Search results for: emergency decree in Turkey

Authors: Aadil Khan, Yasser Chomayil, P. P. Venugopalan

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Background: Budd-Chiari syndrome is caused by thrombosis of the hepatic veins and/or the thrombosis of the intrahepatic or suprahepatic IVC. The etiology remains idiopathic in 16% -35% of cases. Malignancy, rheumatological disorder, myeloproliferative disease, inheritable coagulopathy, infection or hyperestrogen state can be identified in many cases. Methodology: Review of case records of the patient presented to Aster Medcity, Emergency Department, Cochin. Introduction:17 years old female was presented to ED with fever, jaundice and abdominal distention since 1 week. O/E: Pallor+, icterus+. Abdomen- gross distension+, shifting dullness+, generalized anasarca+. USG abdomen showed hepatomegaly with mild coarse echotexture and moderate to gross ascites. CT abdomen and chest showed hepatomegaly with thrombosis of all three hepatic vein and moderate ascites suggestive of Budd-Chiari syndrome. Patient was taken for catheter vein thrombolysis. Venogram done the next day revealed almost > 50% opening of the right hepatic vein. Concurrent doppler showed colour and doppler signals in middle hepatic veins. She gradually improved and was discharged home on anticoagulant and adviced regular follow up. Conclusion: Being a rare disease in this young population, high suspicion is required when evaluating young patients with abdominal pain and jaundice.

Keywords: Budd-Chiari syndrome, rare disease, abdominal pain, India

Procedia PDF Downloads 277

Authors: Derya Yucel, Nigar Angın, Dürdane Mart, Meltem Turkeri, Volkan Catalkaya, Celal Yucel

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Chickpea (Cicer arietinum L.) is one of the important legumes widely grown for dietery proteins in semi-arid Mediteranean climatic conditions. To evaluate the genetic diversity with improved heat and drought tolerance capacity in chickpea, thirty-four selected chickpea genotypes were tested under different field-growing conditions (rainfed winter sowing, irrigated-late sowing and rainfed-late sowing) in 2015 growing season. A factorial experiment in randomized complete block design with 3 reps was conducted at the Eastern Mediterranean Research Institute Adana, Turkey. Based on grain yields under different growing conditions, several indices were calculated to identify economically higher-yielding chickpea genotypes with greater heat and drought tolerance capacity. Average across chickpea genotypes, the values of tolerance index, mean productivity, yield index, yield stability index, stress tolerance index, stress susceptibility index, and geometric mean productivity were ranged between 1.1 to 218, 38 to 202, 0.3 to 1.7, 0.2 to 1, 0.1 to 1.2, 0.02 to 1.4, and 36 to 170 for drought stress and 3 to 54, 23 to 118, 0.3 to 1.7, 0.4 to 0.9, 0.2 to 2, 0.2to 2.3, and 23 to 118 for heat stress, respectively. There were highly significant differences observed among the tested chickpea genotypes response to drought and heat stresses. Among the chickpea genotypes, the Aksu, Arda, Çakır, F4 09 (X 05 TH 21-16189), FLIP 03-108 were identified with a higher drought and heat tolerance capacity. Based on our field studies, it is suggested that the drought and heat tolerance indicators of plants can be used by breeders to select stress-resistant economically productive chickpea genotypes suitable to grow under Mediteranean climatic conditions.

Keywords: irrigation, rainfed, stress susceptibility, tolerance indice

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Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

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Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Ranjith Kumar Kankala, Wei-Zhi Lin, Chia-Hung Lee

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Antibiotic resistance in bacteria has become an emergency situation clinically. To improve the efficacy of antibiotics in resistant strains, advancement of nanoparticles is inevitable than ever. Herewith, we demonstrate a design by immobilizing tetracycline (TET) in copper substituted mesoporous silica nanoparticles (Cu-MSNs) through a pH-sensitive coordination link, enabling its release in the acidic environment. Subsequently, MSNs are coated with silver nanoparticles stabilized polyethyleneimine (PEI-SNP) to act against drug-resistant (MDR) bacterial strains. Silver ions released from SNP are capable of sensitizing the resistant strains and facilitate the generation of free radicals capable of damaging the cell components. In addition, copper ions in the framework are also capable of generating free radicals through Fenton-like reaction. Furthermore, the nanoparticles are well-characterized physically, and various antibacterial efficacious tests against isolated multidrug resistant bacterial strain were highly commendable. However, this formulation has no significant toxic effect on normal mammalian fibroblast cells accounting its high biocompatibility. These MSN trio-hybrids, i.e., SNP, tetracycline, and copper ions result in synergistic effects, and their advancement could bypass resistance and allow synergism for effective treatment of antibiotic clinically.

