Search results for: emergency department admission
1261 Performance Evaluation and Planning for Road Safety Measures Using Data Envelopment Analysis and Fuzzy Decision Making
Authors: Hamid Reza Behnood, Esmaeel Ayati, Tom Brijs, Mohammadali Pirayesh Neghab
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Investment projects in road safety planning can benefit from an effectiveness evaluation regarding their expected safety outcomes. The objective of this study is to develop a decision support system (DSS) to support policymakers in taking the right choice in road safety planning based on the efficiency of previously implemented safety measures in a set of regions in Iran. The measures considered for each region in the study include performance indicators about (1) police operations, (2) treated black spots, (3) freeway and highway facility supplies, (4) speed control cameras, (5) emergency medical services, and (6) road lighting projects. To this end, inefficiency measure is calculated, defined by the proportion of fatality rates in relation to the combined measure of road safety performance indicators (i.e., road safety measures) which should be minimized. The relative inefficiency for each region is modeled by the Data Envelopment Analysis (DEA) technique. In a next step, a fuzzy decision-making system is constructed to convert the information obtained from the DEA analysis into a rule-based system that can be used by policy makers to evaluate the expected outcomes of certain alternative investment strategies in road safety.Keywords: performance indicators, road safety, decision support system, data envelopment analysis, fuzzy reasoning
Procedia PDF Downloads 3371260 Securitization of Illegal Fishing Cases in Natuna Waters by Indonesian Government: Study Case of Chinese Vessels Shootouts 2016
Authors: Ray Maximillian, Idil Syawfi
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Indonesia’s Exclusive Economic Zone and the infamous China’s nine-dash line are intersected in Natuna waters. Even though from Indonesia perspective, that line does not possess any legal basis, China treat that line as their national boundaries, therefore allowing Chinese fishermen to fish in the area. Under President Joko Widodo leadership, Indonesia which now focusing to suppress illegal fishing cases while emphasizing their maritime sovereignty is facing an imminent threat from China’s presence in Natuna. Tension between these countries spiked after three incident happened on 2016, especially after Indonesian navy shot Chinese fishermen vessel that suspected doing illegal fishing activity. This action seen as an attempt to secure Indonesia’s law enforcement in their waters after several months before such attempt was intervened by Chinese coast guard. Indonesia tries to securitize this issue to justify the shooting they done to Chinese vessels. In the process of securitization, it is imperative to identify the existential threat that leads to implementation of emergency measures which responded by units in the cases. Chinese coast guard presence in Natuna perceived as an existential threat to Indonesia, therefore, responded by shooting to Chinese vessels on the next encounter. This action then responded by Chinese government who said that there is overlapping claim between them and Indonesia in Natuna.Keywords: China, illegal fishing, Indonesia, natuna, securitization
Procedia PDF Downloads 2071259 The Lean Manufacturing Practices in an Automotive Company Using Value Stream Mapping Technique
Authors: Seher Arslankaya, Merve Si̇mge Usuk
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Lean manufacturing, which is based on the Toyota Production System, has focused on increasing the performance in various fields by eliminating the waste. By waste elimination, the lead time is reduced significantly and lean manufacturing provides companies with an important privilege under today's competitive conditions. The initial point of lean thinking is the value. This notion create of a specific product with specific properties for which the customer is ready to pay and which satisfies his needs within a specific time frame and at a specific price. Considering this, the final customer determines the value but the manufacturer creates this value of the product. The value stream is the whole set of activities required for each product. These activities may or may not be essential for the value. Through value stream mapping, all employees can see the sources of waste and develop future cases to eliminate it. This study focused on manufacturing to eliminate the waste which created a cost but did not create any value. The study was carried out at the Department of Assembly/Logistics at Toyota Motor Manufacturing Turkey from the automotive industry with a high product mix and variable demands. As a result of the value stream analysis, improvements are planned for the future cases. The process was improved by applying these suggestions.Keywords: lead time, lean manufacturing, performance improvement, value stream papping
Procedia PDF Downloads 3031258 Yield Enhancement and Reduced Nutrient Removal by Weeds in Winter Irrigated Cotton Using Potassium Salt Based Glyphosate
Authors: N. Viji, K. Siddeswaran
