Search results for: elective cesarean section

Authors: Majeda Hammoud

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Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

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Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

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Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

Procedia PDF Downloads 126

Authors: Vahid Bairami Rad

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Due to the tremendous progress in computer technology in the last decades, the capabilities of computers increased enormously and working with a computer became a normal activity for nearly everybody. With all the possibilities a computer can offer, humans and their interaction with computers are now a limiting factor. This gave rise to a lot of research in the field of HCI (human computer interaction) aiming to make interaction easier, more intuitive, and more efficient. To research eye gaze based interfaces it is necessary to understand both sides of the interaction–the human eye and the eye tracker. The first section gives an overview on the anatomy of the eye. The second section accuracy and calibration issue. The subsequent section presents data from a user study where eye movements have been recorded while watching a video and while surfing the Internet. Statistics on the eye movement during these tasks for several individuals provide typical values and ranges for fixation times and saccade lengths and are the foundation for discussions in later chapters. The data also reveal typical limitations of eye trackers.

Keywords: human computer interaction, gaze tracking, calibration, eye movement

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Authors: Ya-Chu May Tsai, Ibrahim Yacoub, Eoin Casey

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The Australian and New Zealand College of Anaesthetists (ANZCA) advises that smoking should not be permitted within 12 hours of surgery. There is little information in the medical literature regarding patients awareness of perioperative smoking cessation recommendations nor their appreciation of how smoking might negatively impact their perioperative course. The aim of the study is to assess the prevalence of current smokers presenting to Werribee Mercy Hospital (WMH) and to evaluate if pre-operative provision of both written and verbal pre-operative advice was, 1: Effective in improving patient awareness of the benefits of pre-operative smoking cessation, 2: Associated with an increase in the number of elective surgical patients who stop smoking at least 12 hours pre-operatively. Methods: The initial survey included all patients who presented to WMH for elective surgical procedures from 19 – 30 September 2016 using a standardized questionnaire focused on patients’ smoking history and their awareness of smoking cessation preoperatively. The intervention consisted of a standard pre-operative phone call to all patients advising them of the increased perioperative risks associated with smoking, and advised patients to cease 12 hours prior. In addition, written information on smoking cessation strategies were sent out in mail at least 1 week prior to planned procedure date to all patients. Questionnaire-based study after the intervention was conducted on day of elective procedure from 10 – 21 October 2016 inclusive. Primary outcomes measured were patient’s awareness of smoking cessation and proportion of smokers who quit >12 hours, considered a clinically meaning duration to reduce anaesthetics complications. Comparison of pre and post intervention results were made using SPSS 21.0. Results: In the pre-intervention group (n=156), 36 (22.4%) patients were current smokers, 46 were ex-smokers (29.5%) and 74 were non-smokers (48.1%). Of the smokers, 12 (33%) reported having been informed of smoking cessation prior to operation and 8 (22%) were aware of increased intra- and perioperative adverse events associated with smoking. In the post-intervention group n= 177, 38 (21.5%) patients were current smokers, 39 were ex-smokers (22.0%) and 100 were non-smokers (56.5%). Of the smokers, 32 (88.9%) reported having been informed of smoking cessation prior to operation and 35 (97.2%) reported being aware of increased intra- and perioperative adverse events associated with smoking. The median time since last smoke in the pre-intervention group was 5.5 hours (Q1-Q3 = 2-14) compared with 13 hours (Q1-Q3 = 5-24) in post intervention group. Amongst the smokers, smoking cessation at least 12 hours prior to surgery significantly increased from 27.8% pre-intervention to 52.6% post intervention (P=0.03). Conclusion: A standard preoperative phone call and written instruction on smoking cessation guidelines at time of waitlist placement increase preoperative smoking cessation rates by almost 2-fold.

