Search results for: solid waste management system
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 26850

Search results for: solid waste management system

13500 Calculation of the Normalized Difference Vegetation Index and the Spectral Signature of Coffee Crops: Benefits of Image Filtering on Mixed Crops

Authors: Catalina Albornoz, Giacomo Barbieri

Abstract:

Crop monitoring has shown to reduce vulnerability to spreading plagues and pathologies in crops. Remote sensing with Unmanned Aerial Vehicles (UAVs) has made crop monitoring more precise, cost-efficient and accessible. Nowadays, remote monitoring involves calculating maps of vegetation indices by using different software that takes either Truecolor (RGB) or multispectral images as an input. These maps are then used to segment the crop into management zones. Finally, knowing the spectral signature of a crop (the reflected radiation as a function of wavelength) can be used as an input for decision-making and crop characterization. The calculation of vegetation indices using software such as Pix4D has high precision for monoculture plantations. However, this paper shows that using this software on mixed crops may lead to errors resulting in an incorrect segmentation of the field. Within this work, authors propose to filter all the elements different from the main crop before the calculation of vegetation indices and the spectral signature. A filter based on the Sobel method for border detection is used for filtering a coffee crop. Results show that segmentation into management zones changes with respect to the traditional situation in which a filter is not applied. In particular, it is shown how the values of the spectral signature change in up to 17% per spectral band. Future work will quantify the benefits of filtering through the comparison between in situ measurements and the calculated vegetation indices obtained through remote sensing.

Keywords: coffee, filtering, mixed crop, precision agriculture, remote sensing, spectral signature

Procedia PDF Downloads 374
13499 Quantitative Analysis of Contract Variations Impact on Infrastructure Project Performance

Authors: Soheila Sadeghi

Abstract:

Infrastructure projects often encounter contract variations that can significantly deviate from the original tender estimates, leading to cost overruns, schedule delays, and financial implications. This research aims to quantitatively assess the impact of changes in contract variations on project performance by conducting an in-depth analysis of a comprehensive dataset from the Regional Airport Car Park project. The dataset includes tender budget, contract quantities, rates, claims, and revenue data, providing a unique opportunity to investigate the effects of variations on project outcomes. The study focuses on 21 specific variations identified in the dataset, which represent changes or additions to the project scope. The research methodology involves establishing a baseline for the project's planned cost and scope by examining the tender budget and contract quantities. Each variation is then analyzed in detail, comparing the actual quantities and rates against the tender estimates to determine their impact on project cost and schedule. The claims data is utilized to track the progress of work and identify deviations from the planned schedule. The study employs statistical analysis using R to examine the dataset, including tender budget, contract quantities, rates, claims, and revenue data. Time series analysis is applied to the claims data to track progress and detect variations from the planned schedule. Regression analysis is utilized to investigate the relationship between variations and project performance indicators, such as cost overruns and schedule delays. The research findings highlight the significance of effective variation management in construction projects. The analysis reveals that variations can have a substantial impact on project cost, schedule, and financial outcomes. The study identifies specific variations that had the most significant influence on the Regional Airport Car Park project's performance, such as PV03 (additional fill, road base gravel, spray seal, and asphalt), PV06 (extension to the commercial car park), and PV07 (additional box out and general fill). These variations contributed to increased costs, schedule delays, and changes in the project's revenue profile. The study also examines the effectiveness of project management practices in managing variations and mitigating their impact. The research suggests that proactive risk management, thorough scope definition, and effective communication among project stakeholders can help minimize the negative consequences of variations. The findings emphasize the importance of establishing clear procedures for identifying, assessing, and managing variations throughout the project lifecycle. The outcomes of this research contribute to the body of knowledge in construction project management by demonstrating the value of analyzing tender, contract, claims, and revenue data in variation impact assessment. However, the research acknowledges the limitations imposed by the dataset, particularly the absence of detailed contract and tender documents. This constraint restricts the depth of analysis possible in investigating the root causes and full extent of variations' impact on the project. Future research could build upon this study by incorporating more comprehensive data sources to further explore the dynamics of variations in construction projects.

Keywords: contract variation impact, quantitative analysis, project performance, claims analysis

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13498 Functions of Public Policy in Private International Law

Authors: Fedorova Elena

Abstract:

In this article, we draw a distinction between two important functions of public policy in private international law. The first function is widely recognized and relates to the prevention of application of foreign laws and enforcement of foreign court judgments whenever their effects are incompatible with the domestic legal system of the forum. This effectively protects sovereign rights of the forum state as it allows to resist against the undesirable effects of foreign law-making and law-enforcement policies. The second function is less obvious, but not less important. As the internal private legal relationships, international private relationships are usually governed by rules of public policy, to which the parties can not derogate by mutual agreement. Thefore, for international private law relations public policy has a different function than previously mentioned: in this case, the public policy acts as a defense against unacceptable effects of the party autonomy. Thus, this second function of public policy consists in the limitation of the party autonomy wich effects would be unacceptable for the local legal system. In the frame of this second function the author will analyse two types of public policy which can limit the party autonomy: « substantial » public policy (which regulates the substance of international legal relationship) and « conflictual » public policy (which regulates the party autonomy to choose the law applicable for the substance of relationship). The author provides an analysis of these functions of the public policy in the field of international contract law because of the important role of the principle of party autonomy for international contract relations.