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Field experiment was conducted at Eastern Block farm, Department of Farm Management, Tamil Nadu Agricultural University, Coimbatore during winter season of 2011-2012 to evaluate potassium salt based glyphosate (Roundup Crop Shield 460 SL) with and without intercultural operations on seed cotton yield and weed nutrient removal in irrigated cotton. The experiment was laid out in Randomized Block Design with treatments replicated thrice. The treatments consisted of POE glyphosate (Roundup Crop Shield 460 SL) at 1350 (T1), 1800 (T2), 2250 (T3) g a.e. ha-1, 1800 g a.e. ha-1 + IC (T4), PE pendimethalin at 750 g a.i. ha-1 + IC (T5), HW at 35 and 70 DAS + IC (T6), HWW at 35 and 70 DAS + IC (T7), PWW at 35 and 70 DAS + IC (T8), HW at 25 and 45 DAS (T9) and Unweeded control (T10). Among the weed management methods, decreased nutrient removal by weeds were observed with POE glyphosate at 1800 g a.e. ha-1 + IC which was comparable with PE pendimethalin at 750 g a.i. ha-1 + IC. Higher seed cotton yield was obtained with POE glyphosate at 1800 g a.e. ha-1 at 35 and 70 DAS with + IC at 45 and 55 DAS which was comparable with PE pendimethalin at 750 g a.i. ha-1 + IC at 45 and 55 DAS. Comparing treatments without intercultural operation, intercultural operation carried out treatments performed better and recorded more seed cotton yield.Keywords: cotton, weed, glyphosate, nutrient
Procedia PDF Downloads 6271257 Effects of LED Lighting on Visual Comfort with Respect to the Reading Task
Authors: Ayşe Nihan Avcı, İpek Memikoğlu
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Lighting systems in interior architecture need to be designed according to the function of the space, the type of task within the space, user comfort and needs. Desired and comfortable lighting levels increase task efficiency. When natural lighting is inadequate in a space, artificial lighting is additionally used to support the level of light. With the technological developments, the characteristics of light are being researched comprehensively and several business segments have focused on its qualitative and quantitative characteristics. These studies have increased awareness and usage of artificial lighting systems and researchers have investigated the effects of lighting on physical and psychological aspects of human in various ways. The aim of this study is to research the effects of illuminance levels of LED lighting on user visual comfort. Eighty participants from the Department of Interior Architecture of Çankaya University participated in three lighting scenarios consisting of 200 lux, 500 lux and 800 lux that are created with LED lighting. Each lighting scenario is evaluated according to six visual comfort criteria in which a reading task is performed. The results of the study indicated that LED lighting with three different illuminance levels affect visual comfort in different ways. The results are limited to the participants and questions that are attended and used in this study.Keywords: illuminance levels, LED lighting, reading task, visual comfort criteria
Procedia PDF Downloads 2481256 Crash Statistics Comparison for Riyadh, Eastern Province, and Qaseem for 2016 and 2017
Authors: Hassan M. Al-Ahmadi
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The fatality index (deaths/100 K population) due to road traffic accidents in the Kingdom of Saudi Arabia (KSA) is over 25, according to the World Health Organization Statistics (WHO) statistics, which is much higher than in the neighboring Arab regions. The KSA has implemented measures to mitigate traffic accidents by enforcing road safety regulations. As a result, there has been a slight decline in the frequency of road traffic accidents within the Kingdom. This study was based on the variations in the accidents for three provinces of KSA, i.e., Riyadh, Eastern Province (EP), & Qaseem, for 2016 and 2017 using ANOVA method. Data appropriateness for the ANOVA method was confirmed by the normality and the randomness of residuals. Additionally, the half-normal plot was used to identify the significant terms for the ANOVA analysis. The analysis revealed that the accidents in the EP were significantly higher than in the other two provinces during the analysis period. The monthly variation showed a spike in the accidents from month 7th to 9th month in the EP region and a slight drop in the accidents in the Qaseem and the Riyadh region during the same period, which was attributed to the increased leisure travels from the other regions to the EP. Furthermore, most of the accidents were found to occur in the age group of 18+ and 30+, and also the major reduction of accidents in 2017 as compared to 2016 was found to have occurred in the same group. These findings can be beneficial for developing strategies to further reduce the number of accidents.Keywords: fatality index, emergency, road traffic accident, safety, leisure travels
Procedia PDF Downloads 221255 Early Intervention and Teletherapy during the COVID-19 Pandemic
Authors: Stephen Hernandez, Nikita Sharma
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The Coronavirus disease (COVID-19) emerged as a worldwide pandemic at the beginning of 2020. The pandemic and its impact reached the shores of the United States by the second week of March. Once infections started to grow in numbers, early intervention programs, including those providing home-based services, recognized that to reduce the spread of the virus, many traditional in-person therapeutic interventions were going to be impossible due to social distancing and self-quarantine requirements. Initially, infants, toddlers, and their families were left without any services from their educators and therapists, but within a few weeks of the public health emergency, various states, including New York, approved the use of teletherapy/virtual visits for early intervention service provision. This paper will detail the results of a survey from over 400 E.I. service providers about their experiences utilizing teletherapy to deliver services to children in early intervention programs. The survey questions focused on how did COVID-19 stay-at-home orders impact E.I. services for young children with special needs? Sub-questions included topics such as availability of the parents, the amount of time that babies remained engaged, as well as the perceived success of teletherapy as a viable option to provide service by both parent and professional. The results of this study found that therapists found teletherapy to be a viable manner of providing services and could be very effective on a case by case basis.Keywords: early intervention, teletheraphy, telehealth, COVID-19
