Search results for: Occupational safety

Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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Authors: Cheong Hyeon Oh, Dongho Nam, Byungsik Kim

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Due to the recent climate change, flood damage caused by local floods and typhoons has frequently occurred, the incidence rate and intensity of wildfires are greatly increased due to increased temperatures and changes in precipitation patterns. Wildfires cause primary damage, such as loss of forest resources, as well as secondary disasters, such as landslides, floods, and debris flow. In many countries around the world, damage and economic losses from secondary damage are occurring as well as the direct effects of forest fires. Therefore, in this study, the Rainfall-Runoff model(S-RAT) was used for the wildfire affected areas in Gangneung and Goseong, which occurred on April 2019, when the stability of vegetation and soil were destroyed by wildfires. Rainfall data from Typhoon Rusa were used in the S-RAT model, and flood discharge was calculated according to changes in land cover before and after wildfire damage. The results of the calculation showed that flood discharge increased significantly due to changes in land cover, as the increase in flood discharge increases the possibility of the occurrence of the debris flow and the extent of the damage, the debris flow height and range were calculated before and after forest fire using RAMMS. The analysis results showed that the height and extent of damage increased after wildfire, but the result value was underestimated due to the characteristics that using DEM and maximum flood discharge of the RAMMS model. This research was supported by a grant(2017-MOIS31-004) from Fundamental Technology Development Program for Extreme Disaster Response funded by Korean Ministry of Interior and Safety (MOIS). This paper work (or document) was financially supported by Ministry of the Interior and Safety as 'Human resoure development Project in Disaster management'.

Keywords: wildfire, debris flow, land cover, rainfall-runoff meodel S-RAT, RAMMS, height

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Authors: Diego de Almeida Pereira

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The roughness index of a road is considered the most important parameter about the quality of the pavement, as it has a close relation with the comfort and safety of the road users. Such condition can be established by means of functional evaluation of pavement surface deviations, measured by the International Roughness Index (IRI), an index that came out of the international evaluation of pavements, coordinated by the World Bank, and currently owns, as an index of limit measure, for purposes of receiving roads in Brazil, the value of 2.7 m/km. This work make use of the e.IRI parameter, obtained by the Roadroid app. for smartphones which use Android operating system. The choice of such application is due to the practicality for the user interaction, as it possesses a data storage on a cloud of its own, and the support given to universities all around the world. Data has been collected for six months, once in each month. The studies begun in March 2018, season of precipitations that worsen the conditions of the roads, besides the opportunity to accompany the damage and the quality of the interventions performed. About 350 kilometers of sections of four federal highways were analyzed, BR-020, BR-040, BR-060 and BR-070 that connect the Federal District (area where Brasilia is located) and surroundings, chosen for their economic and tourist importance, been two of them of federal and two others of private exploitation. As well as much of the road network, the analyzed stretches are coated of Hot Mix Asphalt (HMA). Thus, this present research performs a contrastive discussion between comfort conditions and safety of the roads under private exploitation in which users pay a fee to the concessionaires so they could travel on a road that meet the minimum requirements for usage, and regarding the quality of offered service on the roads under Federal Government jurisdiction. And finally, the contrast of data collected by National Department of Transport Infrastructure – DNIT, by means of a laser perfilometer, with data achieved by Roadroid, checking the applicability, the practicality and cost-effective, considering the app limitations.

Keywords: roadroid, international roughness index, Brazilian roads, pavement

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Authors: Klementina Puto, Ermelinda Nexhipi, Evi Llaka

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Dairy by-products are a fairly good environment for microorganisms due to their composition for their growth. Microbial populations have a significant impact in the production of cheese, butter, yogurt, etc. in terms of their organoleptic quality and at the same time some also cause their breakdown. In this paper, the microbiological contamination of soft cheese, butter and yogurt produced in the country (domestic) and imported is assessed, as an indicator of hygiene with impact on public health. The study was extended during September 2018-June 2019 and was divided into three periods, September-December, January-March, and April-June. During this study, a total of 120 samples were analyzed, of which 60 samples of cheese and butter locally produced, and 60 samples of imported soft cheese and butter productions. The microbial indicators analyzed are Staphylococcus aureus and E. coli. Analyzes have been conducted at the Food Safety Laboratory (FSIV) in Tirana in accordance with EU Regulation 2073/2005. Sampling was performed according to the specific international standards for these products (ISO 6887 and ISO 8261). Sampling and transport of samples were done under sterile conditions. Also, coding of samples was done to preserve the anonymity of subjects. After the analysis, the country's soft cheese products compared to imports were more contaminated with S. aureus and E. coli. Meanwhile, the imported butter samples that were analyzed, resulted within norms compared to domestic ones. Based on the results, it was concluded that the microbial quality of samples of cheese, butter and yogurt analyzed remains a real problem for hygiene in Albania. The study will also serve business operators in Albania to improve their work to ensure good hygiene on the basis of the HACCP plan and to provide a guarantee of consumer health.

Keywords: consumer, health, dairy, by-products, microbial

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Authors: Fossarello Maurizio, Mattana Giorgio, Tatti Filippo.

