Search results for: ground improvement
4866 Flow Characterization in Complex Terrain for Aviation Safety
Authors: Adil Rasheed, Mandar Tabib
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The paper describes the ability of a high-resolution Computational Fluid Dynamics model to predict terrain-induced turbulence and wind shear close to the ground. Various sensitivity studies to choose the optimal simulation setup for modeling the flow characteristics in a complex terrain are presented. The capabilities of the model are demonstrated by applying it to the Sandnessjøen Airport, Stokka in Norway, an airport that is located in a mountainous area. The model is able to forecast turbulence in real time and trigger an alert when atmospheric conditions might result in high wind shear and turbulence.Keywords: aviation safety, terrain-induced turbulence, atmospheric flow, alert system
Procedia PDF Downloads 4054865 Reliability Analysis of Geometric Performance of Onboard Satellite Sensors: A Study on Location Accuracy
Authors: Ch. Sridevi, A. Chalapathi Rao, P. Srinivasulu
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The location accuracy of data products is a critical parameter in assessing the geometric performance of satellite sensors. This study focuses on reliability analysis of onboard sensors to evaluate their performance in terms of location accuracy performance over time. The analysis utilizes field failure data and employs the weibull distribution to determine the reliability and in turn to understand the improvements or degradations over a period of time. The analysis begins by scrutinizing the location accuracy error which is the root mean square (RMS) error of differences between ground control point coordinates observed on the product and the map and identifying the failure data with reference to time. A significant challenge in this study is to thoroughly analyze the possibility of an infant mortality phase in the data. To address this, the Weibull distribution is utilized to determine if the data exhibits an infant stage or if it has transitioned into the operational phase. The shape parameter beta plays a crucial role in identifying this stage. Additionally, determining the exact start of the operational phase and the end of the infant stage poses another challenge as it is crucial to eliminate residual infant mortality or wear-out from the model, as it can significantly increase the total failure rate. To address this, an approach utilizing the well-established statistical Laplace test is applied to infer the behavior of sensors and to accurately ascertain the duration of different phases in the lifetime and the time required for stabilization. This approach also helps in understanding if the bathtub curve model, which accounts for the different phases in the lifetime of a product, is appropriate for the data and whether the thresholds for the infant period and wear-out phase are accurately estimated by validating the data in individual phases with Weibull distribution curve fitting analysis. Once the operational phase is determined, reliability is assessed using Weibull analysis. This analysis not only provides insights into the reliability of individual sensors with regards to location accuracy over the required period of time, but also establishes a model that can be applied to automate similar analyses for various sensors and parameters using field failure data. Furthermore, the identification of the best-performing sensor through this analysis serves as a benchmark for future missions and designs, ensuring continuous improvement in sensor performance and reliability. Overall, this study provides a methodology to accurately determine the duration of different phases in the life data of individual sensors. It enables an assessment of the time required for stabilization and provides insights into the reliability during the operational phase and the commencement of the wear-out phase. By employing this methodology, designers can make informed decisions regarding sensor performance with regards to location accuracy, contributing to enhanced accuracy in satellite-based applications.Keywords: bathtub curve, geometric performance, Laplace test, location accuracy, reliability analysis, Weibull analysis
Procedia PDF Downloads 624864 Interactive Virtual Patient Simulation Enhances Pharmacology Education and Clinical Practice
Authors: Lyndsee Baumann-Birkbeck, Sohil A. Khan, Shailendra Anoopkumar-Dukie, Gary D. Grant
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Technology-enhanced education tools are being rapidly integrated into health programs globally. These tools provide an interactive platform for students and can be used to deliver topics in various modes including games and simulations. Simulations are of particular interest to healthcare education, where they are employed to enhance clinical knowledge and help to bridge the gap between theory and practice. Simulations will often assess competencies for practical tasks, yet limited research examines the effects of simulation on student perceptions of their learning. The aim of this study was to determine the effects of an interactive virtual patient simulation for pharmacology education and clinical practice on student knowledge, skills and confidence. Ethics approval for the study was obtained from Griffith University Research Ethics Committee (PHM/11/14/HREC). The simulation was intended to replicate the pharmacy environment and patient interaction. The content was designed to enhance knowledge of proton-pump inhibitor pharmacology, role in therapeutics and safe supply to patients. The tool was deployed into a third-year clinical pharmacology and therapeutics course. A number of core practice areas were examined including the competency domains of questioning, counselling, referral and product provision. Baseline measures of student self-reported knowledge, skills and confidence were taken prior to the simulation using a specifically designed questionnaire. A more extensive questionnaire was deployed following the virtual patient simulation, which also included measures of student engagement with the activity. A quiz assessing student factual and conceptual knowledge of proton-pump inhibitor pharmacology and related counselling information was also included in both questionnaires. Sixty-one students (response rate >95%) from two cohorts (2014 and 2015) participated in the study. Chi-square analyses were performed and data analysed using Fishers exact test. Results demonstrate that student knowledge, skills and confidence within the competency domains of questioning, counselling, referral and product provision, show improvement following the implementation of the virtual patient simulation. Statistically significant (p<0.05) improvement occurred in ten of the