Keywords: antibiotic resistance, copper, mesoporous silica nanoparticles, Ph-sensitive release, polyethyleneimine, silver, tetracycline

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Authors: Rania Mustafa, Anfal Gadour

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Specialty area: Manchester University NHS Foundation Trust, Wythenshawe Hospital Accident and Emergency Department. About, Documentation of verbal and written head injury advice given to all adults presenting following a head injury. Our aim was to assess verbal & written head injury advice for an adult patient attending ED in Wythenshawe hospital during the period from January 2022 to May 2022, with a view to evaluating the NICE head injury guidelines concerning discharge advice and also to review the clinical notes to ensure that all adult patients presenting with a head injury are documented to have received both verbal & written head injury advice as per the NICE guidelines. Here we collected data from a random sample over a 1 month period. This data was furtherly filtered to include the adult patient >16 years and resulted in 54 patients with head injuries attending ED during this time period; then patient’s age, sex and hospital number were used to identify the discharge advice for the purpose of chart review and to assess the documentation of head injuries compliance with recommendation for NICE assessment. Data were checked between January 2022 up to May 2022 to allow more intervals for better assessment. Our finding indicates that documentation of verbal advice, 26% of patients were not recorded to have received this in January compared to only 3% in May & Written advice was not recorded in 44% of patients studied in January compared to 1% in May.

Keywords: head, injuries, advice, leaflets

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Authors: Lindsay Fink, Sarha Smith-Moyo, Leanne W. Charlesworth

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In recent years, the number of individuals experiencing homelessness has increased in the United States. This paper analyzes 2019 data from 16 different emergency shelters in Monroe County, located in Upstate New York. The data were collected through the County’s Homeless Management Information System (HMIS), and individuals were de-identified and de-duplicated for analysis. The purpose of this study is to explore the basic characteristics of the homeless population in Monroe County, and the dynamics of shelter use. The results of this study showed gender as a significant factor when analyzing the relationship between demographic variables and recorded reasons for shelter entry. Results also indicated that age and ethnicity did not significantly influence odds of re-entering a shelter, but did significantly influence reasons for shelter entry. Overall, the most common recorded cause of shelter entry in 2019 in the examined county was eviction by primary tenant. Recommendations to better address recurrent shelter entry and potential chronic homelessness include more consideration for the diversity existing within the homeless population, and the dynamics leading to shelter stays, including enhanced funding and training for shelter staff, as well as expanded access to permanent supportive housing programs.

Keywords: chronic homelessness, homeless shelter stays, permanent supportive housing, shelter population dynamics

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Authors: Belaynesh Tsegay Beyene, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are of important health and socioeconomic problem of the globe with remarkable diseases and deaths in Sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigrai. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners of Tigrai, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigrai. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliter of blood was collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA) (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20 and p < 0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1(0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18-25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell [AOR =3.95, 95% CI= (1.15, 13.6, p =0.029)] and having history of alcohol consumption [AOR =3.01, 95% CI= (1.17, 7.74, p =0.022)] were significantly associated with HBV infections. Conclusions: The seroprevalence of HBV among prisoners was nearly high or borderline (7.9%) with a very low HCV prevalence (0.3%). HBV was most prevalent among young adults, large number of prisoners per cell and those who had history of alcohol consumption. This study recommends that there should be prison-focused intervention including regular health education by emphasis on the mode of transmission and introducing HBV screening policy for prisoners especially when they enter to the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, Tigrai

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Authors: Angelis P. Barlampas

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PURPOSE: The purpose of this paper is to demonstrate the important role of taking an appropriate and detailed history, in order to reach the best possible diagnostic conclusion. MATERIAL: A patient presented to the emergency department due to the sudden onset of continuous abdominal pain, during the last hour and with the clinical symptoms of an acute abdomen. During the clinical examination, signs of peritoneal irritation and diffuse abdominal tenderness were found. The rest of the clinical and laboratory tests did not reveal anything important. From the reported medical history, nothing of note was found, except for the report of a large liver cyst, for which he was advised not to take any further action, except from regular ultrasound examination . METHOD: A computed tomography examination was performed after per os administration of gastrografin, which revealed a hyperdense ascitic effusion, similar in density to that of gastrografin within the intestinal tract. The presence of a large cyst of the left hepatic lobe was confirmed, contacting and pushing against the stomach. In the area of the contact between the liver cyst and the pylorus, there were extraluminal air bubbles and local opacity of the peritoneal fat, with a small hyperdense effusion. Result : The above, as well as the absence of a history of stomach ulcer or recent trauma, or other pathology, argue in favor of acute pyloric perforation, due to mural necrosis, in response to chronic external pressure from the pre-existing large liver cyst.