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The most widely performed surgical procedure in Open-Angle Glaucoma (OAG) is trabeculectomy. Although this filtering procedure is extremely effective, surgical failure and postoperative complications are reported. Due to the its invasive nature and possible complications, trabeculectomy is usually reserved, in practice, for patients who are refractory to medical and laser therapy. Recently, a number of micro-invasive surgical techniques (MIGS: Micro-Invasive Glaucoma Surgery), have been introduced in clinical practice. They meet the criteria of micro-incisional approach, minimal tissue damage, short surgical time, reliable IOP reduction, extremely high safety profile and rapid post-operative recovery. Xen45 Gel Implant (Allergan, Dublin, Ireland) is one of the MIGS alternatives, and consists in a porcine gelatin tube designed to create an aqueous flow from the anterior chamber to the subconjunctival space, bypassing the resistance of the trabecular meshwork. In this study we report the results of this technique as a favorable option in the treatment of OAG for its benefits in term of efficacy and safety, either alone or in combination with cataract surgery. This is a retrospective, single-center study conducted in consecutive OAG patients, who underwent Xen45 Gel Stent implantation alone or in combination with phacoemulsification, from October 2018 to June 2019. The primary endpoint of the study was to evaluate the reduction of both IOP and number of antiglaucoma medications at 12 months. The secondary endpoint was to correlate filtering bleb morphology evaluated by means of anterior segment OCT with efficacy in IOP lowering and eventual further procedures requirement. Data were recorded on Microsoft Excel and study analysis was performed using Microsoft Excel and SPSS (IBM). Mean values with standard deviations were calculated for IOPs and number of antiglaucoma medications at all points. Kolmogorov-Smirnov test showed that IOP followed a normal distribution at all time, therefore the paired Student’s T test was used to compare baseline and postoperative mean IOP. Correlation between postoperative Day 1 IOP and Month 12 IOP was evaluated using Pearson coefficient. Thirty-six eyes of 36 patients were evaluated. As compared to baseline, mean IOP and the mean number of antiglaucoma medications significantly decreased from 27,33 ± 7,67 mmHg to 16,3 ± 2,89 mmHg (38,8% reduction) and from 2,64 ± 1,39 to 0,42 ± 0,8 (84% reduction), respectively, at 12 months after surgery (both p < 0,001). According to bleb morphology, eyes were divided in uniform group (n=8, 22,2%), subconjunctival separation group (n=5, 13,9%), microcystic multiform group (n=9, 25%) and multiple internal layer group (n=14, 38,9%). Comparing to baseline, there was no significative difference in IOP between the 4 groups at month 12 follow-up visit. Adverse events included bleb function decrease (n=14, 38,9%), hypotony (n=8, 22,2%) and choroidal detachment (n=2, 5,6%). All eyes presenting bleb flattening underwent needling and MMC injection. The higher percentage of patients that required secondary needling was in the uniform group (75%), with a significant difference between the groups (p=0,03). Xen45 gel stent, either alone or in combination with phacoemulsification, provided a significant lowering in both IOP and medical antiglaucoma treatment and an elevated safety profile.

Keywords: anterior segment OCT, bleb morphology, micro-invasive glaucoma surgery, open angle glaucoma, Xen45 gel implant

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Authors: Muhammad Ali Khan

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Education is a word has been derived from Latin word "Educare", means to train. Therefore, the harmonious growth of the potentialities for achieving the qualities desirable and useful in the human society is called education. It is claimed that by educating women we can develop our economy, family health and decrease population growth. To explore the socio-economic impact of education on urban women. A prospective study design was used. Over a period of six months 50 respondents were randomly selected from Hayat Abad, an urban city in the North West of Pakistan. A questionnaire was used to explore marital, educational, occupational, social, economical and political status of urban women. Of the total, 50% (25) were employed, where 56% were married and 44% unmarried. Of the employed participants, 56% were teachers fallowed by social worker 16%. Monthly income was significantly high (p=001) of women with master degree. Understanding between wife and husband was also very significant in women with masters. . 78% of employed women replied that Parda (Hija) should be on choice not imposed. 52% of educated women replied participation in social activates, such as parties, shopping etc. Education has a high impact on urban women because it is directly related to employment, decision of power, economy and social life. Urban women with high education have significant political awareness and empowerment. Improving women educational level in rural areas of Pakistan is the key for economic growth and political empowerment

Keywords: women, urban, Pakistan, socio economic

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Authors: Feras Darwish Elhajji, Alberto Berardi, Manal Ayyash, Iman Basheti

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The concept of the use of probiotics for humans now has been known for decades however, their intake by the Jordanian population seems to be less common when compared to population in the developed countries. Community pharmacy is the main supplier of probiotics, however, after conducting an extensive literature review, not any published research article could be found talking about the role, knowledge, and practice of the pharmacists in the area of probiotics. The main aim of this study was to evaluate the level of knowledge about probiotics and their dispensing practice in community pharmacies in Jordan. Community pharmacy staff (pharmacists and technicians) in Amman and north of Jordan were randomly selected to complete an anonymous questionnaire that had been pre-tested and validated. Ethical approval was obtained from the university ethics committee. The questionnaire included the following sections: demographics, knowledge and perceptions about probiotics, and role of the pharmacist Pharmacists and technicians were visited and interviewed in 281 community pharmacies. Asking about probiotics, 90.4% of them said that they know what probiotics are, although only 29.5% agreed that pharmacy staff in Jordan have good knowledge about probiotics, and 88.3% agreed that pharmacy staff in Jordan need more training and knowledge about probiotics. Variables that were significantly related to knowledge about probiotics were being a pharmacist (ρ= 0.012), area of the community pharmacy (ρ= 0.019), and female staff (ρ= 0.031) after conducting logistic regression statistical analysis. More than two-thirds of the participants thought that probiotics are classified as dietary supplements by Jordan Food and Drug Administration (JFDA). Of those who knew probiotics, the majority of them – 76.8% and 91.7% – agreed that probiotics are effective and safe, respectively. Believing in efficacy of the probiotics was significantly associated with answering their use to be with or after antibiotic administration and to increase normal flora gut population (ρ= 0.007). Efficacy was also significantly associated with recommending probiotics to consumers by the pharmacist (ρ< 0.001) and by the doctor (ρ= 0.041). At the same time, the concept of safety was mainly associated with their use for flatulence and gases (ρ= 0.048). Level of knowledge about probiotics and their uses, efficacy and safety amongst community pharmacy staff in Jordan is found to be good. However, this level can be raised in the future, especially knowledge about uses of probiotics.