Procedia PDF Downloads 1261254 Assessing the Quality of Clinical Photographs Taken for Orthodontic Patients at Queen’s Hospital, Romford
Authors: Maya Agarwala
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Objectives: Audit the quality of clinical photographs taken for Orthodontic patients at Queen’s hospital, Romford. Design and setting: All Orthodontic photographs are taken in the Medical Photography Department at Queen’s Hospital. Retrospective audit with data collected between January - March 2023. Gold standard: Institute of Medical Illustrators (IMI) standard 12 photographs: 6 extraoral and 6 intraoral. 100% of patients to have the standard 12 photographs meeting a satisfactory diagnostic quality. Materials and methods: 30 patients randomly selected. All photographs analysed against the IMI gold standard. Results: A total of 360 photographs were analysed. 100% of the photographs had the 12 photographic views. Of which, 93.1% met the gold standard. Of the extraoral photos: 99.4% met the gold standard, 0.6% had incorrect head positioning. Of the intraoral photographs: 87.2% met the gold standard. The most common intraoral errors were: the presence of saliva pooling (7.2%), insufficient soft tissue retraction (3.3%), incomplete occlusal surface visibility (2.2%) and mirror fogging (1.1%). Conclusion: The gold standard was not met, however the overall standard of Orthodontic photographs is high. Further training of the Medical Photography team is needed to improve the quality of photographs. Following the training, the audit will be repeated. High-quality clinical photographs are an important part of clinical record keeping.Keywords: orthodontics, paediatric, photography, audit
Procedia PDF Downloads 781253 Feminine Gender Identity in Nigerian Music Education: Trends, Challenges and Prospects
Authors: Julius Oluwayomi Oluwadamilare, Michael Olutayo Olatunji
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In the African traditional societies, women have always played the role of a teacher, albeit informally. This is evident in the upbringing of their babies. As mothers, they also serve as the first teachers to teach their wards lessons through day-to-day activities. Furthermore, women always play the role of a musician during naming ceremonies, in the singing of lullabies, during initiation rites of adolescent boys and girls into adulthood, and in preparing their children especially daughters (and sons) for marriage. They also perform this role during religious and cultural activities, chieftaincy title/coronation ceremonies, singing of dirges during funeral ceremonies, and so forth. This traditional role of the African/Nigerian women puts them at a vantage point to contribute maximally to the teaching and learning of music at every level of education. The need for more women in the field of music education in Nigeria cannot be overemphasized. Today, gender equality is a major discourse in most countries of the world, Nigeria inclusive. Statistical data in the field of education and music education reveal the high ratio of male teachers/lecturers over their female counterparts in Nigerian tertiary institutions. The percentage is put at 80% Male and a distant 20% Female! This paper, therefore, examines feminine gender in Nigerian music education by tracing the involvement of women in musical practice from the pre-colonial to the post-colonial periods. The study employed both primary and secondary sources of data collection. The primary source included interviews conducted with 19 music lecturers from 8 purposively selected tertiary institutions from 4 geo-political zones of Nigeria. In addition, observation method was employed in the selected institutions. The results show, inter alia, that though there is a remarkable improvement in the rate of admission of female students into the music programme of Nigerian tertiary institutions, there is still an imbalance in the job placement in these institutions especially in the Colleges of Education which is the main focus of this research. Religious and socio-cultural factors are highly traceable to this development. This paper recommends the need for more female music teachers to be employed in the Nigerian tertiary institutions in line with the provisions stated in the Millennium Development Goals (MDGs) of the Federal Republic of Nigeria.Keywords: gender, education, music, women
Procedia PDF Downloads 1931252 Application to Monitor the Citizens for Corona and Get Medical Aids or Assistance from Hospitals
Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge
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It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.Keywords: blockchain, deep learning, NLP, monitoring system
Procedia PDF Downloads 1281251 Improving Students’ Participation in Group Tasks: Case Study of Adama Science and Technology University