Keywords: anaesthesia, audit, perioperative medicine, smoking cessation

Procedia PDF Downloads 300

Authors: Ahmet Y. Gurkan, Cagatay S. Koksal, Cagri Aydin, U. Oral Unal

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The present paper covers the viscous flow computations for the asymmetric diffuser section of a large, high-speed cavitation tunnel which will be constructed in Istanbul Technical University. The analyses were carried out by using the incompressible Reynold-Averaged-Navier-Stokes equations. While determining the diffuser geometry, a high quality, separation-free flow field with minimum energy loses was particularly aimed. The expansion angle has a critical role on the diffuser hydrodynamic performance. In order obtain a relatively short diffuser length, due to the constructive limitations, and hydrodynamic energy effectiveness, three diffuser sections with varying expansion angles for side and bottom walls were considered. A systematic study was performed to determine the most effective diffuser configuration. The results revealed that the inlet condition of the diffuser greatly affects its flow field. The inclusion of the contraction section in the computations substantially modified the flow topology in the diffuser. The effect of the diffuser flow on the test section flow characteristics was clearly observed. The influence of the introduction of small chamfers at the corners of the diffuser geometry is also presented.

Keywords: asymmetric diffuser, diffuser design, cavitation tunnel, viscous flow, computational fluid dynamics (CFD), rans

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Authors: Seyed Saeid Nabavi

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Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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Authors: W. Mohammedsaeed, A. J. Mcbain, S. M. Cruickshank, C. A. O’Neill

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Many studies have demonstrated the importance of probiotics and their potential therapeutic effects within the gut. Recently, the possible therapeutic effects of probiotics in other tissues have also begun to be investigated. Comparatively few studies have evaluated the use of topical probiotics in relation to the skin. In this study, we have conducted preliminary investigations into whether a well-known probiotic, Lactobacillus rhamnosus GG (LGG), can increase the rate of re-epithelialization in a model wound. Full-thickness skin was obtained from individuals undergoing elective cosmetic surgery. This skin was wounded using excisional punch and cultured using a serum-free medium, either in the presence or absence of L. rhamnosus GG lysate. Histological staining of the sections was performed with Haematoxylin& Eosin E to quantify “epithelial tongue length”. This is the length of the new epithelial ‘tongue’ that grows and covers the exposed dermis at the inner wound edges. The length of the new epithelial ‘tongue’ was compared in untreated section and section treated with and L. rhamnosus GG made using108CFU/ml bacterial cells. L. rhamnosus GG lysate enhanced significantly the re-epithelialisation of treated wounds compared with that of untreated wounds (P=0.005, n=3). Tongue length, at day 1 was 7.55μm 0.15, at day 3 it was 18.5μm 0.25 and at day 7 was 22.9μm 0.35. These results can be compared with untreated cultures in which tongue length was 3.25μm 0.35, day 3 was 9.65μm 0.25 and day 7 was 13.5μm 0.15 post-wounding. In ex-vivo proliferation and migration cells were measured by determining the expression of nuclear proliferation marker Ki-67 and the expression of Phosphorylated cortactin respectively demonstrated that L. rhamnosus GG significantly increased NHEK proliferation and migration rates relative to controls. However, the dominant mechanism was migration because in ex-vivo skin treated with the L. rhamnosus GG up-regulated the gene expression of the chemokine receptor and ligands CXCR2 and CXCL2 comparing with controls (P=0.02, P=0.03 respectively, n=3). High levels of CXCL2/CXCL2 have already been implicated in multiple aspects of stimulation of wound healing through activation of keratinocyte migration. These data demonstrate that lysates from Lactobacillus rhamnosus GG increase re-epithelialization by stimulation of keratinocyte migration. The current study identifies the partial mechanism that contribute to stimulating the wound-healing process ex vivo in response to L. rhamnosus GG lysate is an increase in the production of CXCL2/ CXCR2 in ex vivo models. The use of probiotic lysates potentially offers new options to develop treatments that could improve wound healing.

Keywords: Lactobacillus rhamnosus GG, wounds, migration, lysate

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Authors: Mohammad Reza Salimpour, Amir Dehshiri

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In the present article, we investigate experimental laminar forced convective heat transfer specifications of TiO2/water nanofluids through conduits with different cross sections. We check the effects of different parameters such as cross sectional shape, Reynolds number and concentration of nanoparticles in stable suspension on increasing convective heat transfer by designing and assembling of an experimental apparatus. The results demonstrate adding a little amount of nanoparticles to the base fluid improves heat transfer behavior in conduits. Moreover, conduit with circular cross-section has better performance compared to the square and triangular cross sections. However, conduits with square and triangular cross sections have more relative heat transfer enhancement than conduit with circular cross section.