Keywords: community pharmacy, Jordan, prebiotics, probiotics

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Authors: Neha Singh, Shristi Singh

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Accidents involving motor vehicles are more likely to cause serious injuries and fatalities. It also has a host of other perpetual issues, such as the regular loss of life and goods in accidents. To solve these issues, appropriate measures must be implemented, such as establishing an autonomous incident detection system that makes use of machine learning and artificial intelligence. In order to reduce traffic accidents, this article examines the overview of artificial intelligence and machine learning in autonomous event detection systems. The paper explores the major issues, prospective solutions, and use of artificial intelligence and machine learning in road transportation systems for minimising traffic accidents. There is a lot of discussion on additional, fresh, and developing approaches that less frequent accidents in the transportation industry. The study structured the following subtopics specifically: traffic management using machine learning and artificial intelligence and an incident detector with these two technologies. The internet of vehicles and vehicle ad hoc networks, as well as the use of wireless communication technologies like 5G wireless networks and the use of machine learning and artificial intelligence for the planning of road transportation systems, are elaborated. In addition, safety is the primary concern of road transportation. Route optimization, cargo volume forecasting, predictive fleet maintenance, real-time vehicle tracking, and traffic management, according to the review's key conclusions, are essential for ensuring the safety of road transportation networks. In addition to highlighting research trends, unanswered problems, and key research conclusions, the study also discusses the difficulties in applying artificial intelligence to road transport systems. Planning and managing the road transportation system might use the work as a resource.

Keywords: artificial intelligence, machine learning, incident detector, road transport systems, traffic management, automatic incident detection, deep learning

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Authors: Xianping Du, Runlu Miao, Guanjun Zhang, Libo Cao, Feng Zhu

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Current vehicle safety standards and human body injury criteria were established based on the biomechanical response of Euro-American human body, without considering the difference in the body anthropometry and injury characteristics among different races, particularly the East Asian people with smaller body size. Absence of such race specific design considerations will negatively influence the protective performance of safety products for these populations, and weaken the accuracy of injury thresholds derived. To resolve these issues, in this study, we aim to develop a race specific finite element model to simulate the impact response of the lower extremity of a 50th percentile East Asian (Chinese) male. The model was built based on medical images for the leg of an average size Chinese male and slightly adjusted based on the statistical data. The model includes detailed anatomic features and is able to simulate the muscle active force. Thirteen biomechanical tests available in the literature were used to validate its biofidelity. Using the validated model, a pedestrian-car impact accident taking place in China was re-constructed computationally. The results show that the newly developed lower leg model has a good performance in predicting dynamic response and tibia fracture pattern. An additional comparison on the fracture tolerance of the East Asian and Euro-American lower limb suggests that the current injury criterion underestimates the degree of injury of East Asian human body.

Keywords: lower limb, East Asian body characteristics, traffic accident reconstruction, finite element analysis, injury tolerance

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Authors: G. Sridevi, Amalendu Jyotishi, Sushanta Mahapatra, G. Jagadeesh, Satyasiba Bedamatta

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Climate change is a main challenge for agriculture, food security and rural livelihoods for millions of people in India. Agriculture is the sector most vulnerable to climate change due to its high dependence on climate and weather conditions. Among India’s population of more than one billion people, about 68% are directly or indirectly involved in the agricultural sector. This sector is particularly vulnerable to present-day climate variability. In this contest this paper examines the Socio-economic and climate analytical study of the vulnerability index in Indian states of Andhra Pradesh and Karnataka. Using secondary data; it examines the vulnerability through five different sub-indicator of socio-demographic, agriculture, occupational, common property resource (CPR), and climate in respective states among different districts. Data used in this paper has taken from different sources, like census in India 2011, Directorate of Economics and Statistics of respective states governments. Rainfall data was collected from the India Meteorological Department (IMD). In order to capture the vulnerability from two different states the composite vulnerability index (CVI) was developed and used. This indicates the vulnerability situation of different districts under two states. The study finds that Adilabad district in Andhra Pradesh and Chamarajanagar in Karnataka had highest level of vulnerability while Hyderabad and Bangalore in respective states have least level of vulnerability.

Keywords: vulnerability, agriculture, climate change, global warming

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Authors: Ana Neves, John Leander, Ignacio Gonzalez, Raid Karoumi

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Systematic monitoring and inspection are needed to assess the present state of a structure and predict its future condition. If an irregularity is noticed, repair actions may take place and the adequate intervention will most probably reduce the future costs with maintenance, minimize downtime and increase safety by avoiding the failure of the structure as a whole or of one of its structural parts. For this to be possible decisions must be made at the right time, which implies using systems that can detect abnormalities in their early stage. In this sense, Structural Health Monitoring (SHM) is seen as an effective tool for improving the safety and reliability of infrastructures. This paper explores the decision-making problem in SHM regarding the maintenance of civil engineering structures. The aim is to assess the present condition of a bridge based exclusively on measurements using the suggested method in this paper, such that action is taken coherently with the information made available by the monitoring system. Artificial Neural Networks are trained and their ability to predict structural behavior is evaluated in the light of a case study where acceleration measurements are acquired from a bridge located in Stockholm, Sweden. This relatively old bridge is presently still in operation despite experiencing obvious problems already reported in previous inspections. The prediction errors provide a measure of the accuracy of the algorithm and are subjected to further investigation, which comprises concepts like clustering analysis and statistical hypothesis testing. These enable to interpret the obtained prediction errors, draw conclusions about the state of the structure and thus support decision making regarding its maintenance.