Keywords: public policy, general theory of private international law, substantial public policy, conflictual public policy

Procedia PDF Downloads 558
13497 The Determinants of Corporate Hedging Strategy

Authors: Ademola Ajibade

Abstract:

Previous studies have explored several rationales for hedging strategies, but the evidence provided by these studies remains ambiguous. Using a hand-collected dataset of 2460 observations of non-financial firms in eight African countries covering 2013-2022, this paper investigates the determinants and extent of corporate hedge use. In particular, this paper focuses on the link between country-specific conditions and the corporate hedging behaviour of firms. To our knowledge, this represents the first African studies investigating the association between country-specific factors and corporate hedging policy. The evidence based on both univariate and multivariate reveal that country-level corruption and government quality are important indicators of the decisions and extent of hedge use among African firms. However, the connection between country-specific factors as a rationale for corporate hedge use is stronger for firms located in highly corrupt countries. This suggest that firms located in corrupt countries are more motivated to hedge due to the large exposure they face. In addition, we test the risk management theories and observe that CEOs educational qualification and experience shape corporate hedge behaviour. We implement a lagged variables in a panel data setting to address endogeneity concern and implement an interaction term between governance indices and firm-specific variables to test for robustness. Generally, our findings reveal that institutional factors shape risk management decisions and have a predictive power in explaining corporate hedging strategy.

Keywords: corporate hedging, governance quality, corruption, derivatives

Procedia PDF Downloads 76
13496 An Integrated Real-Time Hydrodynamic and Coastal Risk Assessment Model

Authors: M. Reza Hashemi, Chris Small, Scott Hayward

Abstract:

The Northeast Coast of the US faces damaging effects of coastal flooding and winds due to Atlantic tropical and extratropical storms each year. Historically, several large storm events have produced substantial levels of damage to the region; most notably of which were the Great Atlantic Hurricane of 1938, Hurricane Carol, Hurricane Bob, and recently Hurricane Sandy (2012). The objective of this study was to develop an integrated modeling system that could be used as a forecasting/hindcasting tool to evaluate and communicate the risk coastal communities face from these coastal storms. This modeling system utilizes the ADvanced CIRCulation (ADCIRC) model for storm surge predictions and the Simulating Waves Nearshore (SWAN) model for the wave environment. These models were coupled, passing information to each other and computing over the same unstructured domain, allowing for the most accurate representation of the physical storm processes. The coupled SWAN-ADCIRC model was validated and has been set up to perform real-time forecast simulations (as well as hindcast). Modeled storm parameters were then passed to a coastal risk assessment tool. This tool, which is generic and universally applicable, generates spatial structural damage estimate maps on an individual structure basis for an area of interest. The required inputs for the coastal risk model included a detailed information about the individual structures, inundation levels, and wave heights for the selected region. Additionally, calculation of wind damage to structures was incorporated. The integrated coastal risk assessment system was then tested and applied to Charlestown, a small vulnerable coastal town along the southern shore of Rhode Island. The modeling system was applied to Hurricane Sandy and a synthetic storm. In both storm cases, effect of natural dunes on coastal risk was investigated. The resulting damage maps for the area (Charlestown) clearly showed that the dune eroded scenarios affected more structures, and increased the estimated damage. The system was also tested in forecast mode for a large Nor’Easters: Stella (March 2017). The results showed a good performance of the coupled model in forecast mode when compared to observations. Finally, a nearshore model XBeach was then nested within this regional grid (ADCIRC-SWAN) to simulate nearshore sediment transport processes and coastal erosion. Hurricane Irene (2011) was used to validate XBeach, on the basis of a unique beach profile dataset at the region. XBeach showed a relatively good performance, being able to estimate eroded volumes along the beach transects with a mean error of 16%. The validated model was then used to analyze the effectiveness of several erosion mitigation methods that were recommended in a recent study of coastal erosion in New England: beach nourishment, coastal bank (engineered core), and submerged breakwater as well as artificial surfing reef. It was shown that beach nourishment and coastal banks perform better to mitigate shoreline retreat and coastal erosion.

Keywords: ADCIRC, coastal flooding, storm surge, coastal risk assessment, living shorelines

Procedia PDF Downloads 101
13495 Factors That Contribute to Noise Induced Hearing Loss Amongst Employees at the Platinum Mine in Limpopo Province, South Africa

Authors: Livhuwani Muthelo, R. N. Malema, T. M. Mothiba

Abstract:

Long term exposure to excessive noise in the mining industry increases the risk of noise induced hearing loss, with consequences for employee’s health, productivity and the overall quality of life. Objective: The objective of this study was to investigate the factors that contribute to Noise Induced Hearing Loss amongst employees at the Platinum mine in the Limpopo Province, South Africa. Study method: A qualitative, phenomenological, exploratory, descriptive, contextual design was applied in order to explore and describe the contributory factors. Purposive non-probability sampling was used to select 10 male employees who were diagnosed with NIHL in the year 2014 in four mine shafts, and 10 managers who were involved in a Hearing Conservation Programme. The data were collected using semi-structured one-on-one interviews. A qualitative data analysis of Tesch’s approach was followed. Results: The following themes emerged: Experiences and challenges faced by employees in the work environment, hearing protective device factors and management and leadership factors. Hearing loss was caused by partial application of guidelines, policies, and procedures from the Department of Minerals and Energy. Conclusion: The study results indicate that although there are guidelines, policies, and procedures available, failure in the implementation of one element will affect the development and maintenance of employees hearing mechanism. It is recommended that the mine management should apply the guidelines, policies, and procedures and promptly repair the broken hearing protective devices.