possible twelve self-reported measurement areas. Greatest magnitude of improvement occurred in the area of counselling (student confidence p<0.0001). Student confidence in all domains (questioning, counselling, referral and product provision) showed a marked increase. Student performance in the quiz also improved, demonstrating a 10% improvement overall for pharmacology knowledge and clinical practice following the simulation. Overall, 85% of students reported the simulation to be engaging and 93% of students felt the virtual patient simulation enhanced learning. The data suggests that the interactive virtual patient simulation developed for clinical pharmacology and therapeutics education enhanced students knowledge, skill and confidence, with respect to the competency domains of questioning, counselling, referral and product provision. These self-reported measures appear to translate to learning outcomes, as demonstrated by the improved student performance in the quiz assessment item. Future research of education using virtual simulation should seek to incorporate modern quantitative measures of student learning and engagement, such as eye tracking.Keywords: clinical simulation, education, pharmacology, simulation, virtual learning
Procedia PDF Downloads 3234863 The Role of Leadership in Enhancing Health Information Systems to Improve Patient Outcomes in China
Authors: Nisar Ahmad, Xuyi, Ali Akbar
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As healthcare systems worldwide strive for improvement, the integration of advanced health information systems (HIS) has emerged as a pivotal strategy. This study aims to investigate the critical role of leadership in the implementation and enhancement of HIS in Chinese hospitals and how such leadership can drive improvements in patient outcomes and overall healthcare satisfaction. We propose a comprehensive study to be conducted across various hospitals in China, targeting healthcare professionals as the primary population. The research will leverage established theories of transformational leadership and technology acceptance to underpin the analysis. In our approach, data will be meticulously gathered through surveys and interviews, focusing on the experiences and perceptions of healthcare professionals regarding HIS implementation and its impact on patient care. The study will utilize SPSS and SmartPLS software for robust data analysis, ensuring precise and comprehensive insights into the correlation between leadership effectiveness and HIS success. We hypothesize that strong, visionary leadership is essential for the successful adoption and optimization of HIS, leading to enhanced patient outcomes and increased satisfaction with healthcare services. By applying advanced statistical methods, we aim to identify key leadership traits and practices that significantly contribute to these improvements. Our research will provide actionable insights for policymakers and healthcare administrators in China, offering evidence-based recommendations to foster leadership that champions HIS and drives continuous improvement in healthcare delivery. This study will contribute to the global discourse on health information systems, emphasizing the future role of leadership in transforming healthcare environments and outcomes.Keywords: health information systems, leadership, patient outcomes, healthcare satisfaction
Procedia PDF Downloads 164862 Effect of Reinforcement Density on the Behaviour of Reinforced Sand Under a Square Footing
Authors: Dhyaalddin Bahaalddin Noori Zangana
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This study involves the behavior of reinforced sand under a square footing. A series of bearing capacity tests were performed on a small-scale laboratory model, which filled with a poorly-graded homogenous bed of sand, which was placed in a medium dense state using sand raining technique. The sand was reinforced with 40 mm wide household aluminum foil strips. The main studied parameters was to consider the effect of reinforcing strip length, with various linear density of reinforcement, number of reinforcement layers and depth of top layer of reinforcement below the footing, on load-settlement behavior, bearing capacity ratio and settlement reduction factor. The relation of load-settlement generally showed similar trend in all the tests. Failure was defined as settlement equal to 10% of the footing width. The recommended optimum reinforcing strip length, linear density of reinforcement, number of reinforcement layers and depth of top layer of reinforcing strips that give the maximum bearing capacity improvement and minimum settlement reduction factor were presented and discussed. Different bearing capacity ration versus length of the reinforcing strips and settlement reduction factor versus length of the reinforcing strips relations at failure were showed improvement of bearing capacity ratio by a factor of 3.82 and reduction of settlement reduction factor by a factor of 0.813. The optimum length of reinforcement was found to be 7.5 times the footing width.Keywords: square footing, relative density, linear density of reinforcement, bearing capacity ratio, load-settlement behaviour
Procedia PDF Downloads 914861 Impact of an Exercise Program on Physical Fitness of a Candidate to Naval Academy: A Case Study
Authors: Ricardo Chaves, Carlos Vasconcelos
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Candidates to join the Naval Academy have to take a set of physical tests, which is crucial for a high level of physical fitness. Thus, the planning of physical exercises for candidates to the Naval School must take into account the improvement of their physical fitness. The aim of this study was to investigate the impact of a 6-month exercise program to improve the physical fitness of an individual who will apply for the Naval Academy. This was a non-experimental pre-post-evaluation study. The patient was male, had 18 years old, and a body mass index of 21.1 kg.m². The patient participated in a 6-month aerobic and strength exercise program (3 sessions per week, 75 minutes duration each session). Physical fitness tests were performed according to the physical fitness requirements for entry into the Naval academy (muscle strength [maximum number of lifts and maximum number of sit-ups for 1 minute]; aerobic fitness [2.4 km run and 200 m swimming test]) before (baseline) and after the exercise intervention (6 months). Regarding muscle strength, in the abdominal test, the improvements between the pre-test (39 abdominals.) and post-test (61 abdominals) were 56.4%. For elevations, there was an increase in its number by 150% between the pre-test (4 elevations) and post-test (10 elevations). With regard to aerobic fitness, in the 2.4 km race, there was an evolution of 32.0% between the pre-test (16.46 min.) and the post-test (12.42 min.). For the 200-meter swimming test, there was a negative variation of 2% between the pre-test (2.25 min.) and post-test (2.28 min). A 6-month aerobic and strength exercise program leads to a positive evolution in the muscular strength of the patient. Regarding aerobic fitness, opposite results were found, with a positive evolution in the 2.4 km running test and a negative evolution in the swimming test. In future exercise programs for the improvement of the physical fitness of candidates for the Naval Academy, more emphasis has to be done on specific swimming training.Keywords: case study, exercise program, Naval Academy, physical fitness