Authors: Fiseha M. Guangul, Annissa Muhammed, Aja O. Chikere
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Group task is one method to create the conducive environment for the active teaching-learning process. Performing group task with active involvement of students will benefit the students in many ways. However, in most cases all students do not participate actively in the group task, and hence the intended benefits are not acquired. This paper presents the improvements of students’ participation in the group task and learning from the group task by introducing different techniques to enhance students’ participation. For the purpose of this research Carpentry and Joinery II (WT-392) course from Wood Technology Department at Adama Science and Technology University was selected, and five groups were formed. Ten group tasks were prepared and the first five group tasks were distributed to the five groups in the first day without introducing the techniques that are used to enhance participation of students in the group task. On another day, the other five group tasks were distributed to the same groups and various techniques were introduced to enhance students’ participation in the group task. The improvements of students’ learning from the group task after the implementation of the techniques. After implementing the techniques the evaluation showed that significant improvements were obtained in the students’ participation and learning from the group task.Keywords: group task, students participation, active learning, the evaluation method
Procedia PDF Downloads 2091250 Anxiety and Depression in Chronic Headache Patients: Major Concern for Community Mental Health
Authors: Neeti Sharma, Harshika Pareek, Prerna Puri, Manika Mohan
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The present study is aimed at studying the significant relationship between anxiety and depression in chronic headache patients. Chronic Headache patients coming to the Neurology Unit-1 Outpatient Department of the Sawai Mansingh Hospital (SMS) Jaipur, Rajasthan, were included in this study. The sample consisted of 100 patients (N=100). Initially patients were examined by a physician and then they were assessed for Anxiety and Depression using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale for Depression. The relevant information was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and also indicate an association between headache and psychological disorders. Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and the association of co-morbid psychiatric illness with headache intractability. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. Also, various psychotherapies should be applied to the headache patients so as to treat them, at the onset level of anxiety and depression, with the help of medication.Keywords: anxiety, chronic headaches, depression, HAM-A, HAM
Procedia PDF Downloads 4601249 Investigation of Public Perception of Air Pollution and Life Quality in Tehran
Authors: Roghayeh Karami, Ahmad Gharaei
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Backgrounds and objectives: This study was undertaken at four different sites (north polluted, south polluted, south healthy and north healthy) in Tehran, in order to examine whether there was a relationship between publicly available air quality data and the public’s perception of air quality and to suggest some guidelines for reducing air pollution. Materials and Methods: A total of 200 people were accidentally filled out the research questionnaires at mentioned sites and air quality data were obtained simultaneously from the Air Quality Control Department. Data was analyzed in Excel and SPSS software. Results: Clean air and secure job were of great importance to people comparing to other pleasant aspect of life. Also air pollution and fear of dangerous diseases were the most important of people concerns. The Indies bored /news paper services on air quality were little used by the public as a means of obtaining information on air pollution. Using public transportation and avoid unessential journeys are the most important ways for reducing air pollution. Conclusion: The results reveal that the public’s perception of air quality is not a reliable indicator of the actual levels of air pollution. Current earths to down actions are not effective and enough in reducing air pollution, therefore it seems participatory management and public participation is suitable guideline.Keywords: air pollution, quality of life, opinion poll, public participation
Procedia PDF Downloads 4801248 Attributable Mortality of Nosocomial Infection: A Nested Case Control Study in Tunisia
Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said
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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.Keywords: intensive care unit, mortality, nosocomial infection, risk factors
Procedia PDF Downloads 3991247 A Study on the Annual Doses Received by the Workers of Some Medical Practices
Authors: Eltayeb Hamad Elneel Yousif
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This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.Keywords: radiation medicine, non-destructive testing, TLD, public hospital
Procedia PDF Downloads 3651246 Design and Analysis of Electric Power Production Unit for Low Enthalpy Geothermal Reservoir Applications
Authors: Ildar Akhmadullin, Mayank Tyagi