Keywords: nanofluid, cross-sectional shape, TiO2, convection

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Authors: Mina Mortazavi, Pezhman Sharafi

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Cold-formed steel sections are popular construction materials as structural or non-structural elements. The objective of this paper is to propose an optimisation method for open cross sections targeting the maximum nominal axial strength. The cross sections considered in the optimisation process should all meet a determined critical global buckling load to be considered as a candidate for optimisation process. The maximum dimensions of the cross section are fixed and limited into a predefined rectangular area. The optimisation process is repeated for different available coil thicknesses of 1 mm, 2.5 mm and 3 mm to determine the optimum thickness according to the cross section buckling behaviour. A simple-simple boundary is assumed as end conditions. The number of folds is limited to 20 folds to prevent extra complicated sections. The global buckling load is considered as Euler load and is determined according to the moment of inertia of the cross-section with a constant length. The critical buckling loads are obtained using Finite Strip Method. The results of the optimisation analysis are provided, and the optimum cross-section within the considered range is determined.

Keywords: shape optimisation, buckling, cold formed steel, finite strip method

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Authors: Daniel Y. Abebe, Sijeong Jeong, Jaehyouk Choi

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The use of eccentrically braced frame (EBF) is increasing day by day as EBF possesses high elastic stiffness, stable inelastic response under cyclic lateral loading, and excellent ductility and energy dissipation capacity. The ductility and energy dissipation capacity of EBF depends on the active link beams. Recently, there are two types EBFs; these are conventional EBFs and EBFs with replaceable links. The conventional EBF has a disadvantage during maintenance in post-earthquake. The concept of removable active link beam in EBF is developed to overcome the limitation of the conventional EBF in post-earthquake. In this study, a replaceable link with reduced web section is introduced and design equations are suggested. In addition, nonlinear finite element analysis was conducted in order to evaluate the proposed links.

Keywords: EBFs, replaceable link, earthquake disaster, reduced section

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Authors: Carla Ferreira, Helena Barros

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The paper termed “Design of reinforced concrete with Eurocode 2” presents the theory regarding the design of reinforced concrete sections and the development of the tables and abacuses to verify the concrete section to the ultimate limit and service limit states. This paper is a complement of it, showing how to use the previous tools. Different numerical results are shown, proving the capability of the methodology. When a section of a beam is already chosen, the computer program presents the reinforcing steel in many locations along the structure, and it is the engineer´s task to choose the layout available for the construction, considering the maximum regular kind of reinforcing bars. There are many computer programs available for this task, but the interest of the present kind of tools is the fast and easy way of making the design and choose the optimal solution. Another application of these design tools is in the definition of the section dimensions, in a way that when stresses are evaluated, the final design is acceptable. In the design offices, these are considered by the engineers a very quick and useful way of designing reinforced concrete sections, employing variable strength concrete and higher steel classes. Examples of nonlinear analyses and redistribution of the bending moment will be considered, according to the Eurocode 2 recommendations, for sections under bending moment and axial forces. Examples of the evaluation of the service limit state will be presented.

Keywords: design examples, eurocode 2, reinforced concrete, section design

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Authors: I. Badhrees

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This paper is an attempt to describe some of the results that had been found through a journey of study in the field of particle physics. This study consists of two parts, one about the measurement of the cross section of the decay of the Z particle in two electrons, and the other deals with the measurement of the cross section of the multi-photon absorption process using a beam of laser in the Liquid Argon Time Projection Chamber. The first part of the paper concerns the results based on the analysis of a data sample containing 8120 ee candidates to reconstruct the mass of the Z particle for each event where each event has an ee pair with PT(e) > 20GeV, and η(e) < 2.5. Monte Carlo templates of the reconstructed Z particle were produced as a function of the Z mass scale. The distribution of the reconstructed Z mass in the data was compared to the Monte Carlo templates, where the total cross section is calculated to be equal to 1432 pb. The second part concerns the Liquid Argon Time Projection Chamber, LAr TPC, the results of the interaction of the UV Laser, Nd-YAG with λ= 266mm, with LAr and through the study of the multi-photon ionization process as a part of the R&D at Bern University. The main result of this study was the cross section of the process of the multi-photon ionization process of the LAr, σe = 1.24±0.10stat±0.30sys.10 -56cm4.