Procedia PDF Downloads 834860 Prediction of Compressive Strength in Geopolymer Composites by Adaptive Neuro Fuzzy Inference System
Authors: Mehrzad Mohabbi Yadollahi, Ramazan Demirboğa, Majid Atashafrazeh
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Geopolymers are highly complex materials which involve many variables which makes modeling its properties very difficult. There is no systematic approach in mix design for Geopolymers. Since the amounts of silica modulus, Na2O content, w/b ratios and curing time have a great influence on the compressive strength an ANFIS (Adaptive neuro fuzzy inference system) method has been established for predicting compressive strength of ground pumice based Geopolymers and the possibilities of ANFIS for predicting the compressive strength has been studied. Consequently, ANFIS can be used for geopolymer compressive strength prediction with acceptable accuracy.Keywords: geopolymer, ANFIS, compressive strength, mix design
Procedia PDF Downloads 8354859 Exploring the Spatial Relationship between Built Environment and Ride-hailing Demand: Applying Street-Level Images
Authors: Jingjue Bao, Ye Li, Yujie Qi
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The explosive growth of ride-hailing has reshaped residents' travel behavior and plays a crucial role in urban mobility within the built environment. Contributing to the research of the spatial variation of ride-hailing demand and its relationship to the built environment and socioeconomic factors, this study utilizes multi-source data from Haikou, China, to construct a Multi-scale Geographically Weighted Regression model (MGWR), considering spatial scale heterogeneity. The regression results showed that MGWR model was demonstrated superior interpretability and reliability with an improvement of 3.4% on R2 and from 4853 to 4787 on AIC, compared with Geographically Weighted Regression model (GWR). Furthermore, to precisely identify the surrounding environment of sampling point, DeepLabv3+ model is employed to segment street-level images. Features extracted from these images are incorporated as variables in the regression model, further enhancing its rationality and accuracy by 7.78% improvement on R2 compared with the MGWR model only considered region-level variables. By integrating multi-scale geospatial data and utilizing advanced computer vision techniques, this study provides a comprehensive understanding of the spatial dynamics between ride-hailing demand and the urban built environment. The insights gained from this research are expected to contribute significantly to urban transportation planning and policy making, as well as ride-hailing platforms, facilitating the development of more efficient and effective mobility solutions in modern cities.Keywords: travel behavior, ride-hailing, spatial relationship, built environment, street-level image
Procedia PDF Downloads 654858 The Impact of Failure-tolerant Restaurant Culture on Curbing Employees’ Withdrawal Behavior: The Roles of Psychological Empowerment and Mindful Leadership
Authors: Omar Alsetoohy, Mohamed Ezzat, Mahmoud Abou Kamar
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The success of a restaurant or hotel depends very much on the quality and quantity of its human resources. Thus, establishing a competitive edge through human assets requires careful attention to the practices that best leverage these assets. Usually, hotel or restaurant employees recognize customer defection as an unfavorable or unpleasant occurrence associated with failure. These failures could be in handling, communication, learning, or encouragement. Besides, employees could be afraid of blame from their colleagues and managers, which prevents them from freely discussing these mistakes with them. Such behaviors, in turn, would push employees to withdraw from the workplace. However, we have a good knowledge of the leadership outcomes, but less is known about how and why these effects occur. Accordingly, mindful leaders usually analyze the causes and underlying mechanisms of failures for work improvement. However, despite the excessive literature in the field of leadership and employee behaviors, to date, no research studies had investigated the impact of a failure-tolerant restaurant culture on the employees’ withdrawal behaviors considering the moderating role of psychological empowerment and mindful leadership. Thus, this study seeks to investigate the impact of a failure-tolerant culture on the employees’ withdrawal behaviors in fast-food restaurants in Egypt considering the moderating effects of employee empowerment and mindful leaders. This study may contribute to the existing literature by filling the gap between failure-tolerant cultures and employee withdrawal behaviors in the hospitality literature. The study may also identify the best practices for restaurant operators and managers to deal with employees' failures as an improvement tool for their performance.Keywords: failure-tolerant culture, employees’ withdrawal behaviors psychological empowerment, mindful leadership, restaurants
Procedia PDF Downloads 1034857 The Positive Effects of Processing Instruction on the Acquisition of French as a Second Language: An Eye-Tracking Study
Authors: Cecile Laval, Harriet Lowe