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The subject of this paper is the design analysis of a single well power production unit from low enthalpy geothermal resources. A complexity of the project is defined by a low temperature heat source that usually makes such projects economically disadvantageous using the conventional binary power plant approach. A proposed new compact design is numerically analyzed. This paper describes a thermodynamic analysis, a working fluid choice, downhole heat exchanger (DHE) and turbine calculation results. The unit is able to produce 321 kW of electric power from a low enthalpy underground heat source utilizing n-Pentane as a working fluid. A geo-pressured reservoir located in Vermilion Parish, Louisiana, USA is selected as a prototype for the field application. With a brine temperature of 126℃, the optimal length of DHE is determined as 304.8 m (1000ft). All units (pipes, turbine, and pumps) are chosen from commercially available parts to bring this project closer to the industry requirements. Numerical calculations are based on petroleum industry standards. The project is sponsored by the Department of Energy of the US.Keywords: downhole heat exchangers, geothermal power generation, organic rankine cycle, refrigerants, working fluids
Procedia PDF Downloads 3121245 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis
Authors: John Yahng, Hansraj Riteesh Bookun
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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.Keywords: carotid, complication, discharge, surgery
Procedia PDF Downloads 1581244 Exploring the Issue of Occult Hypoperfusion in the Pre-Hospital Setting
Authors: A. Fordham, A. Hudson
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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma
Procedia PDF Downloads 3551243 Distributed Real-time Framework for Experimental Multi Aerial Robotic Systems
Authors: Samuel Knox, Verdon Crann, Peyman Amiri, William Crowther
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There exists a shortage of open-source firmware for allowing researchers to focus on implementing high-level planning and control strategies for multi aerial robotic systems in simulation and experiment. Within this body of work, practical firmware is presented, which performs all supplementary tasks, including communications, pre and post-experiment procedures, and emergency safety measures. This allows researchers to implement high-level planning and control algorithms for path planning, traffic management, flight formation and swarming of aerial robots. The framework is built in Python using the MAVSDK library, which is compatible with flight controllers running PX4 firmware and onboard computers based on Linux. Communication is performed using Wi-Fi and the MQTT protocol, currently implemented using a centralized broker. Finally, a graphical user interface (GUI) has been developed to send general commands and monitor the agents. This framework enables researchers to prepare customized planning and control algorithms in a modular manner. Studies can be performed experimentally and in simulation using PX4 software in the loop (SITL) and the Gazebo simulator. An example experimental use case of the framework is presented using novel distributed planning and control strategies. The demonstration is performed using off-the-shelf components and minimal setup.Keywords: aerial robotics, distributed framework, experimental, planning and control
Procedia PDF Downloads 1061242 Use of a New Multiplex Quantitative Polymerase Chain Reaction Based Assay for Simultaneous Detection of Neisseria Meningitidis, Escherichia Coli K1, Streptococcus agalactiae, and Streptococcus pneumoniae
Authors: Nastaran Hemmati, Farhad Nikkhahi, Amir Javadi, Sahar Eskandarion, Seyed Mahmuod Amin Marashi
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Neisseria meningitidis, Escherichia coli K, Streptococcus agalactiae, and Streptococcus pneumoniae cause 90% of bacterial meningitis. Almost all infected people die or have irreversible neurological complications. Therefore, it is essential to have a diagnostic kit with the ability to quickly detect these fatal infections. The project involved 212 patients from whom cerebrospinal fluid samples were obtained. After total genome extraction and performing multiplex quantitative polymerase chain reaction (qPCR), the presence or absence of each infectious factor was determined by comparing with standard strains. The specificity, sensitivity, positive predictive value, and negative predictive value calculated were 100%, 92.9%, 50%, and 100%, respectively. So, due to the high specificity and sensitivity of the designed primers, they can be used instead of bacterial culture that takes at least 24 to 48 hours. The remarkable benefit of this method is associated with the speed (up to 3 hours) at which the procedure could be completed. It is also worth noting that this method can reduce the personnel unintentional errors which may occur in the laboratory. On the other hand, as this method simultaneously identifies four common factors that cause bacterial meningitis, it could be used as an auxiliary method diagnostic technique in laboratories particularly in cases of emergency medicine.Keywords: cerebrospinal fluid, meningitis, quantitative polymerase chain reaction, simultaneous detection, diagnosis testing
Procedia PDF Downloads 991241 Estimation Cytokines IL-2, IL-4, IL-8 in Serum and Nasal Secretions of Patients with Various Forms of Chronic Polypoid Rhinosinusitis
Authors: U. N. Vokhidov, U. S. Khasanov, A. A. Ismailova