Keywords: artificial neural networks, clustering analysis, model-free damage detection, statistical hypothesis testing, structural health monitoring

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Authors: Chitra Rajagopal, Indra Deo Kumar, Ruchi Joshi, Binoy Bhargavan

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Role of fighter planes in modern network centric military warfare scenarios has changed significantly in the recent past. New generation fighter planes have multirole capability of engaging both air and ground targets with high precision. Multirole aircraft undertakes missions such as Air to Air combat, Air defense, Air to Surface role (including Air interdiction, Close air support, Maritime attack, Suppression and Destruction of enemy air defense), Reconnaissance, Electronic warfare missions, etc. Designers have primarily focused on development of technologies to enhance the combat performance of the fighter planes and very little attention is given to human factor aspects of technologies. Unique physical and psychological challenges are imposed on the pilots to meet operational requirements during these missions. Newly evolved technologies have enhanced aircraft performance in terms of its speed, firepower, stealth, electronic warfare, situational awareness, and vulnerability reduction capabilities. This paper highlights the impact of emerging technologies on human factors for various military operations and missions. Technologies such as ‘cooperative knowledge-based systems’ to aid pilot’s decision making in military conflict scenarios as well as simulation technologies to enhance human performance is also studied as a part of research work. Current and emerging pilot protection technologies and systems which form part of the integrated life support systems in new generation fighter planes is discussed. System safety analysis application to quantify the human reliability in military operations is also studied.

Keywords: combat effectiveness, emerging technologies, human factors, systems safety analysis

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Authors: Dina Kon Mushid, Sage Ngoie, Tshimbalanga Madiba, Kabutakapua Kakanda

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Slope stability assessment is still the biggest challenge in mining activities and civil engineering structures. The slope in an opencast mine frequently reaches multiple weak layers that lead to the instability of the pit. Faults and soft layers throughout the rock would increase weathering and erosion rates. Therefore, it is essential to investigate the stability of the complex strata to figure out how stable they are. In the Dikuluwe-Mashamba (DIMA) area, the lithology of the stratum is a set of metamorphic rocks whose parent rocks are sedimentary rocks with a low degree of metamorphism. Thus, due to the composition and metamorphism of the parent rock, the rock formation is different in hardness and softness, which means that when the content of dolomitic and siliceous is high, the rock is hard. It is softer when the content of argillaceous and sandy is high. Therefore, from the vertical direction, it appears as a weak and hard layer, and from the horizontal direction, it seems like a smooth and hard layer in the same rock layer. From the structural point of view, the main structures in the mining area are the Dikuluwe dipping syncline and the Mashamba dipping anticline, and the occurrence of rock formations varies greatly. During the folding process of the rock formation, the stress will concentrate on the soft layer, causing the weak layer to be broken. At the same time, the phenomenon of interlayer dislocation occurs. This article aimed to evaluate the stability of metasedimentary rocks of the Dikuluwe-Mashamba (DIMA) open-pit mine using limit equilibrium and stereographic methods Based on the presence of statistical structural planes, the stereographic projection was used to study the slope's stability and examine the discontinuity orientation data to identify failure zones along the mine. The results revealed that the slope angle is too steep, and it is easy to induce landslides. The numerical method's sensitivity analysis showed that the slope angle and groundwater significantly impact the slope safety factor. The increase in the groundwater level substantially reduces the stability of the slope. Among the factors affecting the variation in the rate of the safety factor, the bulk density of soil is greater than that of rock mass, the cohesion of soil mass is smaller than that of rock mass, and the friction angle in the rock mass is much larger than that in the soil mass. The analysis showed that the rock mass structure types are mostly scattered and fragmented; the stratum changes considerably, and the variation of rock and soil mechanics parameters is significant.

Keywords: slope stability, weak layer, safety factor, limit equilibrium method, stereography method

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Authors: Himansu, Bedanga Talukdar

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The aim of present study is to investigate the prevalence of various health outcomes and quality of life and analyzes the moderating role of social capital on health outcomes (i.e., self-rated good health (SRH), depression, functional health and quality of life) among elderly in India. Using WHO Study on Global AGEing and adults health (SAGE) data, with sample of 6559 elderly between 50 and above (Mage=61.81, SD=9.00) age were selected for analysis. Multivariate analysis accessed the prevalence of SRH, depression, functional limitation and quality of life among older adults. Logistic regression evaluates the effect of social capital along with other co-founders on SRH, depression, and functional limitation, whereas linear regression evaluates the effect of social capital with other co-founders on quality of life (QoL) among elderly. Empirical results reveal that (74%) of respondents were married, (70%) having low social action, (46%) medium sociability, (45%) low trust-solidarity, (58%) high safety, (65%) medium civic engagement and 37% reported medium psychological resources. The multivariate analysis, explains (SRH) is associated with age, female, having education, higher social action great trust, safety and greater psychological resources. Depression among elderly is greatly related to age, sex, education and higher wealth, higher sociability, having psychological resources. QoL is negatively associated with age, sex, being Muslim, whereas positive associated with higher education, currently married, civic engagement, having wealth, social action, trust and solidarity, safeness, and strong psychological resources.