Keywords: employees, factors, noise induced hearing loss, noise exposure

Procedia PDF Downloads 108
13494 Gas Chromatography and Mass Spectrometry in Honey Fingerprinting: The Occurrence of 3,4-dihydro-3-oxoedulan and (E)-4-(r-1',t-2',c-4'-trihydroxy-3',6',6'-trimethylcyclohexyl)-but-3-en-2-one

Authors: Igor Jerkovic

Abstract:

Owing to the attractive sensory properties and low odour thresholds, norisoprenoids (degraded carotenoid-like structures with 3,5,5-trimethylcyclohex-2-enoic unit) have been identified as aroma contributors in a number of different matrices. C₁₃-Norisoprenoids have been found among volatile organic compounds of various honey types as well as C₉//C₁₀-norisoprenoids or C₁₄/C₁₅-norisoprenoids. Besides degradation of abscisic acid (which produces, e.g., dehydrovomifoliol, vomifoliol, others), the cleavage of the C(9)=C(10) bond of other carotenoid precursors directly generates nonspecific C₁₃-norisoprenoids such as trans-β-damascenone, 3-hydroxy-trans-β-damascone, 3-oxo-α-ionol, 3-oxo-α-ionone, β-ionone found in various honey types. β-Damascenone and β-ionone smelling like honey, exhibit the lowest odour threshold values of all C₁₃-norisoprenoids. The presentation is targeted on two uncommon C₁₃-norisoprenoids in the honey flavor that could be used as specific or nonspecific chemical markers of the botanical origin. Namely, after screening of different honey types, the focus was directed on Centaruea cyanus L. and Allium ursinum L. honey. The samples were extracted by headspace solid-phase microextraction (HS-SPME) and ultrasonic solvent extraction (USE) and the extracts were analysed by gas chromatography and mass spectrometry (GC-MS). SPME fiber with divinylbenzene/carboxen/polydimethylsiloxane (DVB/CAR/PDMS) coating was applied for the research of C. cyanus honey headspace and predominant identified compound was 3,4-dihydro-3-oxoedulan (2,5,5,8a-tetramethyl-2,3,5,6,8,8a-hexahydro-7H-chromen-7-one also known as 2,3,5,6,8,8a-hexahydro-2,5,5,8a-tetramethyl-7H-1-benzo-pyran-7-one). The oxoedulan structure contains epoxide and it is more volatile in comparison with its hydroxylated precursors. This compound has not been found in other honey types and can be considered specific for C. cyanus honey. The dichloromethane extract of A. ursinum honey contained abundant (E)-4-(r-1',t-2',c-4'-trihydroxy-3',6',6'-trimethylcyclohexyl)-but-3-en-2-one that was previously isolated as dominant substance from the ether extracts of New Zealand thyme honey. Although a wide variety of degraded carotenoid-like substances have been identified from different honey types, this appears to be rare situation where 3,4-dihydro-3-oxoedulan and (E)-4-(r-1',t-2',c-4'-trihydroxy-3',6',6'-trimethylcyclohexyl)-but-3-en-2-one have been found that is of great importance for chemical fingerprinting and identification of the chemical biomarkers that can complement the pollen analysis as the major method for the honey classification.

Keywords: 3, 4-dihydro-3-oxoedulan, (E)-4-(r-1', t-2', c-4'-trihydroxy-3', 6', 6'-trimethylcyclohexyl)-but-3-en-2-one, honey flavour, C₁₃-norisoprenoids

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13493 The Effect of Sustainable Land Management Technologies on Food Security of Farming Households in Kwara State, Nigeria

Authors: Shehu A. Salau, Robiu O. Aliu, Nofiu B. Nofiu

Abstract:

Nigeria is among countries of the world confronted with food insecurity problem. The agricultural production systems that produces food for the teaming population is not endurable. Attention is thus being given to alternative approaches of intensification such as the use of Sustainable Land Management (SLM) technologies. Thus, this study assessed the effect of SLM technologies on food security of farming households in Kwara State, Nigeria. A-three stage sampling technique was used to select a sample of 200 farming households for this study. Descriptive statistics, Shriar index, Likert scale, food security index and logistic regression were employed for the analysis. The result indicated that majority (41%) of the household heads were between the ages of 51 and 70 years with an average of 60.5 years. Food security index revealed that 35% and 65% of the households were food secure and food insecure respectively. The logistic regression showed that SLM technologies, estimated income, household size, gender and age of the household heads were the critical determinants of food security among farming households. The most effective coping strategies adopted by households geared towards lessening the effects of food insecurity are reduced quality of food consumed, employed off-farm jobs to raise household income and diversion of money budgeted for other uses to purchase foods. Governments should encourage the adoption and use of SLM technologies at all levels. Policies and strategies that reduce household size should be enthusiastically pursued to reduce food insecurity.

Keywords: agricultural practices, coping strategies, farming households, food security, SLM technologies, logistic regression

Procedia PDF Downloads 159
13492 Role of Hyperbaric Oxygen Therapy in Management of Diabetic Foot

Authors: Magdy Al Shourbagi

Abstract:

Diabetes mellitus is the commonest cause of neuropathy. The common pattern is a distal symmetrical sensory polyneuropathy, associated with autonomic disturbances. Less often, Diabetes mellitus is responsible for a focal or multifocal neuropathy. Common causes for non-healing of diabetic foot are the infection and ischemia. Diabetes mellitus is associated with a defective cellular and humoral immunity. Particularly, decreased phagocytosis, decreased chemotaxis, impaired bacterial killing and abnormal lymphocytic function resulting in a reduced inflammatory reaction and defective wound healing. Hyperbaric oxygen therapy is defined by the Undersea and Hyperbaric Medical Society as a treatment in which a patient intermittently breathes 100% oxygen and the treatment chamber is pressurized to a pressure greater than sea level (1 atmosphere absolute). The pressure increase may be applied in mono-place (single person) or multi-place chambers. Multi-place chambers are pressurized with air, with oxygen given via face mask or endotracheal tube; while mono-place chambers are pressurized with oxygen. Oxygen gas plays an important role in the physiology of wound healing. Hyperbaric oxygen therapy can raise tissue oxygen tensions to levels where wound healing can be expected. HBOT increases the killing ability of leucocytes also it is lethal for certain anaerobic bacteria and inhibits toxin formation in many other anaerobes. Multiple anecdotal reports and studies in HBO therapy in diabetic patients report that HBO can be an effective adjunct therapy in the management of diabetic foot wounds and is associated with better functional outcomes.