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Background: Currently, the researches on the development of chronic polypoid rhinosinusitis cytokines play a major role. The aim of this study was the comparison of indicators IL-2, IL-4, IL-8 in the peripheral blood and nasal secretions of patients with various forms of chronic polypoid rhinosinusitis. Material and methods: We studied 50 patients with chronic polypoid rhinosinusitis receiving hospital treatment in the ENT department of the 3-rd clinic of Tashkent Medical Academy. It was carried out a comprehensive study including morphological examination, immunological study of blood and nasal secretions on the IL-2, IL-4 and IL-8. Results: The results of immunological studies of peripheral blood showed that patients with ‘eosinophilic’ polyps were increased IL-2 and IL-4 in patients with ‘neutrophils’ polyps were increased IL-2 and IL-8. Immunological investigation nasal secretions taken from patients with nasal polyposis rhinosinusitis showed that patients with ‘eosinophilic’ polyps also increased IL- 2 and IL- 4 in patients with ‘neutrophils’ polyps - increased IL-2 and IL-8. Conclusion: In patients with ‘eosinophilic’ polyps revealed the presence of immunity to the allergy of the body, patients with ‘neutrophilic’ polyps identified immunity to the presence of inflammation, it is necessary to take into account the doctor-otolaryngologist when choosing a treatment strategy for the prevention of recurrence of the disease.Keywords: chronic polypoid rhinosinusitis, immunology, cytikines, nasal secretion
Procedia PDF Downloads 2131240 Predicting Dose Level and Length of Time for Radiation Exposure Using Gene Expression
Authors: Chao Sima, Shanaz Ghandhi, Sally A. Amundson, Michael L. Bittner, David J. Brenner
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In a large-scale radiologic emergency, potentially affected population need to be triaged efficiently using various biomarkers where personal dosimeters are not likely worn by the individuals. It has long been established that radiation injury can be estimated effectively using panels of genetic biomarkers. Furthermore, the rate of radiation, in addition to dose of radiation, plays a major role in determining biological responses. Therefore, a better and more accurate triage involves estimating both the dose level of the exposure and the length of time of that exposure. To that end, a large in vivo study was carried out on mice with internal emitter caesium-137 (¹³⁷Cs). Four different injection doses of ¹³⁷Cs were used: 157.5 μCi, 191 μCi, 214.5μCi, and 259 μCi. Cohorts of 6~7 mice from the control arm and each of the dose levels were sacrificed, and blood was collected 2, 3, 5, 7 and 14 days after injection for microarray RNA gene expression analysis. Using a generalized linear model with penalized maximum likelihood, a panel of 244 genes was established and both the doses of injection and the number of days after injection were accurately predicted for all 155 subjects using this panel. This has proven that microarray gene expression can be used effectively in radiation biodosimetry in predicting both the dose levels and the length of exposure time, which provides a more holistic view on radiation exposure and helps improving radiation damage assessment and treatment.Keywords: caesium-137, gene expression microarray, multivariate responses prediction, radiation biodosimetry
Procedia PDF Downloads 1891239 Interactive Effects of Organizational Learning and Market Orientation on New Product Performance
Authors: Qura-tul-aain Khair
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Purpose- The purpose of this paper is to empirically examining the strength of association of responsive market orientation and proactive market orientation with new product performance and exploring the possible moderating role of organizational learning based on contingency theory. Design/methodology/approach- Data for this study was collected from FMCG manufacturing industry and services industry, where customers are in contact frequently and responses are recorded on continuous basis. Sample was collected through convenience sampling. The data collected from different marketing department and sales personnel were analysed using SPSS 16 version. Findings- The paper finds that responsive market orientation is more strongly associated with new product performance. The moderator, organizational learning, plays it significant role on the relationship between responsive market orientation and new product performance. Research limitations/implications- this paper has taken sample from just FMCG industry and service industry, more work can be done regarding how different-markets require different market orientation behaviours. Originality/value- This paper will be useful for foreign business looking for investing and expanding in Pakistan, they can find opportunity to get sustained competitive advantage through exploring the proactive side of market orientation and importance of organizational learning.Keywords: organizational learning, proactive market orientation, responsive market orientation, new product performance
Procedia PDF Downloads 3711238 Remediation of Crude Oil Contaminated Soils by Indigenous Bacterial Isolates Using Cow Dung as a Bioenhancement Agent
Authors: E. Osazee, L. U. Bashir