Keywords: depressive symptom, functional limitation, older adults, quality of life, self rated health, social capital

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Authors: Sharda Kumari, Saiman Shetty

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Autonomous trucking is just one of the numerous significant shifts impacting fleet management services. The Society of Automotive Engineers (SAE) has defined six levels of vehicle automation that have been adopted internationally, including by the United States Department of Transportation. On public highways in the United States, organizations are testing driverless vehicles with at least Level 4 automation which indicates that a human is present in the vehicle and can disable automation, which is usually done while the trucks are not engaged in highway driving. However, completely driverless vehicles are presently being tested in the state of California. While autonomous trucking can increase safety, decrease trucking costs, provide solutions to trucker shortages, and improve efficiencies, logistics, too, requires advancements to keep up with trucking innovations. Given that artificial intelligence, machine learning, and automated procedures enable people to do their duties in other sectors with fewer resources, CRM (Customer Relationship Management) can be applied to the autonomous trucking business to provide the same level of efficiency. In a society witnessing significant digital disruptions, fleet management is likewise being transformed by technology. Utilizing strategic alliances to enhance core services is an effective technique for capitalizing on innovations and delivering enhanced services. Utilizing analytics on CRM systems improves cost control of fuel strategy, fleet maintenance, driver behavior, route planning, road safety compliance, and capacity utilization. Integration of autonomous trucks with automated fleet management, yard/terminal management, and customer service is possible, thus having significant power to redraw the lines between the public and private spheres in autonomous trucking logistics.

Keywords: autonomous vehicles, customer relationship management, customer experience, autonomous trucking, digital transformation

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Authors: Hengameh Hosseini

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Design of large healthcare facilities – such as hospitals, multi-service line clinics, and nursing facilities - that can accommodate patients with wide-ranging disabilities is a challenging endeavor and one that is poorly understood among healthcare facility managers, administrators, and executives. An even less-understood extension of this problem is the implications of weakly or insufficiently accommodative design of facilities for healthcare workers in physically-intensive jobs who may also suffer from a range of disabilities and who are therefore at increased risk of workplace accident and injury. Combine this reality with the vast range of facility types, ages, and designs, and the problem of universal accommodation becomes even more daunting and complex. In this study, we focus on the implication of facility design for healthcare workers suffering with low vision who also have physically active jobs. The points of difficulty are myriad and could span health service infrastructure, the equipment used in health facilities, and transport to and from appointments and other services can all pose a barrier to health care if they are inaccessible, less accessible, or even simply less comfortable for people with various disabilities. We conduct a series of surveys and interviews with employees and administrators of 7 facilities of a range of sizes and ownership models in the Northeastern United States and combine that corpus with in-facility observations and data collection to identify five major points of failure common to all the facilities that we concluded could pose safety threats to employees with vision impairments, ranging from very minor to severe. We determine that lack of design empathy is a major commonality among facility management and ownership. We subsequently propose three methods for remedying this lack of empathy-informed design, to remedy the dangers posed to employees: the use of an existing open-sourced Augmented Reality application to simulate the low-vision experience for designers and managers; the use of a machine learning model we develop to automatically infer facility shortcomings from large datasets of recorded patient and employee reviews and feedback; and the use of a computer vision model fine tuned on images of each facility to infer and predict facility features, locations, and workflows, that could again pose meaningful dangers to visually impaired employees of each facility. After conducting a series of real-world comparative experiments with each of these approaches, we conclude that each of these are viable solutions under particular sets of conditions, and finally characterize the range of facility types, workforce composition profiles, and work conditions under which each of these methods would be most apt and successful.

Keywords: artificial intelligence, healthcare workers, facility design, disability, visually impaired, workplace safety

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Authors: A. E. Emam, M. Abd Elghany

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The change in orbit evolution between collocated satellites (X, Y) inside +/-0.09 ° E/W and +/- 0.07 ° N/S cluster, after one of these satellites is placed in an inclined orbit (satellite X) and the effect of this change in the collocation safety inside the cluster window has been studied and evaluated. Several collocation scenarios had been studied in order to adjust the location of both satellites inside their cluster to maximize the separation between them and safe the mission.

Keywords: satellite, GEO, collocation, risk assessment

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Authors: Paul Lemarignier, Olivier Fiquet, Vincent Pateloup

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In line with the strong desire of nuclear energy players to have ever more effective products in terms of safety, research programs on E-ATF (Enhanced-Accident Tolerant Fuels) that are more resilient, particularly to the loss of coolant, have been launched in all countries with nuclear power plants. Among the multitude of solutions being developed internationally, carcinoembryonic antigen (CEA) and its partners are investigating a promising solution, which is the realization of CERMET (CERamic-METal) type fuel pellets made of a matrix of fissile material, uranium dioxide UO2, which has a low thermal conductivity, and a metallic phase with a high thermal conductivity to improve heat evacuation. Work has focused on the development by powder metallurgy of micro-structured CERMETs, characterized by networks of metallic phase embedded in the UO₂ matrix. Other types of macro-structured CERMETs, based on concepts proposed by thermal simulation studies, have been developed with a metallic phase with a specific geometry to optimize heat evacuation. This solution could not be developed using traditional processes, so additive manufacturing, which revolutionizes traditional design principles, is used to produce these innovative prototype concepts. At CEA Cadarache, work is first carried out on a non-radioactive surrogate material, alumina, in order to acquire skills and to develop the equipment, in particular the robocasting machine, an additive manufacturing technique selected for its simplicity and the possibility of optimizing the paste formulations. A manufacturing chain was set up, with the pastes production, the 3D printing of pellets, and the associated thermal post-treatment. The work leading to the first elaborations of macro-structured alumina/molybdenum CERMETs will be presented. This work was carried out with the support of Framatome and EdF.

