induced by the government, but with broad participation of private investments and accelerated adoption of digital technologies. As a result of the slow pace of digitalization in the sector, the potential for energy efficiency stands at levels below 10% of the total of 161TWh by 2050. In the moderate digitalization scenario, the potential reaches 20 to 30% of the total 161TWh by 2050. Furthermore, in the rapid digitalization scenario, it will reach 30 to 40% of the total 161TWh by 2050.

Keywords: building digitalization, energy efficiency, scenario building, prospective structural analysis, morphological analysis

Procedia PDF Downloads 94
3685 Tourism as Benefactor to Peace amidst the Structural Conflict: An Exploratory Case Study of Nepal

Authors: Pranil Kumar Upadhayaya

Abstract:

While peace is dividend to tourism, tourism can also be a vital force for world peace. The existing body of knowledge on a tripartite complex nexus between tourism, peace and conflict reveals that tourism is benefactor to peace and sensitive to conflict. By contextualizing the ongoing sporadic structural conflict in the transitional phase in the aftermath of a decade long (1996-2006), Maoist armed conflict in Nepal, the purpose of this study is to explore the potentials of tourism in peace-building. The outcomes of this research paper is based on the mixed methods of research (qualitative and quantitative). Though the armed conflict ended with the comprehensive peace agreement in 2006 but there is constant manifestations of non-violent structural conflicts, which continue to threaten the sustainability of tourism industry. With the persistent application of coping strategies, tourism is found resilient during the ongoing structural political conflict. The strong coping abilities of the private sector of tourism industry have also intersected with peace-building efforts with more reactive and less proactive (pro-peace) engagements. This paper ascertains about the application of the ‘theory of tourism security’ by Nepalese tourism industry while coping with conflict and reviving, and sustaining. It reveals that the multiple verities of tourism at present has heterogeneous degree of peace potentials. The opportunities of ‘peace through tourism’ can be promoted subject to its molding with responsible, sustainable and participatory characteristics. This paper comes out with pragmatic policy recommendations for strengthening the position of tourism as a true peace-builder: (a) a broad shift from mainstream conventional tourism to the community based rural with local participation and ownership to fulfill Nepal’s potentials for peace, and (b) building and applications of the managerial and operational codes of conducts for owners and workers (labor unions) at all tourism enterprises and strengthen their practices.

Keywords: code of conduct, community based tourism, conflict, peace-building, tourism

Procedia PDF Downloads 250
3684 A Case-Series Analysis of Tuberculosis in Patients at Internal Medicine Department

Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

Abstract:

Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

Procedia PDF Downloads 173
3683 Dermatomyositis: It is Not Always an Allergic Reaction

Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

Abstract:

Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

Procedia PDF Downloads 320
3682 Applying Participatory Design for the Reuse of Deserted Community Spaces

Authors: Wei-Chieh Yeh, Yung-Tang Shen

Abstract:

The concept of community building started in 1994 in Taiwan. After years of development, it fostered the notion of active local resident participation in community issues as co-operators, instead of minions. Participatory design gives participants more control in the decision-making process, helps to reduce the friction caused by arguments and assists in bringing different parties to consensus. This results in an increase in the efficiency of projects run in the community. Therefore, the participation of local residents is key to the success of community building. This study applied participatory design to develop plans for the reuse of deserted spaces in the community from the first stage of brainstorming for design ideas, making creative models to be employed later, through to the final stage of construction. After conducting a series of participatory designed activities, it aimed to integrate the different opinions of residents, develop a sense of belonging and reach a consensus. Besides this, it also aimed at building the residents’ awareness of their responsibilities for the environment and related issues of sustainable development. By reviewing relevant literature and understanding the history of related studies, the study formulated a theory. It took the “2012-2014 Changhua County Community Planner Counseling Program” as a case study to investigate the implementation process of participatory design. Research data are collected by document analysis, participants’ observation and in-depth interviews. After examining the three elements of “Design Participation”, “Construction Participation”, and” Follow–up Maintenance Participation” in the case, the study emerged with a promising conclusion: Maintenance works were carried out better compared to common public works. Besides this, maintenance costs were lower. Moreover, the works that residents were involved in were more creative. Most importantly, the community characteristics could be easy be recognized.

Keywords: participatory design, deserted space, community building, reuse

Procedia PDF Downloads 350
3681 Study on the Thermal Conductivity about Porous Materials in Wet State

Authors: Han Yan, Jieren Luo, Qiuhui Yan, Xiaoqing Li

Abstract:

The thermal conductivity of porous materials is closely related to the thermal and moisture environment and the overall energy consumption of the building. The study of thermal conductivity of porous materials has great significance for the realization of low energy consumption building and economic construction building. Based on the study of effective thermal conductivity of porous materials at home and abroad, the thermal conductivity under a variety of different density of polystyrene board (EPS), plastic extruded board (XPS) and polyurethane (PU) and phenolic resin (PF) in wet state through theoretical analysis and experimental research has been studied. Initially, the moisture absorption and desorption properties of specimens had been discussed under different density, which led a result indicates the moisture absorption of four porous materials all have three stages, fast, stable and gentle. For the moisture desorption, there are two types. One is the existence of the rapid phase of the stage, such as XPS board, PU board. The other one does not have the fast desorption, instead, it is more stabilized, such as XPS board, PF board. Furthermore, the relationship between water content and thermal conductivity of porous materials had been studied and fitted, which figured out that in the wake of the increasing water content, the thermal conductivity of porous material is continually improving. At the same time, this result also shows, in different density, when the same kind of materials decreases, the saturated moisture content increases. Finally, the moisture absorption and desorption properties of the four kinds of materials are compared comprehensively, and it turned out that the heat preservation performance of PU board is the best, followed by EPS board, XPS board, PF board.

Keywords: porous materials, thermal conductivity, moisture content, transient hot-wire method

Procedia PDF Downloads 169