Keywords: ATLAS, CERN, KACST, LArTPC, particle physics

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Authors: Waheed Ahmad Safi, Shunichi Nakamura, Abdul Habib Ghaforzai

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Steel and concrete composite bridge with concrete filled steel I-girder (CFIG) was proposed and FEM and laboratory tests were conducted to analysis bending and shear behavior. The proposed form of structural steel I-section is mainly used at the intermediate support zone by placing infilled concrete into the top and bottom flanges of steel I-section to resist negative bending moment. The bending and shear tests were carried out to find out the significance of CFIG section. The result for test showing that the bending and shear capacity of proposed CFIG is at least 3 times and 2 times greater than conventional steel I-section (IG) respectively. Finite element study was also carried out to ensure the result for laboratory tests due to bending and shear behavior and load transfer behavior of proposed structural form. Finite element result result agreed the test result. A design example was carried out for a four-span continuous highway bridge and design method was established.

Keywords: bending strength, concrete filled steel I-girder, steel I-girder, FEM, limit states design and shear strength

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Authors: Jan Gayl Barcelon, N. Gorgonio

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Renal tubular acidosis, a medical condition that involves the accumulation of acid in the body due to failure of the kidneys to maintain normal urine and blood pH, is rarely encountered in pregnancy. The effect of renal tubular acidosis in pregnancy is not fully established. It may worsen during pregnancy and cause maternal and fetal morbidity. A 30-year-old primigravida was diagnosed with renal tubular acidosis at age 7, but due to uncontrolled disease progression, she developed rickets at age 10. She was first seen in our institution at eight weeks gestation and maintained on bicarbonate and potassium supplementation. At 26 weeks gestation, she was diagnosed with polyhydramnios, causing on and off irregular uterine contractions. At 30 weeks gestation, despite oral Nifedipine, premature labor was uncontrolled; hence she was admitted for tocolysis. With elevated creatinine (123 umol/L) and a normal blood urea nitrogen level (6.70 mmol/L), she was referred to Nephrology Service, which cleared the patient prior to MgSO₄ drip. Dosing of 4g MgSO₄ over 20 minutes followed by a maintenance of 2g/hour x 24 hours for neuroprotection and tocolysis was ordered. Two hours after MgSO₄ drip initiation, hematuria developed with adequate urine output. The infusion was immediately stopped. The serum magnesium level was high normal at 6.7 mEq/L. After 4 hours of renal clearance, the repeat serum magnesium level was normal (2.7 mEq/L) and with clear urine output. The patient was then given Nifedipine 30mg/tab, 3x a day which controlled the uterine contractions. At 37 weeks gestation, the patient delivered via primary low transverse Cesarean Section to a live female with a birthweight of 2470gm, appropriate for gestational age. The use of MgSO₄ for the control of premature labor in patients with chronic renal disease secondary to renal tubular can cause hematuria.

Keywords: hematuria, magnesium sulfate, premature labor, renal tubular acidosis

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Authors: K. B. Rajasekarababu, J. Karthik, G. Vinayagamurthy

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This paper is intended to explain the influence of major axis on aerodynamic characteristics of elliptical section. Many engineering applications such as off shore structures, bridge piers, civil structures and pipelines can be modelled as a circular cylinder but flow over complex bodies like, submarines, Elliptical wing, fuselage, missiles, and rotor blades, in which the parameters such as axis ratio can influence the flow characteristics of the wake and nature of separation. Influence of Major axis in Flow characteristics of elliptical sections are examined both experimentally and computationally in this study. For this research, four elliptical models with varying major axis [*AR=1, 4, 6, 10] are analysed. Experimental works have been conducted in a subsonic wind tunnel. Furthermore, flow characteristics on elliptical model are predicted from k-ε turbulence model using the commercial CFD packages by pressure based transient solver with Standard wall conditions.The analysis can be extended to estimation and comparison of Drag coefficient and Fatigue analysis of elliptical sections.

Keywords: elliptical section, major axis, aerodynamic characteristics, k-ε turbulence model

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Authors: Heng Han, Zhilei Liang, Xiangong Zhou

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In this paper, the finite element method is used to study the temperature field of the main cable of the suspension bridge, and the calculation method of the average temperature of the cross-section of the main cable suitable for the construction control of the cable system is proposed; By comparing and analyzing the temperature field of the main cable with five diameters, a reasonable diameter limit for calculating the average temperature of the cross section of the main cable by finite element method is proposed. The results show that the maximum error of this method is less than 1℃, which meets the requirements of construction control accuracy; For the main cable with a diameter greater than 400mm, the surface temperature measuring points combined with the finite element method shall be used to calculate the average cross-section temperature.