Keywords: additive manufacturing, alumina, CERMET, molybdenum, nuclear safety

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Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

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Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

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Authors: Paola Villoria Sáez, Mercedes Del Río Merino, Jaime Santa Cruz Astorqui, Antonio Rodríguez Sánchez

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The Spanish construction industry generates large volumes of waste. However, despite the legislative improvements introduced for construction and demolition waste (CDW), construction waste recycling rate remains well below other European countries and also below the target set for 2020. This situation can be due to many difficulties. i.e.: The difficulty of onsite segregation or the estimation in advance of the total amount generated. Despite these difficulties, the proper management of CDW must be one of the main aspects to be considered by the construction companies. In this sense, some large national companies are implementing Integrated Management Systems (IMS) including not only quality and safety aspects, but also environment issues. However, although this fact is a reality for large construction companies still the vast majority of companies need to adopt this trend. In short, it is common to find in small and medium enterprises a decentralized management system: A single system of quality management, another for system safety management and a third one for environmental management system (EMS). In addition, the EMSs currently used address CDW superficially and are mainly focus on other environmental concerns such as carbon emissions. Therefore, this research determines and implements a specific best practice management system for CDW based on eight procedures in a Spanish Construction company. The main advantages and drawbacks of its implementation are highlighted. Results of this study show that establishing and implementing a CDW management system in building works, improve CDW quantification as the company obtains their own CDW generation ratio. This helps construction stakeholders when developing CDW Management Plans and also helps to achieve a higher adjustment of CDW management costs. Finally, integrating this CDW system with the EMS of the company favors the cohesion of the construction process organization at all stages, establishing responsibilities in the field of waste and providing a greater control over the process.

Keywords: construction and demolition waste, waste management, best practices, waste minimization, building, quality management systems

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Authors: S. Lemoussu, J. C. Chaudemar, R. A. Vingerhoeds

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The aeronautics sector is currently living an unprecedented growth largely due to innovative projects. In several cases, such innovative developments are being carried out by Small and Medium sized-Enterprises (SMEs). For instance, in Europe, a handful of SMEs are leading projects like airships, large civil drones, or flying cars. These SMEs have all limited resources, must make strategic decisions, take considerable financial risks and in the same time must take into account the constraints of safety, cost, time and performance as any commercial organization in this industry. Moreover, today, no international regulations fully exist for the development and certification of this kind of projects. The absence of such a precise and sufficiently detailed regulatory framework requires a very close contact with regulatory instances. But, SMEs do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses additional challenges for those SMEs that have system integration responsibilities and that must provide all the necessary means of compliance to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The final objective of our research is thus to provide a methodological framework supporting SMEs in their development taking into account recent innovation and institutional rules of the sector. We aim to provide a contribution to the problematic by developing a specific Model-Based Systems Engineering (MBSE) approach. Airspace regulation, aeronautics standards and international norms on systems engineering are taken on board to be formalized in a set of models. This paper presents the on-going research project combining Systems Engineering and Project Management process modeling and taking into account the metamodeling problematic.

Keywords: aeronautics, certification, process modeling, project management, SME, systems engineering

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Authors: Mehmet Akköse

Abstract:

Concern about seismic safety of concrete dams have been growing around the world, partly because the population at risk in locations downstream of major dams continues to expand and also because it is increasingly evident that the seismic design concepts in use at the time most existing dams were built were inadequate. Most of the investigations in the past have been conducted on large dams, typically above 100m high. A large number of concrete dams in our country and in other parts of the world are less than 50m high. Most of these dams were usually designed using pseudo-static methods, ignoring the dynamic characteristics of the structure as well as the characteristics of the ground motion. Therefore, it is important to carry out investigations on seismic behavior this category of dam in order to assess and evaluate the safety of existing dams and improve the knowledge for different high dams to be constructed in the future. In this study, size effects on structural performance of concrete gravity dams subjected to near and far-fault ground motions are investigated including dam-water-foundation interaction. For this purpose, a benchmark problem proposed by ICOLD (International Committee on Large Dams) is chosen as a numerical application. Structural performance of the dam having five different heights is evaluated according to damage criterions in USACE (U.S. Army Corps of Engineers). It is decided according to their structural performance if non-linear analysis of the dams requires or not. The linear elastic dynamic analyses of the dams to near and far-fault ground motions are performed using the step-by-step integration technique. The integration time step is 0.0025 sec. The Rayleigh damping constants are calculated assuming 5% damping ratio. The program NONSAP modified for fluid-structure systems with the Lagrangian fluid finite element is employed in the response calculations.

Keywords: concrete gravity dams, Lagrangian approach, near and far-fault ground motion, USACE damage criterions

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Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

Abstract:

Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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Authors: Jessica Cecchinelli, Amer Ali

Abstract:

The continuing growth in road traffic and the resultant impact on the level of pollution and safety especially in urban areas have led local and national authorities to reduce traffic speed and flow in major towns and cities. Various boroughs of London have recently reduced the in-city speed limit from 30mph to 20mph mainly to calm traffic, improve safety and reduce noise and vibration. This paper reports the detailed field measurements using noise sensor and analyser and the corresponding theoretical calculations and analysis of the noise levels on a number of roads in the central London Borough of Camden where speed limit was reduced from 30mph to 20mph in all roads except the major routes of the ‘Transport for London (TfL)’. The measurements, which included the key noise levels and scales at residential streets and main roads, were conducted during weekdays and weekends normal and rush hours. The theoretical calculations were done according to the UK procedure ‘Calculation of Road Traffic Noise 1988’ and with conversion to the European L-day, L-evening, L-night, and L-den and other important levels. The current study also includes comparable data and analysis from previously measured noise in the Borough of Camden and other boroughs of central London. Classified traffic flow and speed on the roads concerned were observed and used in the calculation part of the study. Relevant data and description of the weather condition are reported. The paper also reports a field survey in the form of face-to-face interview questionnaires, which was carried out in parallel with the field measurement of noise, in order to ascertain the opinions and views of local residents and workers in the reduced speed zones of 20mph. The main findings are that the reduction in speed had reduced the noise pollution on the studied zones and that the measured and calculated noise levels for each speed zone are closely matched. Among the other findings was that of the field survey of the opinions and views of the local residents and workers in the reduced speed 20mph zones who supported the scheme and felt that it had improved the quality of life in their areas giving a sense of calmness and safety particularly for families with children, the elderly, and encouraged pedestrians and cyclists. The key conclusions are that lowering the speed limit in built-up areas would not just reduce the number of serious accidents but it would also reduce the noise pollution and promote clean modes of transport particularly walking and cycling. The details of the site observations and the corresponding calculations together with critical comparative analysis and relevant conclusions will be reported in the full version of the paper.