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Processing Instruction is a psycholinguistic pedagogical approach drawing insights from the Input Processing Model which establishes the initial innate strategies used by second language learners to connect form and meaning of linguistic features. With the ever-growing use of technology in Second Language Acquisition research, the present study uses eye-tracking to measure the effectiveness of Processing Instruction in the acquisition of French and its effects on learner’s cognitive strategies. The experiment was designed using a TOBII Pro-TX300 eye-tracker to measure participants’ default strategies when processing French linguistic input and any cognitive changes after receiving Processing Instruction treatment. Participants were drawn from lower intermediate adult learners of French at the University of Greenwich and randomly assigned to two groups. The study used a pre-test/post-test methodology. The pre-tests (one per linguistic item) were administered via the eye-tracker to both groups one week prior to instructional treatment. One group received full Processing Instruction treatment (explicit information on the grammatical item and on the processing strategies, and structured input activities) on the primary target linguistic feature (French past tense imperfective aspect). The second group received Processing Instruction treatment except the explicit information on the processing strategies. Three immediate post-tests on the three grammatical structures under investigation (French past tense imperfective aspect, French Subjunctive used for the expression of doubt, and the French causative construction with Faire) were administered with the eye-tracker. The eye-tracking data showed the positive change in learners’ processing of the French target features after instruction with improvement in the interpretation of the three linguistic features under investigation. 100% of participants in both groups made a statistically significant improvement (p=0.001) in the interpretation of the primary target feature (French past tense imperfective aspect) after treatment. 62.5% of participants made an improvement in the secondary target item (French Subjunctive used for the expression of doubt) and 37.5% of participants made an improvement in the cumulative target feature (French causative construction with Faire). Statistically there was no significant difference between the pre-test and post-test scores in the cumulative target feature; however, the variance approximately tripled between the pre-test and the post-test (3.9 pre-test and 9.6 post-test). This suggests that the treatment does not affect participants homogenously and implies a role for individual differences in the transfer-of-training effect of Processing Instruction. The use of eye-tracking provides an opportunity for the study of unconscious processing decisions made during moment-by-moment comprehension. The visual data from the eye-tracking demonstrates changes in participants’ processing strategies. Gaze plots from pre- and post-tests display participants fixation points changing from focusing on content words to focusing on the verb ending. This change in processing strategies can be clearly seen in the interpretation of sentences in both primary and secondary target features. This paper will present the research methodology, design and results of the experimental study using eye-tracking to investigate the primary effects and transfer-of-training effects of Processing Instruction. It will then provide evidence of the cognitive benefits of Processing Instruction in Second Language Acquisition and offer suggestion in second language teaching of grammar.Keywords: eye-tracking, language teaching, processing instruction, second language acquisition
Procedia PDF Downloads 2754856 Nation Building versus Self Determination: Thai State’s Response to Insurgency in South
Authors: Sunaina Sunaina
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The emergence of Thailand as a modern nation was amalgamation of several minority groups. Eventually, the nation tried to mitigate these diversities in the name of nationalism in the backdrop of colonial powers presence in neighboring nations. However, the continued imposition of modern nation building processes (which is a western concept) in the post-colonial era deepen the feelings of alienation among the minority groups and leads to separatist conflicts. It is significant that whatever form these conflicts take, will impact the security of nation as well as the region of Southeast Asia. This paper tries to explore the possible factors behind the state policies adopted by the government of Thailand to manage the insurgency in Southern provinces in the south. The protracted insurgency in the South has historical roots as Pattani kingdom had glorious period whether it was trade or commerce or education and its assimilation was never accepted by the leaders of these areas. But after assimilation of southern provinces in the state, it has been the state policy as an important factor in promoting or mitigating the insurgency. Initial protests from the elite class of southern provinces inflated into a more organized and violent uprising after Second World War. It was only the decade of 1990s that a relative peace could prevail for some time. The violence reemerged in 2004 with more intensity and till today this area is suffering with violence. Period of different Prime Ministers dealt this insurgency in different ways sometimes very hard line approach had been adopted especially under Primeminstership of Thaksin Shinawatra. Recently, the peace talks which were started during the period of Yinglunck Shinawatra and were carried forward by Junta government also halted. And again, the region stays in a very volatile state. Violence in these provinces not only questions the capability of government to provide political solution to the problem, but also emerges as a major threat to the internal security of the state. The current era where global terrorism is spreading fast, such vulnerable areas may work as a new ground for its proliferation in Southeast Asia. The paper attempts to understand how Thailand’s historical experience of security determines a different approach to national unity which limits the prospects for autonomy in the South. In conjunction with this experience it is nature of national politics and leadership that influences the nature of policies on the ground in Southern Thailand. The paper also tries to bring out conflict between state sovereignty and self-determination as demanded by many in the southern provinces.Keywords: insurgency, southern Thailand, security, nation building
Procedia PDF Downloads 1184855 Cephalometric Changes of Patient with Class II Division 1 [Malocclusion] Post Orthodontic Treatment with Growth Stimulation: A Case Report
Authors: Pricillia Priska Sianita
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An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.Keywords: cephalometric evaluation, class II division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems
Procedia PDF Downloads 2444854 Characterization of Aerosol Particles in Ilorin, Nigeria: Ground-Based Measurement Approach
Authors: Razaq A. Olaitan, Ayansina Ayanlade