Keywords: hyperbari oxygen therapy, diabetic foot, neuropathy, multiplace chambers

Procedia PDF Downloads 277
13491 Evaluation of the Performance of ACTIFLO® Clarifier in the Treatment of Mining Wastewaters: Case Study of Costerfield Mining Operations, Victoria, Australia

Authors: Seyed Mohsen Samaei, Shirley Gato-Trinidad

Abstract:

A pre-treatment stage prior to reverse osmosis (RO) is very important to ensure the long-term performance of the RO membranes in any wastewater treatment using RO. This study aims to evaluate the application of the Actiflo® clarifier as part of a pre-treatment unit in mining operations. It involves performing analytical testing on RO feed water before and after installation of Actiflo® unit. Water samples prior to RO plant stage were obtained on different dates from Costerfield mining operations in Victoria, Australia. Tests were conducted in an independent laboratory to determine the concentration of various compounds in RO feed water before and after installation of Actiflo® unit during the entire evaluated period from December 2015 to June 2018. Water quality analysis shows that the quality of RO feed water has remarkably improved since installation of Actiflo® clarifier. Suspended solids (SS) and turbidity removal efficiencies has been improved by 91 and 85 percent respectively in pre-treatment system since the installation of Actiflo®. The Actiflo® clarifier proved to be a valuable part of pre-treatment system prior to RO. It has the potential to conveniently condition the mining wastewater prior to RO unit, and reduce the risk of RO physical failure and irreversible fouling. Consequently, reliable and durable operation of RO unit with minimum requirement for RO membrane replacement is expected with Actiflo® in use.

Keywords: ACTIFLO ® clarifier, mining wastewater, reverse osmosis, water treatment

Procedia PDF Downloads 182
13490 Improving Customer Service through Empathy

Authors: Abiola Olukemi Ogunyemi

Abstract:

Many organizations would like to gain customer loyalty, and to achieve this they invest in customer management systems which help them to learn and anticipate the customers’ needs, get feedback from them and serve them. One of the most elementary ways to achieve customer loyalty is for employees to be able to empathize with their customers, and to be able to feel what they feel when the company betrays their trust, which usually otherwise shown in patronage and loyalty. Unfortunately, the staff and management of organizations do not always realize the negative impact of treating customers badly, because they do not stop to think how these customers feel. If they did, they would be more careful and more respectful of these people who are human beings just like they are. They would be wiser, since this would ultimately make them more profitable businesses. This paper looks at thirteen descriptions of situations in which customers felt treated badly by organizations they trusted, and focuses on the feelings of these customers. If the organization (made of people) could empathize with the customer, then customer service would be surely enhanced. It is expected that these stories, real experiences narrated by young professionals working in Nigeria, can awaken greater empathy for consumers within organizations. Thus, they may help the organization to learn empathy and to incorporate it into their foundational principles for ethical behavior. The paper’s contents contribute to a heightened appreciation of empathy as an organizing mechanism by showing how putting one in the consumer’s shoes can help managers to understand how he or she feels. This will lead organizations to be even more innovative in finding ways to meet their customers’ needs and to deserve and win their loyalty. It addresses an issue that cuts across cultures, and therefore can be quite thought-provoking for every business owner or for team leads within organizations. By trying to stimulate empathy across the seller-buyer divide, it necessarily contributes to a deeper understanding of empathy as a building block for a sustainable society.

Keywords: customer service, empathy, ethical behavior, respectfulness

Procedia PDF Downloads 242
13489 Comparative Syudy Of Heat Transfer Capacity Limits of Heat Pipe

Authors: H. Shokouhmand, A. Ghanami

Abstract:

Heat pipe is simple heat transfer device which combines the conduction and phase change phenomena to control the heat transfer without any need for external power source. At hot surface of heat pipe, the liquid phase absorbs heat and changes to vapor phase. The vapor phase flows to condenser region and with the loss of heat changes to liquid phase. Due to gravitational force the liquid phase flows to evaporator section.In HVAC systems the working fluid is chosen based on the operating temperature. The heat pipe has significant capability to reduce the humidity in HVAC systems. Each HVAC system which uses heater, humidifier or dryer is a suitable nominate for the utilization of heat pipes. Generally heat pipes have three main sections: condenser, adiabatic region and evaporator.Performance investigation and optimization of heat pipes operation in order to increase their efficiency is crucial. In present article, a parametric study is performed to improve the heat pipe performance. Therefore, the heat capacity of heat pipe with respect to geometrical and confining parameters is investigated. For the better observation of heat pipe operation in HVAC systems, a CFD simulation in Eulerian- Eulerian multiphase approach is also performed. The results show that heat pipe heat transfer capacity is higher for water as working fluid with the operating temperature of 340 K. It is also observed that the vertical orientation of heat pipe enhances it’s heat transfer capacity.

Keywords: heat pipe, HVAC system, grooved heat pipe, heat pipe limits

Procedia PDF Downloads 358
13488 Heat Pipe Thermal Performance Improvement in H-VAC Systems Using CFD Modeling

Authors: H. Shokouhmand, A. Ghanami

Abstract:

Heat pipe is a simple heat transfer device which combines the conduction and phase change phenomena to control the heat transfer without any need for external power source. At hot surface of the heat pipe, the liquid phase absorbs heat and changes to vapor phase. The vapor phase flows to condenser region and with the loss of heat changes to liquid phase. Due to gravitational force, the liquid phase flows to evaporator section. In HVAC systems, the working fluid is chosen based on the operating temperature. The heat pipe has significant capability to reduce the humidity in HVAC systems. Each HVAC system which uses heater, humidifier or dryer is a suitable nominate for the utilization of heat pipes. Generally, heat pipes have three main sections: condenser, adiabatic region, and evaporator.Performance investigation and optimization of heat pipes operation in order to increase their efficiency is crucial. In the present article, a parametric study is performed to improve the heat pipe performance. Therefore, the heat capacity of the heat pipe with respect to geometrical and confining parameters is investigated. For the better observation of heat pipe operation in HVAC systems, a CFD simulation in Eulerian- Eulerian multiphase approach is also performed. The results show that heat pipe heat transfer capacity is higher for water as working fluid with the operating temperature of 340 K. It is also showed that the vertical orientation of heat pipe enhances its heat transfer capacity.