Keywords: noise calculation, noise field measurement, road traffic noise, speed limit in london, survey of people satisfaction

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Authors: Rossana Roila, Raffaella Branciari, Lorenzo Cardinali, David Ranucci

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The wild boar (Sus scrofa) population has strongly increased across Europe in the last decades, also causing severe fauna management issues. In central Italy, wild boar is the main hunted wild game species, with approximately 40,000 animals killed per year only in the Umbria region. The meat of the game is characterized by high-quality nutritional value as well as peculiar taste and aroma, largely appreciated by consumers. This type of meat and products thereof can meet the current consumers’ demand for higher quality foodstuff, not only from a nutritional and sensory point of view but also in relation to environmental sustainability, the non-use of chemicals, and animal welfare. The game meat production chain is characterized by some gaps from a hygienic point of view: the harvest process is usually conducted in a wild environment where animals can be more easily contaminated during hunting and subsequent practices. The definition and implementation of a certified and controlled supply chain could ensure quality, traceability and safety for the final consumer and therefore promote game meat products. According to European legislation in some animal species, such as bovine, the use of weak acid solutions for carcass decontamination is envisaged in order to ensure the maintenance of optimal hygienic characteristics. A preliminary study was carried out to evaluate the applicability of similar strategies to control the hygienic level of wild boar carcasses. The carcasses, harvested according to the selective method and processed into the game-handling establishment, were treated by nebulization with two different solutions: a 2% food-grade lactic acid solution and aromatic vinegar. Swab samples were performed before treatment and in different moments after-treatment of the carcasses surfaces and subsequently tested for Total Aerobic Mesophilic Load, Total Aerobic Psychrophilic Load, Enterobacteriaceae, Staphylococcus spp. and lactic acid bacteria. The results obtained for the targeted microbial populations showed a positive effect of the application of the lactic acid solution on all the populations investigated, while aromatic vinegar showed a lower effect on bacterial growth. This study could lay the foundations for the optimization of the use of a lactic acid solution to treat wild boar carcasses aiming to guarantee good hygienic level and safety of meat.

Keywords: game meat, food safety, process hygiene criteria, microbial population, microbial growth, food control

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Authors: Alan S. Weber

Abstract:

This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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Authors: Ganbat Danaa, Chuluundorj Puntsag

Abstract:

The steel structures of the Oyu-Tolgoi mining Concentrator plant are corroded during operation, which raises doubts about the continued use of some important structures of the plant, which is one of the problems facing the plant's regular operation. As a part of the main operation of the plant, the bottom part of the pressure vessel, which plays an important role in the reliable operation of the concentrate filter-drying unit, was heavily corroded, so it was necessary to study by engineering calculations, modeling, and simulation using modern advanced engineering programs and methods. The purpose of this research is to investigate whether the corroded part of the pressure vessel can be used normally in the future using advanced engineering software and to predetermine the remaining life of the time of the pressure vessel based on engineering calculations. When the thickness of the bottom part of the pressure vessel was thinned by 0.5mm due to corrosion detected by non-destructive testing, finite element analysis using ANSYS WorkBench software was used to determine the mechanical stress, strain and safety factor in the wall and bottom of the pressure vessel operating under 2.2 MPa working pressure, made conclusions on whether it can be used in the future. According to the recommendations, by using sand-blast cleaning and anti-corrosion paint, the normal, continuous and reliable operation of the Concentrator plant can be ensured, such as ordering new pressure vessels and reducing the installation period. By completing this research work, it will be used as a benchmark for assessing the corrosion condition of steel parts of pressure vessels and other metallic and non-metallic structures operating under severe conditions of corrosion, static and dynamic loads, and other deformed steels to make analysis of the structures and make it possible to evaluate and control the integrity and reliable operation of the structures.

Keywords: corrosion, non-destructive testing, finite element analysis, safety factor, structural reliability

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Authors: Chris Cadman, Marcel Strauss