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Understanding aerosol properties is the main goal of global research in order to lower the uncertainty associated with climate change in the trends and magnitude of aerosol particles. In order to identify aerosol particle types, optical properties, and the relationship between aerosol properties and particle concentration between 2019 and 2021, a study conducted in Ilorin, Nigeria, examined the aerosol robotic network's ground-based sun/sky scanning radiometer. The AERONET algorithm version 2 was utilized to retrieve monthly data on aerosol optical depth and angstrom exponent. The version 3 algorithm, which is an almucantar level 2 inversion, was employed to retrieve daily data on single scattering albedo and aerosol size distribution. Excel 2016 was used to analyze the data's monthly, seasonal, and annual mean averages. The distribution of different types of aerosols was analyzed using scatterplots, and the optical properties of the aerosol were investigated using pertinent mathematical theorems. To comprehend the relationships between particle concentration and properties, correlation statistics were employed. Based on the premise that aerosol characteristics must remain constant in both magnitude and trend across time and space, the study's findings indicate that the types of aerosols identified between 2019 and 2021 are as follows: 29.22% urban industrial (UI) aerosol type, 37.08% desert (D) aerosol type, 10.67% biomass burning (BB), and 23.03% urban mix (Um) aerosol type. Convective wind systems, which frequently carry particles as they blow over long distances in the atmosphere, have been responsible for the peak-of-the-columnar aerosol loadings, which were observed during August of the study period. The study has shown that while coarse mode particles dominate, fine particles are increasing in seasonal and annual trends. Burning biomass and human activities in the city are linked to these trends. The study found that the majority of particles are highly absorbing black carbon, with the fine mode having a volume median radius of 0.08 to 0.12 meters. The investigation also revealed that there is a positive coefficient of correlation (r = 0.57) between changes in aerosol particle concentration and changes in aerosol properties. Human activity is rapidly increasing in Ilorin, causing changes in aerosol properties, indicating potential health risks from climate change and human influence on geological and environmental systems.Keywords: aerosol loading, aerosol types, health risks, optical properties
Procedia PDF Downloads 504853 Assessment of Collapse Potential of Degrading SDOF Systems
Authors: Muzaffer Borekci, Murat Serdar Kirçil
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Predicting the collapse potential of a structure during earthquakes is an important issue in earthquake engineering. Many researchers proposed different methods to assess the collapse potential of structures under the effect of strong ground motions. However most of them did not consider degradation and softening effect in hysteretic behavior. In this study, collapse potential of SDOF systems caused by dynamic instability with stiffness and strength degradation has been investigated. An equation was proposed for the estimation of collapse period of SDOF system which is a limit value of period for dynamic instability. If period of the considered SDOF system is shorter than the collapse period then the relevant system exhibits dynamic instability and collapse occurs.Keywords: collapse, degradation, dynamic instability, seismic response
Procedia PDF Downloads 3694852 Analysis of Ancient and Present Lightning Protection Systems of Large Heritage Stupas in Sri Lanka
Authors: J.R.S.S. Kumara, M.A.R.M. Fernando, S.Venkatesh, D.K. Jayaratne
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Protection of heritage monuments against lightning has become extremely important as far as their historical values are concerned. When such structures are large and tall, the risk of lightning initiated from both cloud and ground can be high. This paper presents a lightning risk analysis of three giant stupas in Anuradhapura era (fourth century BC onwards) in Sri Lanka. The three stupas are Jethawaaramaya (269-296 AD), Abayagiriya (88-76 BC) and Ruwanweliseya (161-137 BC), the third, fifth and seventh largest ancient structures in the world. These stupas are solid brick structures consisting of a base, a near hemispherical dome and a conical spire on the top. The ancient stupas constructed with a dielectric crystal on the top and connected to the ground through a conducting material, was considered as the hypothesis for their original lightning protection technique. However, at present, all three stupas are protected with Franklin rod type air termination systems located on top of the spire. First, a risk analysis was carried out according to IEC 62305 by considering the isokeraunic level of the area and the height of the stupas. Then the standard protective angle method and rolling sphere method were used to locate the possible touching points on the surface of the stupas. The study was extended to estimate the critical current which could strike on the unprotected areas of the stupas. The equations proposed by (Uman 2001) and (Cooray2007) were used to find the striking distances. A modified version of rolling sphere method was also applied to see the effects of upward leaders. All these studies were carried out for two scenarios: with original (i.e. ancient) lightning protection system and with present (i.e. new) air termination system. The field distribution on the surface of the stupa in the presence of a downward leader was obtained using finite element based commercial software COMSOL Multiphysics for further investigations of lightning risks. The obtained results were analyzed and compared each other to evaluate the performance of ancient and new lightning protection methods and identify suitable methods to design lightning protection systems for stupas. According to IEC standards, all three stupas with new and ancient lightning protection system has Level IV protection as per protection angle method. However according to rolling sphere method applied with Uman’s equation protection level is III. The same method applied with Cooray’s equation always shows a high risk with respect to Uman’s equation. It was found that there is a risk of lightning strikes on the dome and square chamber of the stupa, and the corresponding critical current values were different with respect to the equations used in the rolling sphere method and modified rolling sphere method.Keywords: Stupa, heritage, lightning protection, rolling sphere method, protection level
Procedia PDF Downloads 2334851 Evaluation of the Capabilities of Saccharomyces cerevisiae and Lactobacillus plantarum in Improvement of Total Phenolic Content and Antioxidant Activity in Carob Kibble
Authors: Thi Huong Vu, Vijay Jayasena, Zhongxiang Fang, Gary Dykes