Keywords: suspension bridge, main cable, temperature field, finite element

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Authors: Adnan Lanjawi

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This paper is carried out to investigate the management of hazardous waste in the chemistry section which belongs to Dubai Police forensic laboratory. The chemicals are the main contributor toward the accumulation of hazardous waste in the section. This is due to the requirement to use it in analysis, such as of explosives, drugs, inorganic and fire debris cases. This leads to negative effects on the environment and to the employees’ health and safety. The research investigates the quantity of chemicals there, the labels, the storage room and equipment used. The target is to reduce the need for disposal by looking at alternative options, such as elimination, substitution and recycling. The data was collected by interviewing the top managers there who have been working in the lab more than 20 years. Also, data was collected by observing employees and how they carry out experiments. Therefore, a survey was made to assess their knowledge about the hazardous waste. The management of hazardous chemicals in the chemistry section needs to be improved. The main findings illustrate that about 110 bottles of reference substances were going to be disposed of in 2014. These bottles were bought for about 100,000 UAE Dirhams (£17,600). This means that the management of substances purchase is not organised. There is no categorisation programme in place, which makes the waste control very difficult. In addition, the findings show that chemical are segregated according to alphabetical order, whereas the efficient way is to separate them according to their nature and property. In addition, the research suggested technology and experiments to follow to reduce the need for using solvents and chemicals in the sample preparation.

Keywords: control, hazard, laboratories, waste,

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Authors: Ahmad A. Kader

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In the principles of Microeconomics course taught during the Fall Semester 2019, 158out of 179 students participated in the completion of two questionnaires and a survey describing their demographic and academic profiles. The two questionnaires include the 29 items of the Rotter Locus of Control Scale and the 52 items of the Schraw andDennisonMetacognitive Awareness Scale. The 52 items consist of 17 items describing knowledge of cognition and 37 items describing the regulation of cognition. The paper is intended to show the combined influence of locus of control, metacognitive knowledge, and metacognitive regulation on student performance. The survey covers variables that have been tested and recognized in economic education literature, which include GPA, gender, age, course level, race, student classification, whether the course was required or elective, employments, whether a high school economic course was taken, and attendance. Regression results show that of the economic education variables, GPA, classification, whether the course was required or elective, and attendance are the only significant variables in their influence on student grade. Of the educational psychology variables, the regression results show that the locus of control variable has a negative and significant effect, while the metacognitive knowledge variable has a positive and significant effect on student grade. Also, the adjusted R square value increased markedly with the addition of the locus of control, metacognitive knowledge, and metacognitive regulation variables to the regression equation. The t test results also show that students who are internally oriented and are high on the metacognitive knowledge scale significantly outperform students who are externally oriented and are low on the metacognitive knowledge scale. The implication of these results for educators is discussed in the paper.

Keywords: locus of control, metacognitive knowledge, metacognitive regulation, student performance, economic education

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Authors: Lakmali Anthony, Madeline Gillies

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Background: Incisional and ventral hernias are highly prevalent, with primary ventral hernias occurring in approximately 20% of adults and incisional hernias developing in up to 30% of midline abdominal incisions. Recent data from the United States have shown an increasing incidence of elective incisional and ventral hernia repair (IVHR) and emergency repair of complicated hernias. This study examines Australian population trends in IVHR over a two-decade study period. Methods: This retrospective study was performed using procedure data from the Australian Institute of Health and Welfare, and population data from the Australian Bureau of Statistics captured between 2000 and 2021 to calculate incidence rates per 100,000 population by age and sex for selected subcategories of IVHR operations. Trends over time were evaluated using simple linear regression. Results: There were 809,308 IVHR operations performed in Australia during the study period. The cumulative incidence adjusted for the population was 182 per 100,000; this increased by 9.578 per year during the study period (95% CI = 8.431- 10.726, p<.001). IVHR for primary umbilical hernias experienced the most significant increase in population-adjusted incidence, 1.177 per year. (95% CI = 0.654- 1.701, p<.001). Emergency IVHR for incarcerated, obstructed, and strangulated hernias increased by 0.576 per year (95% CI = 0.510 -0.642, p<.001). Only 20.2% of IVHR procedures were performed as day surgery. Conclusions: Australia has seen a significant increase in IVHR operations performed in the last 20 years, particularly those for primary ventral hernias. IVHR for hernias complicated by incarceration, obstruction, and strangulation also increased significantly. The proportion of IVHR operations performed as day surgery is well below the target set by the Royal Australasian College of Surgeons. With the increasing incidence of IVHR operations and an increasing proportion of these being emergent, elective IVHR should be performed as day surgery when it is safe.