Keywords: perforation, stomach, large liver cyst, CT abdomen, acute abdominal pain, intraperitoneal leakage, constrast leakage

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Authors: Merve Ak Efe

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Youth branches in Turkey are one of the sub-fields where political ideologies are intersected with daily life practices. When the youth branches are examined within the framework of daily life practices, a social area can be defined where many types of capital turn into gains. The relationship between politics and capital is not only financial but can also be observed in the form of social, cultural, or emotional capital. This paper examines the political mobilization of young people who are members of the Youth Branch of the Justice and Development Party. The reason why JDP (Adalet ve Kalkınma Partisi) was chosen is that they have been the ruling party for twenty years, and there is a considerable number of young members within the party. Since Bayrampaşa is a district where JDP is politically active, This study is based on Bayrampaşa youth branches. The study examines how young people who are members of the party are mobilized and the everyday life practices and emotions underlying this mobilization. The data was collected through in-depth interviews with 13 young people, and the participant observation method was applied at the weekly meetings of the Justice and Development Party Bayrampaşa Youth Branch. Youth Branches represent a political space in which emotions turn into action for the young people who are involved in the party. During the field study at the micro level, it has been observed that the Bayrampaşa JDP Youth Branch hosted a transformation that incorporates political and social practices into modern tactics. One of the other results shows that being a member of youth branches causes a significant rise in social capital for young people. On the other hand, for the members with low cultural capital, there is an increase in social capital; however, an increase in cultural capital is not prominent.

Keywords: political mobilization, everyday practices, emotional capital, social capital, cultural capital

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Authors: Mars Burke, Alvin Gatto

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Rotary-wing aircraft serve as indispensable components in the advancement of aviation, valued for their ability to operate in diverse and challenging environments without the need for conventional runways. This versatility makes them ideal for applications like environmental conservation, precision agriculture, emergency medical support, and rapid-response operations in rugged terrains. However, although highly maneuverable, rotary-wing platforms generally have lower aerodynamic efficiency than fixed-wing aircraft. This study takes the view of improving aerodynamic performance by examining a 1/7th scale rotor blade model with a NACA0012 airfoil using CROTOR software. The analysis focuses on optimal spanwise locations for separating morphing and fixed blade sections at 85%, 90%, and 95% of the blade radius (r/R) with up to +20 degrees of twist incorporated to the design.. Key performance metrics assessed include lift coefficient (CL), drag coefficient (CD), lift-to-drag ratio (CL / CD), Mach number, power, thrust coefficient, and Figure of Merit (FOM). Results indicate that the 0.90 r/R position is optimal for dividing the morphing and fixed sections, achieving a significant improvement of over 7% in both lift-to-drag ratio and FOM. These findings underscoring the substantial impact on overall performance of the rotor system and rotational aerodynamics that geometric modifications through the inclusion of a morphing capability can ultimately realise.

Keywords: rotary morphing, rotational aerodynamics, rotorcraft morphing, rotor blade, twist morphing

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Authors: Sanjaya N. Munasinghe, R. Gnanasekeram, Dimuthu Tennakoon

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During the last few years there has been a dramatic increase in the number of motorcyclists in Sri Lankan roads and thus an increase of motorcycle accidents (MCAs) with a heavy death and casualty toll. Extremity injuries due to MCAs cause a heavy burden on government hospitals. However, data on MCA injuries are limited. This study tries to determine the relationship between extremity injuries with protective gears and clothing motorcycle riders were wearing at the time of the accident. Data were collected from 410 motorcycle riders and passengers involved with MCAs and admitted to orthopedic and emergency observation wards in Teaching Hospital Kurunegala with extremity injuries between 1st February 2015 and 31st July 2015 using an interviewer administered questioner. Data were analyzed using SPSS version 17.0. Distal radial fracture is the most common upper extremity injury (12%), and Tibial fracture is the most common and severe lower extremity injury (23%). Very few participants were wearing safety gloves (2%) and jackets (10%). Most of the participants were wearing slippers (66%), short sleeved upper clothing (96%) and light cloth trousers (49%). According to Chi-square test associations were found between footwear and foot injuries (p-value - 0.001, Cramer's v-value - 0.203) and safety jacket and upper extremity injuries (p-value - 0.002, Cramer's v-value - 0.177). The results indicate that using safety gear can minimize the number of injuries in MCA victims. Thus it is necessary to ensure that motorcycle riders and pillion riders use proper safety gear.