Keywords: heat pipe, HVAC system, grooved heat pipe, CFD simulation

Procedia PDF Downloads 480
13487 Investigating Interference Errors Made by Azzawia University 1st year Students of English in Learning English Prepositions

Authors: Aimen Mohamed Almaloul

Abstract:

The main focus of this study is investigating the interference of Arabic in the use of English prepositions by Libyan university students. Prepositions in the tests used in the study were categorized, according to their relation to Arabic, into similar Arabic and English prepositions (SAEP), dissimilar Arabic and English prepositions (DAEP), Arabic prepositions with no English counterparts (APEC), and English prepositions with no Arabic counterparts (EPAC). The subjects of the study were the first year university students of the English department, Sabrata Faculty of Arts, Azzawia University; both males and females, and they were 100 students. The basic tool for data collection was a test of English prepositions; students are instructed to fill in the blanks with the correct prepositions and to put a zero (0) if no preposition was needed. The test was then handed to the subjects of the study. The test was then scored and quantitative as well as qualitative results were obtained. Quantitative results indicated the number, percentages and rank order of errors in each of the categories and qualitative results indicated the nature and significance of those errors and their possible sources. Based on the obtained results the researcher could detect that students made more errors in the EPAC category than the other three categories and these errors could be attributed to the lack of knowledge of the different meanings of English prepositions. This lack of knowledge forced the students to adopt what is called the strategy of transfer.

Keywords: foreign language acquisition, foreign language learning, interference system, interlanguage system, mother tongue interference

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13486 Evaluation of the Efficacy and Tolerance of Gabapentin in the Treatment of Neuropathic Pain

Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

Abstract:

INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

Procedia PDF Downloads 86
13485 Heat Pipes Thermal Performance Improvement in H-VAC Systems Using CFD Modeling

Authors: M. Heydari, A. Ghanami

Abstract:

Heat pipe is simple heat transfer device which combines the conduction and phase change phenomena to control the heat transfer without any need for external power source. At hot surface of heat pipe, the liquid phase absorbs heat and changes to vapor phase. The vapor phase flows to condenser region and with the loss of heat changes to liquid phase. Due to gravitational force the liquid phase flows to evaporator section.In HVAC systems the working fluid is chosen based on the operating temperature. The heat pipe has significant capability to reduce the humidity in HVAC systems. Each HVAC system which uses heater, humidifier or dryer is a suitable nominate for the utilization of heat pipes. Generally heat pipes have three main sections: condenser, adiabatic region and evaporator.Performance investigation and optimization of heat pipes operation in order to increase their efficiency is crucial. In present article, a parametric study is performed to improve the heat pipe performance. Therefore, the heat capacity of heat pipe with respect to geometrical and confining parameters is investigated. For the better observation of heat pipe operation in HVAC systems, a CFD simulation in Eulerian- Eulerian multiphase approach is also performed. The results show that heat pipe heat transfer capacity is higher for water as working fluid with the operating temperature of 340 K. It is also showed that the vertical orientation of heat pipe enhances it’s heat transfer capacity.

Keywords: heat pipe, HVAC system, grooved heat pipe, heat pipe limits

Procedia PDF Downloads 431
13484 Comparison of On-Site Stormwater Detention Real Performance and Theoretical Simulations

Authors: Pedro P. Drumond, Priscilla M. Moura, Marcia M. L. P. Coelho

Abstract:

The purpose of On-site Stormwater Detention (OSD) system is to promote the detention of addition stormwater runoff caused by impervious areas, in order to maintain the peak flow the same as the pre-urbanization condition. In recent decades, these systems have been built in many cities around the world. However, its real efficiency continues to be unknown due to the lack of research, especially with regard to monitoring its real performance. Thus, this study aims to compare the water level monitoring data of an OSD built in Belo Horizonte/Brazil with the results of theoretical methods simulations, usually adopted in OSD design. There were made two theoretical simulations, one using the Rational Method and Modified Puls method and another using the Soil Conservation Service (SCS) method and Modified Puls method. The monitoring data were obtained with a water level sensor, installed inside the reservoir and connected to a data logger. The comparison of OSD performance was made for 48 rainfall events recorded from April/2015 to March/2017. The comparison of maximum water levels in the OSD showed that the results of the simulations with Rational/Puls and SCS/Puls methods were, on average 33% and 73%, respectively, lower than those monitored. The Rational/Puls results were significantly higher than the SCS/Puls results, only in the events with greater frequency. In the events with average recurrence interval of 5, 10 and 200 years, the maximum water heights were similar in both simulations. Also, the results showed that the duration of rainfall events was close to the duration of monitored hydrograph. The rising time and recession time of the hydrographs calculated with the Rational Method represented better the monitored hydrograph than SCS Method. The comparison indicates that the real discharge coefficient value could be higher than 0.61, adopted in Puls simulations. New researches evaluating OSD real performance should be developed. In order to verify the peak flow damping efficiency and the value of the discharge coefficient is necessary to monitor the inflow and outflow of an OSD, in addition to monitor the water level inside it.