Keywords: ventral, incisional, hernia, trends

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Authors: Emre Bayamlıoğlu

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This paper aims to provide an account of the legal and the regulative aspects of the algorithmic reputation systems with a special emphasis on the sharing economy (i.e., Uber, Airbnb, Lyft) business model. The first section starts with an analysis of the legal and commercial nature of the tripartite relationship among the parties, namely, the host platform, individual sharers/service providers and the consumers/users. The section further examines to what extent an algorithmic system of reputational information could serve as an alternative to legal regulation. Shortcomings are explained and analyzed with specific examples from Airbnb Platform which is a pioneering success in the sharing economy. The following section focuses on the issue of governance and control of the reputational information. The section first analyzes the legal consequences of algorithmic filtering systems to detect undesired comments and how a delicate balance could be struck between the competing interests such as freedom of speech, privacy and the integrity of the commercial reputation. The third section deals with the problem of manipulation by users. Indeed many sharing economy businesses employ certain techniques of data mining and natural language processing to verify consistency of the feedback. Software agents referred as "bots" are employed by the users to "produce" fake reputation values. Such automated techniques are deceptive with significant negative effects for undermining the trust upon which the reputational system is built. The third section is devoted to explore the concerns with regard to data mobility, data ownership, and the privacy. Reputational information provided by the consumers in the form of textual comment may be regarded as a writing which is eligible to copyright protection. Algorithmic reputational systems also contain personal data pertaining both the individual entrepreneurs and the consumers. The final section starts with an overview of the notion of reputation as a communitarian and collective form of referential trust and further provides an evaluation of the above legal arguments from the perspective of public interest in the integrity of reputational information. The paper concludes with certain guidelines and design principles for algorithmic reputation systems, to address the above raised legal implications.

Keywords: sharing economy, design principles of algorithmic regulation, reputational systems, personal data protection, privacy

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Authors: Merve Aygün Esastürk, Deren Ataç Yılmaz, Görkem Oğur, Emre Özgen Kuzu, Sadık Ödemiş

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Hydrocracker plants are one of the most complicated and most profitable units in the refinery process. It takes long chain paraffinic hydrocarbons as feed and turns them into smaller and more valuable products, mainly kerosene and diesel under high pressure with the excess amount of hydrogen. Controlling the product qualities well directly contributes to the unit profit. Control of a plant is mainly based on PID and MPC controllers. Controlling the reaction section is important in terms of reaction severity. However, controlling the fractionation section is more crucial since the end products are separated in fractionation section. In this paper, the importance of well-configured base layer control mechanism, composed of PID controllers, is highlighted. For this purpose, two different base layer control scheme is applied in a hydrocracker fractionator column performances of schemes, which is a direct contribution to better product quality, are compared.

Keywords: controller, distillation, configuration selection, hydrocracker, model predictive controller, proportional-integral-derivative controller

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Authors: Mahdieh Khanmohammadi, Sune Darkner, Nicoletta Nava, Jens Randel Nyengaard, Jon Sporring

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We study the effect of stress on nervous system and we use two experimental groups of rats: sham rats and rats subjected to acute foot-shock stress. We investigate the synaptic vesicles density as a function of distance to the active zone in serial section transmission electron microscope images in 2 and 3 dimensions. By estimating the density in 2D and 3D we compare two groups of rats.