Keywords: extremity injuries, fractures, motorcycle accidents, safety gear

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Authors: Vishaal Subramanian, Annuatha Vinod Kumar, Santosh Kumar Budankayala, M. Senthil Kumar

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This paper discusses the aerodynamic and structural design, simulation and optimization of a mini-High Altitude Long Endurance (HALE) UAV. The applications of this mini HALE UAV vary from aerial topological surveys, quick first aid supply, emergency medical blood transport, search and relief activates to border patrol, surveillance and estimation of forest fire progression. Although classified as a mini UAV according to UVS International, our design is an amalgamation of the features of ‘mini’ and ‘HALE’ categories, combining the light weight of the ‘mini’ and the high altitude ceiling and endurance of the HALE. Designed with the idea of implementation in India, it is in strict compliance with the UAS rules proposed by the office of the Director General of Civil Aviation. The plane can be completely automated or have partial override control and is equipped with an Infra-Red camera and a multi coloured camera with on-board storage or live telemetry, GPS system with Geo Fencing and fail safe measures. An additional of 1.5 kg payload can be attached to three major hard points on the aircraft and can comprise of delicate equipment or releasable payloads. The paper details the design, optimization process and the simulations performed using various software such as Design Foil, XFLR5, Solidworks and Ansys.

Keywords: aircraft, endurance, HALE, high altitude, long range, UAV, unmanned aerial vehicle

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Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

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Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

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Authors: Ojin Kwon, Yong-Jin Yoon, Liu Xin, Zhang Hongbao

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Wireless Body Area Network (WBAN) is a short-range wireless communication around human body for various applications such as wearable devices, entertainment, military, and especially medical devices. WBAN attracts the attention of continuous health monitoring system including diagnostic procedure, early detection of abnormal conditions, and prevention of emergency situations. Compared to cellular network, WBAN system is more difficult to control inter- and inner-cell interference due to the limited power, limited calculation capability, mobility of patient, and non-cooperation among WBANs. In this paper, we compare the performance of resource allocation scheme based on several Pseudo Orthogonal Codewords (POCs) to mitigate inter-WBAN interference. Previously, the POCs are widely exploited for a protocol sequence and optical orthogonal code. Each POCs have different properties of auto- and cross-correlation and spectral efficiency according to its construction of POCs. To identify different WBANs, several different pseudo orthogonal patterns based on POCs exploits for resource allocation of WBANs. By simulating these pseudo orthogonal resource allocations of WBANs on MATLAB, we obtain the performance of WBANs according to different POCs and can analyze and evaluate the suitability of POCs for the resource allocation in the WBANs system.

Keywords: wireless body area network, body sensor network, resource allocation without feedback, interference mitigation, pseudo orthogonal pattern

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Authors: Emine Yılmaz, Serap Fındık

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Baker’s yeast industry uses molasses as a raw material. Molasses is end product of sugar industry. Wastewater from molasses processing presents large amount of coloured substances that give dark brown color and high organic load to the effluents. The main coloured compounds are known as melanoidins. Melanoidins are product of Maillard reaction between amino acid and carbonyl groups in molasses. Dark colour prevents sunlight penetration and reduces photosynthetic activity and dissolved oxygen level of surface waters. Various methods like biological processes (aerobic and anaerobic), ozonation, wet air oxidation, coagulation/flocculation are used to treatment of baker’s yeast effluent. Before effluent is discharged adequate treatment is imperative. In addition to this, increasingly stringent environmental regulations are forcing distilleries to improve existing treatment and also to find alternative methods of effluent management or combination of treatment methods. Sonochemical oxidation is one of the alternative methods. Sonochemical oxidation employs ultrasound resulting in cavitation phenomena. In this study, decolorization of baker’s yeast effluent was investigated by using ultrasound. Baker’s yeast effluent was supplied from a factory which is located in the north of Turkey. An ultrasonic homogenizator used for this study. Its operating frequency is 20 kHz. TiO2-ZnO catalyst has been used as sonocatalyst. The effects of molar proportion of TiO2-ZnO, calcination temperature and time, catalyst amount were investigated on the decolorization of baker’s yeast effluent. The results showed that prepared composite TiO2-ZnO with 4:1 molar proportion treated at 700°C for 90 min provides better result. Initial decolorization rate at 15 min is 3% without catalyst, 14,5% with catalyst treated at 700°C for 90 min respectively.