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This study was conducted at the Department of Biological Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria, to determine the effects of different weights of cow dung on indigenous bacterial isolates in remediation of crude oil contaminated soils. The soil (1kg) was contaminated with 20g of crude oil and this was treated with three (40g, 80g and 120g) weights of cow dung. The soils were amended after two weeks of crude oil contamination. Soil samples were collected from the plastic bags for microbiological analyses. The isolates were cultured to test their ability to grow on crude oil. The ability of the isolates to utilize the crude oil was determined using media dilution technique. Bacteria such as Proteus mirabilis, Bacillus lacterosporus, Morganella morganii, Serratia marcescens and Bacillus alvei were isolated. The variables measured were heterotrophic bacterial populations, hydrocarbon utilizing bacterial populations and the percentage of crude oil degraded in the soils. Data collected were subjected to analysis of variance (ANOVA). Results obtained indicated that all the different weights of cow dung showed appreciable effect in crude oil decontamination. Based on the findings of the experiments, it could be deduced that 120g of cow dung promoted higher degradation of hydrocarbons. Thus, it should be recommended for remediation of crude oil contaminated soil in the study area.Keywords: crude oil, cow dung, amendment, bioremediation, decontamination
Procedia PDF Downloads 431237 Risk Assessment of Oil Spill Pollution by Integration of Gnome, Aloha and Gis in Bandar Abbas Coast, Iran
Authors: Mehrnaz Farzingohar, Mehran Yasemi, Ahmad Savari
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The oil products are imported and exported via Rajaee’s tanker terminal. Within loading and discharging in several cases the oil is released into the berths and made oil spills. The spills are distributed within short time and seriously affected Rajaee port’s environment and even extended areas. The trajectory and fate of oil spills investigated by modeling and parted by three risk levels base on the modeling results. First GNOME (General NOAA Operational Modeling Environment) applied to trajectory the liquid oil. Second, ALOHA (Areal Location Of Hazardous Atmosphere) air quality model, is integrated to predict the oil evaporation path within the air. Base on the identified zones the high risk areas are signed by colored dots which their densities calculated and clarified on a map which displayed the harm places. Wind and water circulation moved the pollution to the East of Rajaee Port that accumulated about 12 km of coastline. Approximately 20 km of north east of Qeshm Island shore is covered by the three levels of risky areas. Since the main wind direction is SSW the pollution pushed to the east and the highest risk zones formed on the crests edges hence the low risk appeared on the concavities. This assessment help the management and emergency systems to monitor the exposure places base on the priority factors and find the best approaches to protect the environment.Keywords: oil spill, modeling, pollution, risk assessment
Procedia PDF Downloads 3781236 Advanced Seismic Retrofit of a School Building by a DFP Base Isolation Solution
Authors: Stefano Sorace, Gloria Terenzi
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The study of a base isolation seismic retrofit solution for a reinforced concrete school building is presented in this paper. The building was assumed as a benchmark structure for a Research Project financed by the Italian Department of Civil Protection, and is representative of several similar public edifices designed with earlier Technical Standards editions, in Italy as well as in other earthquake-prone European countries. The structural characteristics of the building, and a synthesis of the investigation campaigns developed on it, are initially presented. The mechanical parameters, dimensions, locations and installation details of the base isolation system, incorporating double friction pendulum sliding bearings as protective devices, are then illustrated, along with the performance assessment analyses carried out in original and rehabilitated conditions according to a full non-linear dynamic approach. The results of the analyses show a remarkable enhancement of the seismic response capacities of the structure in base-isolated configuration. This allows reaching the high performance levels postulated in the rehabilitation design with notably lower costs and architectural intrusion as compared to traditional retrofit interventions designed for the same objectives.Keywords: seismic retrofit, seismic assessment, r/c structures, school buildings, base isolation
Procedia PDF Downloads 2571235 Flipped Learning Application on the Development of Capabilities for Civil Engineering Education in Labs
Authors: Hector Barrios-Piña, Georgia García-Arellano, Salvador García-Rodríguez, Gerardo Bocanegra-García, Shashi Kant
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This work shows the methodology of application and the effectiveness of the Flipped Learning technique for Civil Engineering laboratory classes. It was experimented by some of the professors of the Department of Civil Engineering at Tecnológico de Monterrey while teaching their laboratory classes. A total of 28 videos were created. The videos primarily demonstrate instructions of the experimental practices other than the usage of tools and materials. The technique allowed the students to prepare for their classes in advance. A survey was conducted on the participating professors and students (semester of August-December 2019) to quantify the effectiveness of the Flipped Learning technique. The students reported it as an excellent way of improving their learning aptitude, including self-learning whereas, the professors felt it as an efficient technique for optimizing their class session, which also provided an extra slot for class-interaction. A comparison of grades was analyzed between the students of the traditional classes and with Flipped Learning. It did not distinguish the benefits of Flipped Learning. However, the positive responses from the students and the professors provide an impetus for continuing and promoting the Flipped Learning technique in future classes.Keywords: flipped learning, laboratory classes, civil engineering, competences development