Keywords: best management practices, on-site stormwater detention, source control, urban drainage

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13483 Improving the Quality and Nutrient Content of Palm Kernel Cake through Fermentation with Bacillus subtilis

Authors: Mirnawati, Gita Ciptaan, Ferawati

Abstract:

Background and Objective: Palm kernel cake (PKC) is a waste of the palm oil industry. Indonesia, as the largest palm oil producer in the world, produced 45-46% palm kernel cake. Palm kernel cake can potentially be used as animal ration but its utilization for poultry is limited. Thus, fermentation process was done in order to increase the utilization PKC in poultry ration. An experiment was conducted to study the effect between Inoculum Doses with Bacillus subtilis and fermentation time to improve the quality and nutrient content of fermented Palm Kernel Cake. Material and Methods: 1) Palm kernel cake derived from Palm Kernel Processing Manufacture of Andalas Agro Industry in Pasaman, West Sumatra. 2) Bacillus subtilis obtained from The Research Center of Applied Chemistry LIPI, Bogor. 3) Preparations nutrient agar medium (NA) produced by Difoo - Becton Dickinson. 4) Rice bran 5) Aquades and mineral standard. The experiment used completely randomize design (CRD) with 3 x 3 factorial and 3 replications. The first factors were three doses of inoculum Bacillus subtilis: (3%), (5%), and (7%). The second factor was fermentation time: (1) 2 day, (2) 4 day, and (3) 6 day. The parameters were crude protein, crude fiber, nitrogen retention, and crude fiber digestibility of fermented palm kernel cake (FPKC). Results: The result of the study showed that there was significant interaction (P<0.01) between factor A and factor B and each factor A and B also showed significant effect (P<0.01) on crude protein, crude fiber, nitrogen retention, and crude fiber digestibility. Conclusion: From this study, it can be concluded that fermented PKC with 7% doses of Bacillus subtilis and 6 days fermentation time provides the best result as seen from 24.65% crude protein, 17.35% crude fiber, 68.47% nitrogen retention, 53.25% crude fiber digestibility of fermented palm kernel cake (FPKC).

Keywords: fermentation, Bacillus Subtilis, inoculum, palm kernel cake, quality, nutrient

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13482 The Implementation of Anti-Circumvention Legislations in Thai Copyright System

Authors: Chuencheewin Yimfuang

Abstract:

The WIPO copyright treaty (WCT) was established by the World Intellectual Property Organisation (WIPO). This agreement required the contracting nations to provide adequate protection to technological measures to prevent massive copyright infringement in the internet system. Thailand had to implement the anti-circumvention rules into domestic legislation to comply with this international obligation. The purpose of this paper is to critically discuss the legislative standard under the WCT. It also aims to examine the legal development of technological protection measures in Thailand and demonstrate that the scope of prohibitions under the copyright Act 2022 (NO.5) is similar to the Digital Millennium Copyright Act 1998 (DMCA) of the United States (US). It could be found that the anti-circumvention laws of Thailand prohibit the circumvention of access-control technologies, and the regulation on trafficking circumvention devices has been added to the latest version of the Thai Copyright Act. These legislative evolutions have revealed the attempt to reinforce the legal protection of technological measures and copyright holders in order to be in line with global practices. However, the amendment has problems concerning the legal definitions of effective technological measure and the prohibited act of circumvention. The vagueness might affect the scope of protection and the boundary of prohibition. With this aspect, the DMCA will be evaluated and compared to gain guidelines for interpretation and enforcement in Thailand. The lessons and experiences learned from this study might be useful to correct the flaws or at least clarify the ambiguities embodied in Thai copyright legislation.

Keywords: legal development, technological protection measure, circumvention, Thailand

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13481 HIV and AIDS in Kosovo, Stigma Persist!

Authors: Luljeta Gashi, Naser Ramadani, Zana Deva, Dafina Gexha-Bunjaku

Abstract:

The official HIV/AIDS data in Kosovo are based on HIV case reporting from health-care services, the blood transfusion system and Voluntary Counselling and Testing centres. Between 1986 and 2014, are reported 95 HIV and AIDS cases, of which 49 were AIDS, 46 HIV and 40 deaths. The majority (69%) of cases were men, age group 25 to 34 (37%) and route of transmission is: heterosexual (90%), MSM (7%), vertical transmission (2%) and IDU (1%). Based on existing data and the UNAIDS classification system, Kosovo is currently still categorised as having a low-level HIV epidemic. Even though with a low HIV prevalence, Kosovo faces a number of threatening factors, including increased number of drug users, a stigmatized and discriminated MSM community, high percentage of youth among general population (57% of the population under the age of 25), with changing social norms and especially the sexual ones. Methods: Data collection was done using self administered structured questionnaires amongst 249 high school students. Data were analysed using the Statistical Package for Social Sciences (SPSS). Results: The findings revealed that 68% of students know that HIV transmission can be reduced by having sex with only one uninfected partner who has no other partners, 94% know that the risk of getting HIV can be reduced by using a condom every time they have sex, 68% know that a person cannot get HIV from mosquito bites, 81% know that they cannot get HIV by sharing food with someone who is infected and 46% know that a healthy looking person can have HIV. Conclusions: Seventy one percent of high school students correctly identify ways of preventing the sexual transmission of HIV and who reject the major misconceptions about HIV transmission. The findings of the study indicate a need for more health education and promotion.

Keywords: Kosovo, KPAR, HIV, high school

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13480 Construction Innovation: Support for 3D Printing House

Authors: Andrea Palazzo, Daniel Macek, Veronika Malinova

Abstract:

Contour processing is the new technology challenge for architects and construction companies. The many advantages it promises make it one of the most interesting solutions for construction in terms of automation of building processes. The technology for 3D printing houses offers many application possibilities, from low-cost construction, to being considered by NASA for visionary projects as a good solution for building settlements on other planets. Another very important point is that clients, as architects, will no longer have many limits in design concerning ideas and creativity. The prices for real estate are constantly increasing and the lack of availability of construction materials as well as the speculation that has been created around it in 2021 is bringing prices to such a level that in the future real estate developers risk not being able to find customers for these ultra-expensive homes. Hence, this paper starts with the introduction of 3D printing, which now has the potential to gain an important position in the market, becoming a valid alternative to the classic construction process. This technology is not only beneficial from an economic point of view but it is also a great opportunity to have an impact on the environment by reducing CO2 emissions. Further on in the article we will also understand if, after the COP 26 (2021 United Nations Climate Change Conference), world governments could also push towards building technologies that reduce the waste materials that are needed to be disposed of and at the same time reduce emissions with the contribution of governmental funds. This paper will give us insight on the multiple benefits of 3D printing and emphasise the importance of finding new solutions for materials that can be used by the printer. Therefore, based on the type of material, it will be possible to understand the compatibility with current regulations and how the authorities will be inclined to support this technology. This will help to enable the rise and development of this technology in Europe and in the rest of the world on actual housing projects and not only on prototypes.