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Carob kibble has recently received attention due to the presence of high level of polyphenol antioxidants. The capacity of microorganisms to improve antioxidant activities and total phenolics in carob kibble was investigated in the study. Two types of microorganisms including lactic acid bacteria Lactobacillus plantarum (L. plantarum) and yeast Saccharomyces cerevisiae (S. cerevisiae) were used in single and in their combination as starters. The total phenolic content was determined by the Folin–Ciocalteu method. Antioxidant activities were assessed scavenging capacity using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS). The study found that S. cerevisiae alone considerably improved 55% total phenolics content at 15 h, while L. plantarum caused in a loss of 20% through the process. Antioxidant capacity of the yeast-fermented samples significantly increased by 43 % and 10 % in ABTS and DPPH assays, respectively. However, reduction of 13 % and 32 % inhibition were recorded in the carob treated with L. plantarum. In the combination of S. cerevisiae and L. plantarum (1:1), both total phenolic content and antioxidant activity of carob kibble were a similar trend as these of S. cerevisiae single, but a lower improvement. The antioxidant power of the extracts was linearly correlated to their total phenolic contents (R=0.75). The results suggested that S. cerevisiae alone was the better for enhancement of both total phenolic content and antioxidant activity in carob kibble using submerged fermentation. The efficiency of fermentation reached the highest at 15h. Thus submerged fermentation with S. cerevisiae offers a tool with simple and cost effective to further increase the bioactive potential of carob kibble, which is in use for food, cosmetic and pharmaceutical industries.Keywords: antioxidant activity, carob kibble, lactobacillus plantarum, saccharomyces cerevisiae, total phenolics
Procedia PDF Downloads 2784850 Neuron Point-of-Care Stem Cell Therapy: Intrathecal Transplant of Autologous Bone Marrow-Derived Stem Cells in Patients with Cerebral Palsy
Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia
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Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders
Procedia PDF Downloads 4074849 Environmental Implications of Groundwater Quality in Irrigated Agriculture in Kebbi State, Nigeria
Authors: O. I. Ojo, W. B. R. Graham, I. W. Pishiria
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The quality of groundwater used for irrigation in Kebbi State, northwestern Nigeria was evaluated. Open-well, tube-well and borehole water samples were collected from various locations in the State. The water samples analyzed had pH values below the normal range for irrigation water and very low to moderate salinity (electrical conductivity 0.05-0.82 dS.m-1). The adjusted sodium adsorption ratio values in all the samples were also very low (<0.2), indicating very low sodicity hazards. However, irrigation water of very low salinity (<0.2dS.m-1) and low SAR can lead to problems of infiltration into soils. The Ca: Mg ratio (<1) in most of the samples may lead to Ca deficiency in soils after long term use. The nitrate concentration in most of the samples was high ranging from 4.5 to >50mg/L.Keywords: ground water quality, irrigation, characteristics, soil drainage, salinity, Fadama
Procedia PDF Downloads 2774848 Access to Inclusive and Culturally Sensitive Mental Healthcare in Pharmacy Students and Residents
Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris
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Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers
Procedia PDF Downloads 844847 Investigation of Zinc Corrosion in Tropical Soil Solution
Authors: M. Lebrini, L. Salhi, C. Deyrat, C. Roos, O. Nait-Rabah
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The paper presents a large experimental study on the corrosion of zinc in tropical soil and in the ground water at the various depths. Through this study, the corrosion rate prediction was done on the basis of two methods the electrochemical method and the gravimetric. The electrochemical results showed that the corrosion rate is more important at the depth levels 0 m to 0.5 m and 0.5 m to 1 m and beyond these depth levels, the corrosion rate is less important. The electrochemical results indicated also that a passive layer is formed on the zinc surface. The found SEM and EDX micrographs displayed that the surface is extremely attacked and confirmed that a zinc oxide layer is present on the surface whose thickness and relief increase as the contact with soil increases.Keywords: soil corrosion, galvanized steel, electrochemical technique, SEM and EDX
Procedia PDF Downloads 1184846 Evaluation of the Grammar Questions at the Undergraduate Level
Authors: Preeti Gacche
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A considerable part of undergraduate level English Examination papers is devoted to grammar. Hence the grammar questions in the question papers are evaluated and the opinions of both students and teachers about them are obtained and analyzed. A grammar test of 100 marks is administered to 43 students to check their performance. The question papers have been evaluated by 10 different teachers and their scores compared. The analysis of 38 University question papers reveals that on an average 20 percent marks are allotted to grammar. Almost all the grammar topics are tested. Abundant use of grammatical terminology is observed in the questions. Decontextualization, repetition, possibility of multiple correct answers and grammatical errors in framing the questions have been observed. Opinions of teachers and students about grammar questions vary in many respects. The students responses are analyzed medium-wise and sex-wise. The Medium at the School level and the sex of the students are found to play no role as far as interest in the study of grammar is concerned. English medium students solve grammar questions intuitively whereas non-English medium students are required to recollect the rules of grammar. Prepositions, Verbs, Articles and Model auxiliaries are found to be easy topics for most students whereas the use of conjunctions is the most difficult topic. Out of context items of grammar are difficult to answer in comparison with contextualized items of grammar. Hence contextualized texts to test grammar items are desirable. No formal training in setting questions is imparted to teachers by the competent authorities like the University. They need to be trained in testing. Statistically there is no significant change of score with the change in the rater in testing of grammar items. There is scope of future improvement. The question papers need to be evaluated and feedback needs to be obtained from students and teachers for future improvement.Keywords: context, evaluation, grammar, tests