Procedia PDF Downloads 1511234 Carbon Monoxide Poisoning in Children
Authors: Atitallah Sofien, Bouyahia Olfa, Hadj Salah Ibrahim, Ben Saleh Foued, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir
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Introduction: Carbon monoxide (CO) poisoning is a common pathology responsible for high morbidity and mortality worldwide. Aim: The purpose of this study was to determine the epidemiological profile of CO poisoning as well as its clinical, paraclinical, therapeutic, and evolutionary aspects. Methods: Our study included observations of CO poisoning in children hospitalized in the pediatric department C of the Children's Hospital in Tunis over a period of 3 years. Results: We have collected 199 cases of CO poisoning in children. The average age was 5.43 years, with a sex ratio of 0.98. The source of CO was inside the home in 73.2% of cases, and it was the gas bath heater in 68.8% of cases. The intoxication was collective in 93.5% of the cases, and it occurred during the month of January in 35.8% of the cases. The clinical manifestations were headaches in 69.5% of cases. The rate of carboxyhemoglobin was pathological in 73.9% of cases. All patients received normobaric oxygen therapy, and only 3.6% of patients had a hyperbaric oxygen therapy session. We did not deplore any case of death in our study. Conclusion: CO poisoning remains a public health problem in Tunisia with high morbidity. The risk of secondary complications, particularly neuropsychiatric, requires clinical and possibly neuroradiological monitoring of these victims.Keywords: poisoning, carbon monoxide, children, hyperbaric oxygenation
Procedia PDF Downloads 531233 Understanding of Heritage Values within University Education Systems in the Kingdom of Saudi Arabia
Authors: Mahmoud Tarek Mohamed Hammad
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Despite the importance of the role and efforts made by the universities of the Kingdom of Saudi Arabia in reviving and preserving heritage architecture as an important cultural heritage in the Kingdom, The idea revolves around restoration and conservation processes and neglects the architectural heritage values, whose content can be used in sustainable contemporary architectural works. Educational values based on heritage architecture and how to integrate with the contemporary requirements were investigated in this research. For this purpose, by understanding the heritage architectural values as well as educational, academic process, the researcher presented an educational model of questionnaire forms for architecture students and the staff at the Architecture Department at Al-Baha University as a case study that serves the aims of the research. The results of the research show that heritage values especially those interview results are considered as a positive indicator of the importance of these values. The students and the staff need both to gain an understanding of heritage values as well as an understanding of theories of incorporating those values into the design process of contemporary local architecture. The research concludes that a correct understanding of the heritage values, its performance, and its reintegration with modern architecture technology should be focused on architectural education.Keywords: heritage architecture, academic work, heritage values, sustainable contemporary local architectural
Procedia PDF Downloads 1551232 Flood Disaster Prevention and Mitigation in Nigeria Using Geographic Information System
Authors: Dinebari Akpee, Friday Aabe Gaage, Florence Fred Nwaigwu
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Natural disasters like flood affect many parts of the world including developing countries like Nigeria. As a result, many human lives are lost, properties damaged and so much money is lost in infrastructure damages. These hazards and losses can be mitigated and reduced by providing reliable spatial information to the generality of the people through about flood risks through flood inundation maps. Flood inundation maps are very crucial for emergency action plans, urban planning, ecological studies and insurance rates. Nigeria experience her worst flood in her entire history this year. Many cities were submerged and completely under water due to torrential rainfall. Poor city planning, lack of effective development control among others contributes to the problem too. Geographic information system (GIS) can be used to visualize the extent of flooding, analyze flood maps to produce flood damaged estimation maps and flood risk maps. In this research, the under listed steps were taken in preparation of flood risk maps for the study area: (1) Digitization of topographic data and preparation of digital elevation model using ArcGIS (2) Flood simulation using hydraulic model and integration and (3) Integration of the first two steps to produce flood risk maps. The results shows that GIS can play crucial role in Flood disaster control and mitigation.Keywords: flood disaster, risk maps, geographic information system, hazards
Procedia PDF Downloads 216