Keywords: baker’s yeast effluent, decolorization, sonocatalyst, ultrasound

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Authors: Pinar Sali, Esim Gursoy, Ebru Atak Damar

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Teachers’ awareness of and involvement in educational research (ER) is regarded as an indispensable aspect of professional growth and development. It is also believed to be a catalyst for effective teaching and learning. This strong emphasis on the significance of teacher research engagement has sparked inquiry into how teachers construe ER and whether or not they practice it. However, there seems to exist a few researches on teachers’ perceptions of and experience with ER in the field of English Language Teaching (ELT). The present study thus attempts to fill this gap in the ELT literature and aims to unearth English language teachers’ perceptions of ER. Understanding these perceptions would undoubtedly aid in the development of strategies to promote teacher interest and involvement in research. The participants of the present study are 70 English language teachers in public and private schools in Turkey. A mixed-method approach has been used in the study. Both qualitative and quantitative data have been gathered by means of a questionnaire consisting of two parts. The first part of the questionnaire consists of 20 close-ended items of Teachers’ Attitude Scale Towards Educational Research (TASTER). The second part of the questionnaire has been developed by the researchers via an extensive literature review and consists of a mixture of close- and open-ended questions. In addition, 15 language teachers have been interviewed for an in-depth understanding of the results. Descriptive statistics and dual comparisons have been employed for the quantitative data, and the qualitative data have been analyzed by means of content analysis. The present study provides intriguing information as to the English language teachers’ perceptions of the usefulness and practicality of ER as well as the value they attain to it. The findings are discussed in relation to language teacher education. The research has implications for the teacher education process, teacher trainers and policy makers.

Keywords: attitudes toward educational research, educational research, language teachers, teacher research

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Authors: Anshul, Rajni Kalia, Sachin Kumar

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Introduction: The costoclavicular approach, a modification to the infraclavicular approach, has been described for anesthesia for upper limb surgeries. Material And Methods: In this randomized and single-blind study, fourty patients undergoing emergency/elective upper limb surgery were allocated to two groups. Group C and S received ultrasound-guided Costoclavicular block and Supraclavicular block, respectively, with 20 ml 0.5 % ropivacaine with 8 mg dexamethasone under strict asepsis. The primary outcome assessed was the total duration of sensory and motor block in the postoperative period. Secondary outcomes were to compare the time taken to perform the procedure, block characteristics in terms of onset of motor and sensory blockade, the efficacy of analgesia with respect to the time of administration of the first rescue analgesic dose with both the blocks and note the side effects pertaining to either of the blocks. Results: The mean total duration of sensory and motor blockade was longer in group C vs. group S (p=0.002 and 0.024, respectively). The mean duration to perform a block in group S was more than in group C (p=0.012). The mean onset of sensory and motor Blockade Time in group S was more than in group C (p<0.001 and <0.001, respectively). The mean duration to perform a block in group S was more than in group C (p=0.012). Conclusion: The costoclavicular approach is better than supraclavicular in terms of rapid execution, faster onset of sensory-motor blockade, prolonged postoperative analgesia and similar PONV and safety profile.

Keywords: costoclavicular, supraclavicular, ropivacaine, dexamethasone

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Authors: Juliana Amaka Ugwu

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Trapping efficiency of methyl eugenol and three locally made food-based lures were evaluated in three locations for trapping of B. dorsalis on mango homestead trees in Ibadan South west Nigeria. The treatments were methyl eugenol, brewery waste, pineapple juice, orange juice, and control (water). The experiment was laid in a Complete Randomized Block Design (CRBD) and replicated three times in each location. Data collected were subjected to analysis of variance and significant means were separated by Turkey’s test. The results showed that B. dorsalis was recorded in all locations of study. Methyl eugenol significantly (P < 0.05) trapped higher population of B. dorsalis in all the study area. The population density of B. dorsalis was highest during the ripening period of mango in all locations. The percentage trapped flies after 7 weeks were 77.85%-82.38% (methyl eugenol), 7.29%-8.64% (pineapple juice), 5.62-7.62% (brewery waste), 4.41%-5.95% (orange juice), and 0.24-0.47% (control). There were no significance differences (p > 0.05) on the population of B. dorsalis trapped in all locations. Similarly, there were no significant differences (p > 0.05) on the population of flies trapped among the food attractants. However, the three food attractants significantly (p < 0.05) trapped higher flies than control. Methyl eugenol trapped only male flies while brewery waste and other food based attractants trapped both male and female flies. The food baits tested were promising attractants for trapping B. dorsalis on mango homestead tress, hence increased dosage could be considered for monitoring and mass trapping as management strategies against fruit fly infestation.