Procedia PDF Downloads 3444845 Kuwait Environmental Remediation Program: Fresh Groudwater Risk Assessement from Tarcrete Material across the Raudhatain and Sabriyah Oil Fields, North Kuwait
Authors: Nada Al-Qallaf, Aisha Al-Barood, Djamel Lekmine, Srinivasan Vedhapuri
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Kuwait Oil Company (KOC) under the supervision of Kuwait National Focal Point (KNFP) is planning to remediate 26 million (M) m3 of oil-contaminated soil in oil fields of Kuwait as a direct and indirect fallout of the Gulf War during 1990-1991. This project is funded by the United Nations Compensation Commission (UNCC) under the Kuwait Environmental Remediation Program (KERP). Oil-contamination of the soil occurred due to the destruction of the oil wells and spilled crude oil across the land surface and created ‘oil lakes’ in low lying land. Aerial fall-out from oil spray and combustion products from oil fires combined with the sand and gravel on the ground surface to form a layer of hardened ‘Tarcrete’. The unique fresh groundwater lenses present in the Raudhatain and Sabriya subsurface areas had been impacted by the discharge and/or spills of dissolved petroleum constituents. These fresh groundwater aquifers were used for drinking water purposes until 1990, prior to invasion. This has significantly damages altered the landscape, ecology and habitat of the flora and fauna and in Kuwait Desert. Under KERP, KOC is fully responsible for the planning and execution of the remediation and restoration projects in KOC oil fields. After the initial recommendation of UNCC to construct engineered landfills for containment and disposal of heavily contaminated soils, two landfills were constructed, one in North Kuwait and another in South East Kuwait of capacity 1.7 million m3 and 0.5 million m3 respectively. KOC further developed the Total Remediation Strategy in conjunction with KNFP and has obtained UNCC approval. The TRS comprises of elements such as Risk Based Approach (RBA), Bioremediation of low Contaminated Soil levels, Remediation Treatment Technologies, Sludge Disposal via Beneficial Recycling or Re-use and Engineered landfills for Containment of untreatable materials. Risk Based Assessment as a key component to avoid any unnecessary remedial works, where it can be demonstrated that human health and the environment are sufficiently protected in the absence of active remediation. This study demonstrates on the risks of tarcrete materials spread over areas 20 Km2 on the fresh Ground water lenses/catchment located beneath the Sabriyah and Raudhatain oil fields in North Kuwait. KOC’s primary objective is to provide justification of using RBA, to support a case with the Kuwait regulators to leave the tarcrete material in place, rather than seek to undertake large-scale removal and remediation. The large-scale coverage of the tarcrete in the oil fields and perception that the residual contamination associated with this source is present in an environmentally sensitive area essentially in ground water resource. As part of this assessment, conceptual site model (CSM) and complete risk-based and fate and transport modelling was carried out which includes derivation of site-specific assessment criteria (SSAC) and quantification of risk to identified waters resource receptors posed by tarcrete impacted areas. The outcome of this assessment was determined that the residual tarcrete deposits across the site area shall not create risks to fresh groundwater resources and the remedial action to remove and remediate the surficial tarcrete deposits is not warranted.Keywords: conceptual site model, fresh groundwater, oil-contaminated soil, tarcrete, risk based assessment
Procedia PDF Downloads 1704844 Evaluation of Stone Column Behavior Strengthened Circular Raft Footing under Static Load
Authors: R. Ziaie Moayed, B. Mohammadi-Haji
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Stone columns have been widely employing to improve the load-settlement characteristics of soft soils. The results of two small scale displacement control loading tests on stone columns were used in order to validate numerical finite element simulations. Additionally, a series of numerical calculations of static loading have been performed on strengthened raft footing to investigate the effects of using stone columns on bearing capacity of footings. The bearing capacity of single and group of stone columns under static loading compares with unimproved ground.Keywords: circular raft footing, numerical analysis, validation, vertically encased stone column
Procedia PDF Downloads 2824843 Decolorization and Phenol Removal of Palm Oil Mill Effluent by Termite-Associated Yeast
Authors: P. Chaijak, M. Lertworapreecha, C. Sukkasem
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A huge of dark color palm oil mill effluent (POME) cannot pass the discharge standard. It has been identified as the major contributor to the pollution load into ground water. Here, lignin-degrading yeast isolated from a termite nest was tested to treat the POME. Its lignin-degrading and decolorizing ability was determined. The result illustrated that Galactomyces sp. was successfully grown in POME. The decolorizing test demonstrated that 40% of Galactomyces sp. could reduce the color of POME (50% v/v) about 74-75% in 5 days without nutrient supplement. The result suggested that G. reessii has a potential to apply for decolorizing the dark wastewater like POME and other industrial wastewaters.Keywords: decolorization, palm oil mill effluent, termite, yeast
Procedia PDF Downloads 1994842 YOLO-IR: Infrared Small Object Detection in High Noise Images
Authors: Yufeng Li, Yinan Ma, Jing Wu, Chengnian Long
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Infrared object detection aims at separating small and dim target from clutter background and its capabilities extend beyond the limits of visible light, making it invaluable in a wide range of applications such as improving safety, security, efficiency, and functionality. However, existing methods are usually sensitive to the noise of the input infrared image, leading to a decrease in target detection accuracy and an increase in the false alarm rate in high-noise environments. To address this issue, an infrared small target detection algorithm called YOLO-IR is proposed in this paper to improve the robustness to high infrared noise. To address the problem that high noise significantly reduces the clarity and reliability of target features in infrared images, we design a soft-threshold coordinate attention mechanism to improve the model’s ability to extract target features and its robustness to noise. Since the noise may overwhelm the local details of the target, resulting in the loss of small target features during depth down-sampling, we propose a deep and shallow feature fusion neck to improve the detection accuracy. In addition, because the generalized Intersection over Union (IoU)-based loss functions may be sensitive to noise and lead to unstable training in high-noise environments, we introduce a Wasserstein-distance based loss function to improve the training of the model. The experimental results show that YOLO-IR achieves a 5.0% improvement in recall and a 6.6% improvement in F1-score over existing state-of-art model.Keywords: infrared small target detection, high noise, robustness, soft-threshold coordinate attention, feature fusion