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Background: In 2020, the University Hospital Wishaw in the United Kingdom became the centre for trauma and orthopaedics within its health board. This resulted in the majority of patients with suspected cauda equina syndrome (CES) being assessed and imaged at this site, putting an increased demand on MR imaging and displacing other previous activity. Following this transition, imaging requests for CES did not always follow national guidelines and would often be missing important clinical and safety information. There also appeared to be a very low positive scan rate compared with previously reported studies. In an attempt to improve patient selection and reduce the burden of CES imaging at this site clinical audit was performed. Methods: A total of 250 consecutive patients imaged to assess for CES were evaluated. Patients had to have presented to either the emergency or orthopaedic department acutely with a presenting complaint of suspected CES. Patients were excluded if they were not admitted acutely or were assessed by other clinical specialities. In total, 233 patients were included. Requests were assessed for appropriate clinical history, accurate and complete clinical assessment and MRI safety information. Clinical assessment was allocated a score of 1-6 based on information relating to history of pain, level of pain, dermatomes/myotomes affected, peri-anal paraesthesia/anaesthesia, anal tone and post-void bladder volume with each element scoring one point. Images were assessed for positive findings of CES, acquired spinal stenosis or nerve root compression. Results: Overall, 73% of requests had a clear clinical history of CES. The urgency of the request for imaging was given in 23% of cases. The mean clinical assessment score was 3.7 out of a total of 6. Overall, 2% of scans were positive for CES, 29% had acquired spinal stenosis and 30% had nerve root compression. For patients with CES, 75% had acute neurological signs compared with 68% of the study population. CES patients had a mean clinical history score of 5.3 compared with 3.7 for the study population. Overall, 95% of requests had appropriate MRI safety information. Discussion: it study included 233 patients who underwent specialist assessment and referral for MR imaging for suspected CES. Despite the serious nature of this condition, a large proportion of imaging requests did not have a clear clinical query of CES and the level of urgency was not given, which could potentially lead to a delay in imaging and treatment. Clinical examination was often also incomplete, which can make triaging of patients presenting with similar symptoms challenging. The positive rate for CES was only 2%, much below other studies which had positive rates of 6–40% with a large meta-analysis finding a mean positive rate of 19%. These findings demonstrate an opportunity to improve the quality of imaging requests for suspected CES. This may help to improve patient selection for imaging and result in a positive rate for CES imaging that is more in line with other centres.

Keywords: cauda equina syndrome, acute back pain, MRI, spine

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Authors: Rayanne Branco Dos Santos Lima, Lorena Pinheiro Barbosa, Kamila Ferreira Lima, Victor Manuel Tegoma Ruiz, Monyka Brito Lima Dos Santos, Maria Wendiane Gueiros Gaspar, Luzia Camila Coelho Ferreira, Leandro Cardozo Dos Santos Brito, Deyse Maria Alves Rocha

Abstract:

Introduction: The lack of regulation of the baby's sleep-wake pattern in the first years of life affects the health of thousands of women. Maternal sleep deprivation can trigger or aggravate psychosomatic problems such as depression, anxiety and stress that can directly influence maternal safety, with consequences for the baby's and mother's sleep. Such conditions can affect the family's quality of life and child development. Objective: To correlate maternal security with maternal state anxiety scores and the mother's and baby's total sleep time. Method: Cross-sectional study carried out with 96 mothers of babies aged 10 to 24 months, accompanied by nursing professionals linked to a Federal University in Northeast Brazil. Study variables were maternal security, maternal state anxiety scores, infant latency and sleep time, and total nocturnal sleep time of mother and infant. Maternal safety was calculated using a four-point Likert scale (1=not at all safe, 2=somewhat safe, 3=very safe, 4=completely safe). Maternal anxiety was measured by State-Trait Anxiety Inventory, state-anxiety subscale whose scores vary from 20 to 80 points, and the higher the score, the higher the anxiety levels. Scores below 33 are considered mild; from 33 to 49, moderate and above 49, high. As for the total nocturnal sleep time, values between 7-9 hours of sleep were considered adequate for mothers, and values between 9-12 hours for the baby, according to the guidelines of the National Sleep Foundation. For the sleep latency time, a time equal to or less than 20 min was considered adequate. It is noteworthy that the latency time and the time of night sleep of the mother and the baby were obtained by the mother's subjective report. To correlate the data, Spearman's correlation was used in the statistical package R version 3.6.3. Results: 96 women and babies participated, aged 22 to 38 years (mean 30.8) and 10 to 24 months (mean 14.7), respectively. The average of maternal security was 2.89 (unsafe); Mean maternal state anxiety scores were 43.75 (moderate anxiety). The babies' average sleep latency time was 39.6 min (>20 min). The mean sleep times of the mother and baby were, respectively, 6h and 42min and 8h and 19min, both less than the recommended nocturnal sleep time. Maternal security was positively correlated with maternal state anxiety scores (rh=266, p=0.009) and negatively correlated with infant sleep latency (rh= -0.30. P=0.003). Baby sleep time was positively correlated with maternal sleep time. (rh 0.46, p<0.001). Conclusion: The more secure the mothers considered themselves, the higher the anxiety scores and the shorter the baby's sleep latency. Also, the longer the baby sleeps, the longer the mother sleeps. Thus, interventions are needed to promote the quality and efficiency of sleep for both mother and baby.

Keywords: sleep, anxiety, infant, mother-child relations

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Authors: Tyrus C. Torres, Michael Harris

Abstract:

In a coastal town of Ecuador, the role of women is commonly defined as an ama de casa, a woman who works in the house, raises children, and contributes to the community. This project, under the guidance of Dr. Michael Harris from the Florida Atlantic University, seeks to understand how the role of an ama de casa provides a secure environment for men and women, coexists with economic and environmental constraints that explain the origins of how this environment has been formed. The coastal community aspects of familia (family), trabajo (work), relación (relationships), machismo (masculinity), feminista (femininity), and the culture of Ecuador define the ways of life in a coastal setting. This ethnographic research project included the following methodologies: environment mapping, conducting interviews, surveys, participant observation, direct and indirect observations, and integration into daily life. Immersion into the daily life and building relationships with the local people allowed the documentation of intricacies of both the cultural and social spheres. The findings of this research offer insight on how culture, economics, and environment can form female and male agency. Our investigation shows that occupations such as fishermen, laborers, ama de casas, and even students utilize occupational routes to create social agency in the face of economic and environmental constraints in Ecuador.

Keywords: Ecuador, ethnography, gender division of labor, gender roles

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