Keywords: attractants, trapping, mango, Bactrocera dorsalis

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Authors: J. Gonzalez, P. Jimenez, C. Isaza

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Palms have different characteristics that make them vulnerable; that is the case of the Chamaedorea linearis, with the presence of solitary stems of small diameter and medium leaves, culturally harvested, and in religious festivities used. Additionally, they present a weak apical meristem as the only emergency point, slow development and growth, and an affectation due to the high rate of deforestation in Colombia. Propagation of this species can improve the pressure on wild populations and help their survival in the environment. In this study was used in 177 plants biosolids humus from the Wastewater Treatment Plant (WWTP), located at the UMNG Campus Cajica (Cundinamarca, Colombia). The experiment used a control and two treatments with 10% and 20% of humus. During the process, the variables evaluated were number of leaves, percentage of chlorophyll, stem length, and estimated leaf area. The data set were taking during 14 weeks before the reproductive maturity, evidencing that the most representative development of the palms was in the treatment of 20%, plants in this treatment presented major number of leaves, larger stems, a high quantity of chlorophyll, and was a first treatment that present pinnate leaves them represent an important point in maturity process. The research gives an opportunity to improve times of growth in another species of palms and plants (Product result from INV ING 2986 UMNG).

Keywords: biosolids, humus, growth, palms, wastewater treatment plant, WWTP

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Authors: M. Elder, L. Beech, A. Mackie

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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.

Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy

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Authors: Recep Kesli, Merih Simsek, Cengiz Demir, Onur Turkyilmaz

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Objective: Goal of this study was to determine the antibiotic resistance of Staphylococcus aureus (S. aureus) and Methicillin resistant staphylococcus aureus (MRSA) strains isolated at Medical Microbiology Laboratory of ANS Application and Research Hospital, Afyon Kocatepe University, Turkey. Methods: S. aureus strains isolated between October 2012 and September 2016, from various clinical specimens were evaluated retrospectively. S. aureus strains were identified by both the conventional methods and automated identification system -VITEK 2 (bio-Mérieux, Marcy l’etoile, France), and Meticillin resistance was verified using oxacillin disk with disk-diffusion method. Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria, and intermediate susceptible strains were considered as resistant. Results: Seven hundred S.aureus strains which were isolated from various clinical specimens were included in this study. These strains were mostly isolated from blood culture, tissue, wounds and bronchial aspiration. All of 306 (43,7%) were oxacillin resistant. While all the S.aureus strains were found to be susceptible to vancomycin, teicoplanin, daptomycin and linezolid, 38 (9.6 %), 77 (19.5 %), 116 (29.4 %), 152 (38.6 %) and 28 (7.1 %) were found to be resistant aganist to clindamycin, erythromycin, gentamicin, tetracycline and sulfamethoxazole/trimethoprim, retrospectively. Conclusions: Comparing to the Methicillin sensitive staphylococcus aureus (MSSA) strains, increased resistance rates of, trimethoprim-sulfamethoxazole, clindamycin, erythromycin, gentamicin, and tetracycline were observed among the MRSA strains. In this study, the most effective antibiotic on the total of strains was found to be trimethoprim-sulfamethoxazole, the least effective antibiotic on the total of strains was found to be tetracycline.

Keywords: antibiotic resistance, MRSA, Staphylococcus aureus, VITEK 2

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Authors: Erol Kam, Z. U. Yümün

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Natural and artificial radionuclides cause radioactive contamination in environments, just as the other non-biodegradable pollutants (heavy metals, etc.) sink to the sea floor and accumulate in sediments. Especially the habitat of benthic foraminifera living on the surface of sediments or in sediments at the seafloor are affected by radioactive pollution in the marine environment. Thus, it is important for pollution analysis to determine the radionuclides. Radioactive pollution accumulates in the lowest level of the food chain and reaches humans at the highest level. The more the accumulation, the more the environment is endangered. This study used gamma spectrometry to investigate the natural and artificial radionuclide distribution of sediment samples taken from living benthic foraminifera habitats in the Western Marmara Sea. The radionuclides, K-40, Cs-137, Ra-226, Mn 54, Zr-95+ and Th-232, were identified in the sediment samples. For this purpose, 18 core samples were taken from depths of about 25-30 meters in the Marmara Sea in 2016. The locations of the core samples were specifically selected exclusively from discharge points for domestic and industrial areas, port locations, and so forth to represent pollution in the study area. Gamma spectrometric analysis was used to determine the radioactive properties of sediments. The radionuclide concentration activity values in the sediment samples obtained were Cs-137=0.9-9.4 Bq/kg, Th-232=18.9-86 Bq/kg, Ra-226=10-50 Bq/kg, K-40=24.4–670 Bq/kg, Mn 54=0.71–0.9 Bq/kg and Zr-95+=0.18–0.19 Bq/kg. These values were compared with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) data, and an environmental analysis was carried out. The Ra-226 series, the Th-232 series, and the K-40 radionuclides accumulate naturally and are increasing every day due to anthropogenic pollution. Although the Ra-226 values obtained in the study areas remained within normal limits according to the UNSCEAR values, the K-40, and Th-232 series values were found to be high in almost all the locations.