Keywords: stress, 3-dimensional synaptic vesicle density, image registration, bioinformatics

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Authors: Felix Gbenoba, Opeyemi Dahunsi

Abstract:

Customised, self-instructional materials are at the heart of instructional delivery in Open and Distance Learning (ODL). The success of any ODL institution depends on the availability of learning materials in quality and quantity. An ODL study material is expected to imitate what the teacher does in the face-to-face learning environment. This paper evaluates these expectation based on existing data and evidence. It concludes that the reality has not matched the expectation so far in terms of pedagogic aspect of instructional delivery especially in West Africa. This does not mean that instructional materials development has not produced any significant positive results in improving the overall learning (and teaching) experience in these institutions; it implies what will help further to identify the new challenges. Obstacles and problems of instructional materials development that could have affected the open educational resource initiatives are well established. The first section of this paper recalls some of the proposed values of instructional materials. The second section compares achievements so far and suggests that instructional materials development should be consider first at an early stage to realise the aspirations of instructional delivery. The third section highlights the challenges of instructional materials development in the future.

Keywords: face-to-face learning, instructional delivery, open and distance education, self-instructional materials

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Authors: Nasiri Ahmadullah, Shimozato Tetsuhiro, Masayuki Tai

Abstract:

This paper presents the step-by-step procedure for using Elastic Theory to calculate the internal stresses in composite bridge girders prestressed by the Preflexing Technology, called Prebeam in Japan and Preflex beam worldwide. Elastic Theory approaches preflex beams the same way as it does the conventional composite girders. Since preflex beam undergoes different stages of construction, calculations are made using different sectional and material properties. Stresses are calculated in every stage using the properties of the specific section. Stress accumulation gives the available stress in a section of interest. Concrete presence in the section implies prestress loss due to creep and shrinkage, however; more work is required to be done in this field. In addition to the graphical presentation of this application, this paper further discusses important notes of graphical comparison between the results of an experimental-only research carried out on a preflex beam, with the results of simulation based on the elastic theory approach, for an identical beam using Finite Element Modeling (FEM) by the author.

Keywords: composite girder, Elastic Theory, preflex beam, prestressing

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Authors: Mohsen Solimani Babarsad, Mohammad Rastgoo, Payam Taheri

Abstract:

One of the important applications of hydraulic jets is used for discharge industrial, agricultural and urban wastewater into the rivers or other ambient water to reduce negative effects of pollutant water. Submerged jets due to turbulent condition can mix large amount of dense pollutant water with ambient flow. This study is conducted to investigate the distribution and length of the mixing zone in hydraulic jet's flow field with change in cross section shapes of nozzle. Toward this end, three shapes of cross section (square, circle and rectangular) and three saline densities current with different concentration are considered in a flume with 600 cm as long, 100 cm as high and 150 cm in width. Various discharges were used to evaluate mixing length for a wide range of densimetric Froude numbers, Frd, from 100 to 550 that is defined at the nozzle. Consequently, the circular nozzle, in comparison with other sections, has a densimetric Froude number 11% higher than square nozzle and 26% higher than rectangular nozzle.

Keywords: hydraulic jet, mixing zone, densimetric Froude number, nozzle

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Authors: Shantanu Majumder

Abstract:

This paper attempts to explain the factors contribute in attracting and engaging rural women in Bangladesh toward political Islam that in many cases manifests itself in the form of violent extremism (VE). Bangladesh, the fourth largest Muslim majority country in the world, has been confronting the problem of VE in the name of Islam since a long. The political Islamists, explaining the events like military operations in Afghanistan and Iraq, anti-Muslim politics in neighboring India and Myanmar, Islamophobia in the West, and several other issues in their own way, have become to a vast extent successful in creating a high level of emotion, anger and a feeling of being oppressed worldwide among the ordinary Muslims masses. Half-hearted role of public intellectuals and political expediency of liberal political forces in explaining these events in a secular democratic way also facilitate the extremists to earn political dividend. VE was perceived as an all-male activism of the political Islamists’ in the past in Bangladesh. However, evidence in the recent times shows that there are sympathizers, recruiters, and perpetrators as well among the womenfolk in favor of VE-based political Islam. The first section in this paper sheds light on the way the political Islamists build rapport with and win over the heart of target women in countryside under the camouflage of preaching authentic Islam. This section also describes the role of family in involvement of women in VE. The second section discusses wide-ranging use of websites, facebook, laptop, mobile phones and several other means in the way to motivate and radicalize women. How the involvement with political Islamists brings changes in thinking process, lifestyle and family life of motivated women has been focused in the third section. The final section deals briefly with the way out relying on the argument that law and order forces alone cannot tackle this problem.