Keywords: additive manufacturing, contour crafting, development, new regulation, printing material

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13479 A Protocol for Usability of Teaching to Students with Learning Difficulties at University: An Italian Research

Authors: Tamara Zappaterra

Abstract:

The Learning Difficulties have an evolutionary nature. The international research has focused its analysis on the characteristics of Learning Difficulties in childhood, but we are still far from a thorough understanding of the nature of such disorders in adolescence and adulthood. Such issues become even more urgent in the university context. Spelling, meaning, and appropriate use of the specific vocabulary of the various disciplines represent an additional challenge for the dyslexic student. This paper explores the characteristics of Learning Difficulties in adulthood and the impact with the university teaching. It presents the results of an interdisciplinary project (educational, medical and engineering area) at University of Florence. The purpose of project is to design of a protocol for usability of teaching and individual study at university level. The project, after a first reconnaissance of user needs that have been reached with the participation of the very same protagonists, is at the stage of guidelines drafting for inclusion and education, to be used by teachers, students and administrative staff. The methodologies used are a questionnaire built on purpose and a series of focus groups with users. For collecting data during the focus groups it was decided to use a method typical of the Quality Function Deployment, a tool originally used for quality management, whose versatility makes it easy to use in a number of different context. The paper presents furthermore the findings of the project, the most significant elements of the guidelines for teaching, i.e. the section for teachers, whose aim is to implement a Learning Difficulties-friendly teaching, even at the university level, in compliance with italian Law 170/2010. The Guidelines for the didactic and inclusion of Learning Difficulties students of the University of Florence are articulated around a global and systemic plan of action, meant to accompany and protect the students during their study career, even before enrolling at the University, with different declination: the logistical, relational, educational, and didactic levels have been considered. These guidelines in Italy received the endorsement of the CNUDD. It is a systemic intervention plan for Learning Difficulties students, which roused and keeps rousing the interest of all the university system, with a radical consideration on academic teaching. Since while we try to provide the best Learning Difficulties-friendly didactic in compliance with the rules, no one can be exempted from a wider consideration on the nature and the quality of university teaching offered to all students.

Keywords: didactic tools, learning difficulties, special and inclusive education, university teaching

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13478 A Retrospective Study on the Spectrum of Infection and Emerging Antimicrobial Resistance in Type 2 Diabetes Mellitus

Authors: Pampita Chakraborty, Sukumar Mukherjee

Abstract:

People with diabetes mellitus are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defences in diabetes. People who have minimally elevated blood sugar levels experience worse outcomes with infections. Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalisation and recovery times. A study was done in a tertiary care unit in eastern India. Patients with type 2 diabetes mellitus infection were recruited in the study. A total of 520 cases of Type 2 Diabetes Mellitus were recorded out of which 200 infectious cases was included in the study. All subjects underwent detailed history & clinical examination. Microbiological samples were collected from respective site of the infection for microbial culture and antibiotic sensitivity test. Out of the 200 infectious cases urinary tract infection(UTI) was found in majority of the cases followed by diabetic foot ulcer (DFU), respiratory tract infection(RTI) and sepsis. It was observed that Escherichia coli was the most commonest pathogen isolated from UTI cases and Staphylococcus aureus was predominant in foot ulcers followed by other organisms. Klebsiella pneumonia was the major organism isolated from RTI and Enterobacter aerogenes was commonly observed in patients with sepsis. Isolated bacteria showed differential sensitivity pattern against commonly used antibiotics. The majority of the isolates were resistant to several antibiotics that are usually prescribed on an empirical basis. These observations are important, especially for patient management and the development of antibiotic treatment guidelines. It is recommended that diabetic patients receive pneumococcal and influenza vaccine annually to reduce morbidity and mortality. Appropriate usage of antibiotics based on local antibiogram pattern can certainly help the clinician in reducing the burden of infections.

Keywords: antimicrobial resistance, diabetic foot ulcer, respiratory tract infection, urinary tract infection

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13477 A Literature Review: The Anti-Obesity Effect of Epigallocathecin-3-Gallate of Camellia sinensis (Green Tea) Extraction as a Potential Adjuvant Therapy for Management Obesity

Authors: Nunuy Nuraeni, Vera Amalia Lestari, Atri Laranova, Viena Nissa Mien Fadhillah, Mutia, Muhammad Ikhlas Abdian Putra

Abstract:

Introduction: Obesity is a common disease with high prevalence especially in developing countries including Indonesia. The obesitygenic lifestyle such as excessive intake of food, sedentary lifestyle is the major environmental etiologies of obesity. Obesity is also as one of burden disease with high morbidity due to its complication, such as diabetes mellitus and hypertension. The objective of this literature review is to know how the Epigallocathecin-3-Gallate of Green tea or Camellia sinensis effect as anti-obesity agent and reduce the complication of obesity. Material and Methods: This study based on the secondary data analysis complemented by primary data collection from several journal and textbook. We identified the effect of Epigallocathecin-3-Gallate of Green tea or Camellia sinensis as adjuvant therapy for management obesity and to prevent the complications of obesity. Results: Based on the result, Green tea or Camellia sinensis contain Epigallocathecin-3-Gallate (EGCG) that has anti-obesity effect such as induce apoptosis, inhibit adipogenesis, increasing lipolytic activity, increasing fat oxidation and thermogenesis. Discussion: EGCG are naturally distributed in green tea, that contains a biological activity that has a potential effect to treat obesity. Conclusion: EGCG are capable to treat obesity. By consuming EGCG can prevent obesity in normal health person and prevent complication in patient with obesity.