Keywords: Ra-226, Th-232, K-40, Cs-137, Mn 54, Zr-95+, radionuclides, Western Marmara Sea

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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Authors: Matthias Haerri, Tobias Huettche, Clemens Kustner

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This article discusses the impact of digitization on business valuation. In order to become and remain ‘digital’, investments are necessary whose return on investment (ROI) often remains vague. This uncertainty is contradictory for a valuation, that rely on predictable cash flows, fixed capital structures and the steady state. However digitisation does not make a company valuation impossible, but traditional approaches must be reconsidered. The authors identify four areas that are to be changing: (1) Tools instead of intuition - In the future, company valuation will neither be art nor science, but craft. This does not require intuition, but experience and good tools. Digital evaluation tools beyond Excel will therefore gain in importance. (2) Real-time instead of deadline - At present, company valuations are always carried out on a case-by-case basis and on a specific key date. This will change with the digitalization and the introduction of web-based valuation tools. Company valuations can thus not only be carried out faster and more efficiently, but can also be offered more frequently. Instead of calculating the value for a previous key date, current and real-time valuations can be carried out. (3) Predictive planning instead of analysis of the past - Past data will also be needed in the future, but its use will not be limited to monovalent time series or key figure analyses. With pictures of ‘black swans’ and the ‘turkey illusion’ it was made clear to us that we build forecasts on too few data points of the past and underestimate the power of chance. Predictive planning can help here. (4) Convergence instead of residual value - Digital transformation shortens the lifespan of viable business models. If companies want to live forever, they have to change forever. For the company valuation, this means that the business model valid on the valuation date only has a limited service life.

Keywords: business valuation, corporate finance, digitisation, disruption

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Authors: Gülçin Akbas Uslu

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Honor cultures put importance on the sexual purity of women. Women are expected to avoid acts that may spoil their honor. The emphasis on honor leads to the subordination of women and the dominance of men. In order to protect and clean honor, women are exposed to physical and psychological violence. Therefore, understanding the motivations driving people to endorse honor bears importance. For this purpose, this study aims to explore honor endorsement from the joint perspective of System Justification Theory (SJT) and Regulatory Focus Theory (RFT). SJT asserts that people have a tendency to support and rationalize the system. The motivation to maintain the system may be a factor in the endorsement of honor. RFT proposes two distinct regulatory processes, namely promotion and prevention focus. Having a dominant prevention focus, such as a deep concern for responsibilities, risk avoidance, and minimizing negative outcomes, may have a role in honor. Data were collected conveniently from 366 participants (216 women; 150 men). Participants filled out Honor Endorsement Index, Honor Based System Justification Scale and Regulatory Focus Orientation Scale Results revealed that both regulatory focus and system justification play a role in understanding honor. One-way ANOVA findings showed that individuals with a dominant prevention focus endorse honor beliefs more than individuals with a dominant promotion focus. Besides, regression analysis revealed that prevention focus and system justification significantly and positively predict honor. Results provide clarifications for why honor has an important meaning in individuals’ life and why honor-based violence is approved. These findings bear great importance in Turkey, where emphasis on honor is high and can be used in reducing people’s adherence to honor, which is based on women’s sexuality and men’s power over women.

Keywords: honor, system justification theory, regulatory focus theory, prevention focus

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Authors: S. Shakibaei, P. Alpkokin

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The railway network is one of the major components of a transportation system in a country which may be an indicator of the country’s level of economic improvement. Since 2000s on, revival of national railways and development of High Speed Rail (HSR) lines are one of the most remarkable policies of Turkish government in railway sector. Within this trend, the railway age is to be revived and coming decades will be a golden opportunity. Indubitably, major infrastructures such as road and railway networks require sizeable investment capital, precise maintenance and reparation. Traditionally, governments are held responsible for funding, operating and maintaining these infrastructures. However, lack or shortage of financial resources, risk responsibilities (particularly cost and time overrun), and in some cases inefficacy in constructional, operational and management phases persuade governments to find alternative options. Financial power, efficient experiences and background of private sector are the factors convincing the governments to make a collaboration with private parties to develop infrastructures. Public-Private Partnerships (PPP or 3P or P3) and related regulatory issues are born considering these collaborations. In Turkey, PPP approaches have attracted attention particularly during last decade and these types of investments have been accelerated by government to overcome budget limitations and cope with inefficacy of public sector in improving transportation network and its operation. This study mainly tends to present a comprehensive overview of PPP concept, evaluate the regulatory procedure in Europe and propose a general framework for Turkish State Railways (TCDD) as an outlook on privatization, liberalization and deregulation of railway network.