Keywords: Bangladesh, political Islam, violent extremism, women

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Authors: Hongyun Li, Zhibin Jiang

Abstract:

The travel of passengers in the urban rail transit network is influenced by changes in network structure and operational status, and the response of individual travel preferences to these changes also varies. Firstly, the influence of the suspension of urban rail transit line sections on passenger travel along the line is analyzed. Secondly, passenger travel trajectories containing multi-dimensional semantics are described based on network UD data. Next, passenger panel data based on spatio-temporal sequences is constructed to achieve frequent passenger clustering. Then, the Graph Convolutional Network (GCN) is used to model and identify the changes in travel modes of different types of frequent passengers. Finally, taking Shanghai Metro Line 11 as an example, the travel behavior patterns of frequent passengers after the Huaqiao section shutdown during the COVID-19 epidemic are analyzed. The results showed that after the section shutdown, most passengers would transfer to the nearest Anting station for boarding, while some passengers would transfer to other stations for boarding or cancel their travels directly. Among the passengers who transferred to Anting station for boarding, most of passengers maintained the original normalized travel mode, a small number of passengers waited for a few days before transferring to Anting station for boarding, and only a few number of passengers stopped traveling at Anting station or transferred to other stations after a few days of boarding on Anting station. The results can provide a basis for understanding urban rail transit passenger travel patterns and improving the accuracy of passenger flow prediction in abnormal operation scenarios.

Keywords: urban rail transit, section shutdown, frequent passenger, travel behavior pattern

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Authors: Wed Othman Alghamdi

Abstract:

The current study aims to find a non-toxic, low density, hydrogen-rich material that can be used in aprons without causing health issues for nuclear medical workers that could hinder their work and negatively affect patients. Five samples were tested in terms of fast neutron removal cross-section(C21H25ClO5, C2H4, LiH,H3NBH3,MgH2) mathematically using computer program called Phy-x/PSD it is a computer program designed to calculate the fast neutron removal cross section, and it was obtained that ammonia borane (𝐻3𝑁𝐵𝐻3) with a density of 0.78 (g/ cm3) ,And it containment of the three most important elements that play a major role in protection shields, which are (hydrogen, boron, nitrogen), Hydrogen works as a moderator that slows neutrons and turn them into thermal neutrons, boron and nitrogen both have the largest neutron absorption cross section. Ammonia borane has the highest fast neutron removal cross-section with the value of (0.122959317985393cm-1) and the least for polyethylene (𝐶2𝐻4) with the value of (0.0838038707225853 cm-1) which made the ammonia borane a better candidate than polyethylene and other compounds that have been tasted in previous research for multi-layer aprons in nuclear medicine, and may approve a proper protection against the hazard radiations that its produced in nuclear medicine filed by several ways, due to it is low density and non-toxicity.

Keywords: aprons, radiation, non-toxic, nuclear medicine, neutrons

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Authors: Elham Rajabian

Abstract:

The ascent of cybersecurity incidents is a rising threat to most organisations in general, while the impact of the incidents is unique to each of the organizations. It is a need for behavioural sciences to concentrate on employees’ behaviour in order to prepare key security mitigation opinions versus cybersecurity incidents. There are noticeable differences among users of a computer system in terms of complying with security behaviours. We can discuss the people's differences under several subjects such as delaying tactics on something that must be done, the tendency to act without thinking, future thinking about unexpected implications of present-day issues, and risk-taking behaviours in security policies compliance. In this article, we introduce high-profile cyber-attacks and their impacts on weakening cyber resiliency in organizations. We also give attention to human errors that influence network security. Human errors are discussed as a part of psychological matters to enhance compliance with the security policies. The organizational challenges are studied in order to shape a sustainable cyber risks management approach in the related work section. Insiders’ behaviours are viewed as a cyber security gap to draw proper cyber resiliency in section 3. We carry out the best cybersecurity practices by discussing four CIS challenges in section 4. In this regard, we provide a guideline and metrics to measure cyber resilience in organizations in section 5. In the end, we give some recommendations in order to build a cybersecurity culture based on individual behaviours.

Keywords: cyber resilience, human factors, cybersecurity behavior, attitude, usability, security culture

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Authors: Parsa Keyvani, Alistair Phillips, David Warwick

Abstract:

Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

Procedia PDF Downloads 80