Procedia PDF Downloads 504841 Improving Self-Administered Medication Adherence for Older Adults: A Systematic Review
Authors: Mathumalar Loganathan, Lina Syazana, Bryony Dean Franklin
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Background: The therapeutic benefit of self-administered medication for long-term use is limited by an average 50% non-adherence rate. Patient forgetfulness is a common factor in unintentional non-adherence. With a growing ageing population, strategies to improve self-administration of medication adherence are essential. Our aim was to review systematically the effects of interventions to optimise self-administration of medication. Method: Database searched were MEDLINE, EMBASE, PsynINFO, CINAHL from 1980 to 31 October 2013. Search terms included were ‘self-administration’, ‘self-care’, ‘medication adherence’, and ‘intervention’. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale. Results: The search strategy retrieved 6 studies that met the inclusion and exclusion criteria. Three intervention strategies were identified: self-administration medication programme (SAMP), nursing education and medication packaging (pill calendar). A nursing education programme focused on improving patients’ behavioural self-management of drug prescribing. This was the most studied area and three studies highlighting an improvement in self-administration of medication. Conclusion: Results are mixed and there is no one interventional strategy that has proved to be effective. Nevertheless, self-administration of medication programme seems to show most promise. A multi-faceted approach and clearer policy guideline are likely to be required to improve prescribing for these vulnerable patients. Mixed results were found for SAMP. Medication packaging (pill calendar) was evaluated in one study showing a significant improvement in self-administration of medication. A meta-analysis could not be performed due to heterogeneity in the outcome measures.Keywords: self-administered medication, intervention, prescribing, older patients
Procedia PDF Downloads 3164840 The Surgical Trainee Perception of the Operating Room Educational Environment
Authors: Neal Rupani
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Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.Keywords: education environment, surgery, post-graduate education, OREEM
Procedia PDF Downloads 1754839 Reducing Ambulance Offload Delay: A Quality Improvement Project at Princess Royal University Hospital
Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah
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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.Keywords: ambulance offload, district general hospital, handover, quality improvement
Procedia PDF Downloads 884838 Production of Geopolymers for Structural Applications from Fluidized Bed Combustion Bottom Ash
Authors: Thapelo Aubrey Motsieng
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Fluidized bed combustion (FBC) is a clean coal technology used in the combustion of low-grade coals for power generation. The production of large solid wastes such as bottom ashes from this process is a problem. The bottom ash contains some toxic elements which can leach out soils and contaminate surface and ground water; for this reason, they can neither be disposed of in landfills nor lagoons anymore. The production of geopolymers from bottom ash for structural and concrete applications is an option for their disposal. In this study, the waste bottom ash obtained from the combustion of three low grade South African coals in a bubbling fluidized bed reactor was used to produce geopolymers. The geopolymers were cured in a household microwave. The results showed that the microwave curing enhanced the reactivity and strength of the geopolymers.Keywords: bottom ash, geopolymers, coal, compressive strength
Procedia PDF Downloads 3104837 Parasagittal Approach to Lumbar Epidural Steroid Injections: A Cost-Effectiveness Analysis
Authors: K. D. Candido, A. Lissounov, I. Knezevic, N. Knezevic
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Background: The most commonly performed pain procedures in the USA is Lumbar Epidural Steroid Injections (LESI). There are three main types of these procedures: transforaminal (TF), interlaminar (IL) and caudal injections. It is expected for TF injections to have better outcomes than IL injections, based on the recently published systematic review. The studies presented in that review used a midline IL approach, but those with parasagittal IL approach were not taken into consideration. Our aim is to emphasize the efficacy of the lateral parasagittal (paramedian) IL approach in this review. Methods: We included five studies in this systematic review, which compared Parasagittal-IL (PIL) with either Midline-IL (MIL) or TF LESI. Total of 296 patients who had undergone different types of LESI were observed across the five studies, and the average pain and functional improvements were calculated and compared among groups. Results: Pain and function improvements with PIL approach is superior on 12 months follow up to MIL approach (53.4% vs. 14.7%) and (55% vs. 27.7%), respectively. A 12 months follow-up results between PIL and TF shows a near equivalent effectiveness for pain (58.9% vs. 63.2%) and function improvement (47.3% vs. 48.1%). An average follow-up of 17.1 days have shown better short-term pain relief for PIL than TF approach (45.8% vs. 19.2%), respectively. Number of repeated injections is lower for PIL injections than MIL. Number of weeks between 1st and 2nd injections: PIL averaged 15.8 weeks and MIL averaged 9.7 weeks. Third LESI injection is more common in TF group (30%) than PIL group (18.8%). Conclusion: Higher complication rates are associated with TF injections for which FDA7 issued an official warning. We have recorded better outcomes in pain and function improvement of Parasagittal-IL LESI as compared to midline-IL injection, in the presented systematic review. Parasagittal and TF injections have equivalent efficacy in Pain and Function improvements thus we advocate for Parasagittal-IL approach consideration as an alternative for TF injections.Keywords: parasagital approach, lumbar, back pain, epidural steroid injection
Procedia PDF Downloads 165