Keywords: adjuvant therapy, anti-obesity effect, complication, epigallocathecin-3-gallate, obesity

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13476 Information Communication Technology Based Road Traffic Accidents’ Identification, and Related Smart Solution Utilizing Big Data

Authors: Ghulam Haider Haidaree, Nsenda Lukumwena

Abstract:

Today the world of research enjoys abundant data, available in virtually any field, technology, science, and business, politics, etc. This is commonly referred to as big data. This offers a great deal of precision and accuracy, supportive of an in-depth look at any decision-making process. When and if well used, Big Data affords its users with the opportunity to produce substantially well supported and good results. This paper leans extensively on big data to investigate possible smart solutions to urban mobility and related issues, namely road traffic accidents, its casualties, and fatalities based on multiple factors, including age, gender, location occurrences of accidents, etc. Multiple technologies were used in combination to produce an Information Communication Technology (ICT) based solution with embedded technology. Those technologies include principally Geographic Information System (GIS), Orange Data Mining Software, Bayesian Statistics, to name a few. The study uses the Leeds accident 2016 to illustrate the thinking process and extracts thereof a model that can be tested, evaluated, and replicated. The authors optimistically believe that the proposed model will significantly and smartly help to flatten the curve of road traffic accidents in the fast-growing population densities, which increases considerably motor-based mobility.

Keywords: accident factors, geographic information system, information communication technology, mobility

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13475 The Importance of Zenithal Lighting Systems for Natural Light Gains and for Local Energy Generation in Brazil

Authors: Ana Paula Esteves, Diego S. Caetano, Louise L. B. Lomardo

Abstract:

This paper presents an approach on the advantages of using adequate coverage in the zenithal lighting typology in various areas of architectural production, while at the same time to encourage to the design concerns inherent in this choice of roofing in Brazil. Understanding that sustainability needs to cover several aspects, a roofing system such as zenithal lighting system can contribute to the provision of better quality natural light for the interior of the building, which is related to the good health and welfare; it will also be able to contribute for the sustainable aspects and environmental needs, when it allows the generation of energy in semitransparent or opacity photovoltaic solutions and economize the artificial lightning. When the energy balance in the building is positive, that is, when the building generates more energy than it consumes, it may fit into the Net Zero Energy Building concept. The zenithal lighting systems could be an important ally in Brazil, when solved the burden of heat gains, participate in the set of pro-efficiency actions in search of "zero energy buildings". The paper presents comparative three cases of buildings that have used this feature in search of better environmental performance, both in light comfort and sustainability as a whole. Two of these buildings are examples in Europe: the Notley Green School in the UK and the Isofóton factory in Spain. The third building with these principles of shed´s roof is located in Brazil: the Ipel´s factory in São Paulo.

Keywords: natural lighting, net zero energy building, sheds, semi-transparent photovoltaics

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13474 Structure of the Working Time of Nurses in Emergency Departments in Polish Hospitals

Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: emergency nurses, nursing care, workload, work sampling

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13473 Research on Pilot Sequence Design Method of Multiple Input Multiple Output Orthogonal Frequency Division Multiplexing System Based on High Power Joint Criterion

Authors: Linyu Wang, Jiahui Ma, Jianhong Xiang, Hanyu Jiang

Abstract:

For the pilot design of the sparse channel estimation model in Multiple Input Multiple Output Orthogonal Frequency Division Multiplexing (MIMO-OFDM) systems, the observation matrix constructed according to the matrix cross-correlation criterion, total correlation criterion and other optimization criteria are not optimal, resulting in inaccurate channel estimation and high bit error rate at the receiver. This paper proposes a pilot design method combining high-power sum and high-power variance criteria, which can more accurately estimate the channel. First, the pilot insertion position is designed according to the high-power variance criterion under the condition of equal power. Then, according to the high power sum criterion, the pilot power allocation is converted into a cone programming problem, and the power allocation is carried out. Finally, the optimal pilot is determined by calculating the weighted sum of the high power sum and the high power variance. Compared with the traditional pilot frequency, under the same conditions, the constructed MIMO-OFDM system uses the optimal pilot frequency for channel estimation, and the communication bit error rate performance obtains a gain of 6~7dB.

Keywords: MIMO-OFDM, pilot optimization, compressed sensing, channel estimation

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13472 A Highly Efficient Broadcast Algorithm for Computer Networks

Authors: Ganesh Nandakumaran, Mehmet Karaata

Abstract:

A wave is a distributed execution, often made up of a broadcast phase followed by a feedback phase, requiring the participation of all the system processes before a particular event called decision is taken. Wave algorithms with one initiator such as the 1-wave algorithm have been shown to be very efficient for broadcasting messages in tree networks. Extensions of this algorithm broadcasting a sequence of waves using a single initiator have been implemented in algorithms such as the m-wave algorithm. However as the network size increases, having a single initiator adversely affects the message delivery times to nodes further away from the initiator. As a remedy, broadcast waves can be allowed to be initiated by multiple initiator nodes distributed across the network to reduce the completion time of broadcasts. These waves initiated by one or more initiator processes form a collection of waves covering the entire network. Solutions to global-snapshots, distributed broadcast and various synchronization problems can be solved efficiently using waves with multiple concurrent initiators. In this paper, we propose the first stabilizing multi-wave sequence algorithm implementing waves started by multiple initiator processes such that every process in the network receives at least one sequence of broadcasts. Due to being stabilizing, the proposed algorithm can withstand transient faults and do not require initialization. We view a fault as a transient fault if it perturbs the configuration of the system but not its program.

Keywords: distributed computing, multi-node broadcast, propagation of information with feedback and cleaning (PFC), stabilization, wave algorithms

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13471 Oestrogen Replacement In Post-Oophorectomy Women

Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

Abstract:

Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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