Keywords: deregulation, high-speed railway, liberalization, privatization, public-private partnership

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Authors: Isil Coklar-Okutkan, Miray Akyunus

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Victim sensitivity is a form of justice sensitivity that reflects the tendency to perceive injustice to one’s disadvantage. Victim sensitivity is considered as a dysfunctional trait that predicts anger, aggression, uncooperative behavior, depression and anxiety. Indeed, exploring the mechanism of association between victim sensitivity and anger is clinically important since it can lead to externalizing and internalizing problems. This study aims to investigate the moderating role of pathological narcissism in the relationship between victim sensitivity and anger rumination. Through testing different models where subtypes of narcissism and anger rumination components are included independently, the specific mechanism of different ruminative processes in anger is investigated. The sample consisted of 311 undergraduate students from Turkey, 107 of whom were males, and 204 were females. Participants completed Justice Sensitivity Inventory-Victim Subscale, Pathological Narcissism Inventory and Anger Rumination Scale. In the proposed double moderation model, vulnerable and grandiose narcissism was the moderators in the relationship between victim justice sensitivity and anger rumination. Four separate models were tested where one of the four components of anger rumination (angry afterthoughts, thoughts of revenge, angry memories, understanding of causes) were the dependent variable in each model. Results revealed that two of the moderation models are significant. Firstly, grandiose narcissism is the only moderator in the relationship between victim sensitivity and thoughts of revenge. Secondly, vulnerable narcissism is the only moderator in the relationship between victim sensitivity and understanding causes. Accordingly, grandiose narcissism is positively associated with the thoughts of revenge, and vulnerable narcissism is positively associated with understanding causes, only when the level of victim sensitivity is high. To summarize, increased victim sensitivity leads to ruminative thoughts of revenge in individuals with grandiose narcissism, whereas it leads to rumination on causes of the incident in individuals with vulnerable narcissism. The clinical implications of the findings are discussed.

Keywords: anger rumination, victim sensitivity, grandiose narcissism, vulnerable narcissism

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Authors: S. M. Amin Hosseini, Oriol Pons, Albert de la Fuente

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After natural disasters, displaced people (DP) require important numbers of housing units, which have to be erected quickly due to emergency pressures. These tight timeframes can cause the multiplication of the environmental construction impacts. These negative impacts worsen the already high energy consumption and pollution caused by the building sector. Indeed, post-disaster housing, which is often carried out without pre-planning, usually causes high negative environmental impacts, besides other economic and social impacts. Therefore, it is necessary to establish a suitable strategy to deal with this problem which also takes into account the instability of its causes, like changing ratio between rural and urban population. To this end, this study aims to present a model that assists decision-makers to choose the most suitable building technology for post-disaster housing units. This model focuses on the alternatives sustainability and fulfillment of the stakeholders’ satisfactions. Four building technologies have been analyzed to determine the most sustainability technology and to validate the presented model. In 2003, Bam earthquake DP had their temporary housing units (THUs) built using these four technologies: autoclaved aerated concrete blocks (AAC), concrete masonry unit (CMU), pressed reeds panel (PR), and 3D sandwich panel (3D). The results of this analysis confirm that PR and CMU obtain the highest sustainability indexes. However, the second life scenario of THUs could have considerable impacts on the results.

Keywords: sustainability, post-disaster temporary housing, integrated value model for sustainability assessment, life cycle assessment

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Authors: Hang Ju, Changmin Zhu

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The development level of the BeiDou Navigation Satellite System (BDS) can strongly reflect national defense strength as an important spatial information infrastructure. BDS can be not only used for military purposes, such as intelligence gathering, nuclear explosion monitoring, emergency communications, but also for location services, transportation, mapping, precision agriculture. In order to ensure the national defense security and the wide application of BDS in civil and military areas, BDS must be autonomous and controllable. As a complex system of knowledge-intensive, knowledge transformation runs through the whole process of research and development, production, operation, and maintenance of BDS. Based on the perspective of knowledge transformation, this paper expounds on the meaning of socialization, externalization, combination, and internalization of knowledge transformation, and the coupling relationship of autonomy and control on the basis of analyzing the status quo and problems of the autonomy and control of BDS. The autonomous and controllable framework of BDS based on knowledge transformation is constructed from six dimensions of management capability, R&D capability, technical capability, manufacturing capability, service support capability, and application capability. It can provide support for the smooth implementation of information security policy, provide a reference for the autonomy and control of the upstream and downstream industrial chains in Beidou, and provide a reference for the autonomous and controllable research of aerospace components, military measurement test equipment, and other related industries.

Keywords: knowledge transformation, BeiDou Navigation Satellite System, autonomy and control, framework

Procedia PDF Downloads 184