Search results for: road median

Authors: Kieren Luellman, Makenzi Rockwell, Eduardo Callegari, Nichole Haag, Chun Wu

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Multiple sclerosis (MS) is an autoimmune disorder that damages the myelin sheath of neurons in the central nervous system. The presence of Acinetobacter bacteria and anti-Acinetobacter antibodies in MS patients has led to the hypothesis that the bacteria may contribute to MS pathogenesis. In this study, the protein sequences of Acinetobacter baumannii were compared to five peptides from three mammalian myelin proteins, i.e., Proteolipid Protein (PLP): PLP 139-151, PLP 178-191, Myelin Basic Protein (MBP): MBP 84-104 and Myelin Oligodendrocyte Glycoprotein (MOG): MOG 35-55 and MOG 92-106 respectively, known to induce experimental autoimmune encephalomyelitis (EAE), a condition similar to MS. We found 11 hits (i.e., with five or more amino acid sequence similarity) in Acinetobacter baumannii, which are identical or similar to PLP139-151, 32 hits to PLP178-191, 35 to MBP 84-104, 41 hits to MOG 35-55 and 26 hits to MOG92-106. In addition, Western blotting was used to assess possible interaction between the bacterial proteins and human anti-MBP, anti-MOG, and anti-PLP antibodies produced in rabbits, corresponding to MBP 84-104, MOG 35-55, and PLP 139-151, respectively. We found that both human Polyclonal anti-MOG antibody and anti-PLP antibody recognized a protein or more proteins of the same molecular mass of around 25 kDa. in Acinetobacter baumannii. The results suggested that this/these protein(s) might potentially serve as antigen(s) to induce anti-MOG antibody and anti-PLP antibody production in mammalian B cells. The proteomic study identified 433 hits, among which the sequence of Acinetobacter baumannii protein 491 subunit A matches a previously published enzyme Acinetobacter 3-Oxoadipate CoA-Transferase, in which a fragment of its peptide was observed to recognize MS patient serum via ELISA method. Our findings might pave the road to understanding one of the pathogenesis mechanisms of MS.

Keywords: multiple sclerosis, pathogenesis, Acinetobacter baumannii, antibody recognition

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Authors: Malleshappa Japagal, Srinivas Chitragar

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The use of waste plastic in pavement is becoming important alternative worldwide for disposal of plastic as well as to improve the stability of pavement and to meet out environmental issues. However, there are still concerns on fatigue and fracture resistance of Hot Mix Asphalt with the addition of plastic waste, (HMA-Plastic mixes) and moisture damage potential. The present study was undertaken to evaluate fracture resistance of HMA-Plastic mixes using semi-circular bending (SCB) test and moisture damage potential by Indirect Tensile strength (ITS) test using retained tensile strength (TSR). In this study, a dense graded asphalt mix with 19 mm nominal maximum aggregate size was designed in the laboratory using Marshall Mix design method. Aggregates were coated with different percentages of waste plastic (0%, 2%, 3% and 4%) by weight of aggregate and performance evaluation of fracture resistance and Moisture damage was carried out. The following parameters were estimated for the mixes: J-Integral or Jc, strain energy at failure, peak load at failure, and deformation at failure. It was found that the strain energy and peak load of all the mixes decrease with an increase in notch depth, indicating that increased percentage of plastic waste gave better fracture resistance. The moisture damage potential was evaluated by Tensile strength ratio (TSR). The experimental results shown increased TRS value up to 3% addition of waste plastic in HMA mix which gives better performance hence the use of waste plastic in road construction is favorable.

Keywords: hot mix asphalt, semi circular bending, marshall mix design, tensile strength ratio

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Authors: Shahryar Aftabi, Saeed Fathi, Mohammad H. Aminfar

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It is well known that cemented sand is one of the best approaches for soil stabilization. In some cases, a blend of sand, cement and other pozzolan materials such as zeolite, nano-particles and fiber can be widely (commercially) available and be effectively used in soil stabilization, especially in road construction. In this research, we investigate the effects of CaO which is based on the geotechnical characteristics of zeolite composition with sandy silt soil. Zeolites have low amount of CaO in their structures, that is, varying from 3% to 10%, and by removing the cement paste, we want to investigate the effect of zeolite pozzolan without any activator on soil samples strength. In this research, experiments are concentrated on various weight percentages of zeolite in the soil to examine the effect of the zeolite on drainage shear strength and California Bearing Ratio (CBR) both with and without curing. The study also investigates their liquid limit and plastic limit behavior and makes a comparative result by using Feng's and Wroth-Wood's methods in fall cone (cone penetrometer) device; in the final the SEM images have been presented. The results show that by increasing the percentage of zeolite in without-curing samples, the fine zeolite particles increase some soil's strength, but in the curing-state we can see a relatively higher strength toward without-curing state, since the zeolites have no plastic behavior, the pozzolanic property of zeolites plays a much higher role than cementing properties. Indeed, it is better to combine zeolite particle with activator material such as cement or lime to gain better results.

Keywords: California bearing ratio, CBR, direct shear, fall-cone, sandy silt, SEM, zeolite

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Authors: Alina Svechkina, Boris A. Portnov

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In line with a rapid increase in pollution sources and enforcement of stricter air pollution regulation, which lowers pollution levels, it becomes more difficult to identify actual risk sources behind the observed morbidity patterns, and new approaches are required to identify potential risks and take preventive actions. In the present study, we discuss a probabilistic approach to the spatial identification of a priori unidentified environmental health hazards. The underlying assumption behind the tested approach is that the observed adverse health patterns (morbidity, mortality) can become a source of information on the geographic location of environmental risk factors that stand behind them. Using this approach, we analyzed sources of environmental exposure using data on mortality rates available for the year 2015 for NUTS 3 (Nomenclature of Territorial Units for Statistics) subdivisions of the European Union. We identified several areas in the southwestern part of Europe as primary risk sources for the observed mortality patterns. Multivariate regressions, controlled by geographical location, climate conditions, GDP (gross domestic product) per capita, dependency ratios, population density, and the level of road freight revealed that mortality rates decline as a function of distance from the identified hazard location. We recommend the proposed approach an exploratory analysis tool for initial investigation of regional patterns of population morbidity patterns and factors behind it.

Keywords: mortality, environmental hazards, air pollution, distance decay gradient, multi regression analysis, Europe, NUTS3

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Authors: Petr Daniel Edward Kovarik, Malcolm Jackson, Charles Kelly, Rahul Patil, Shahid Iqbal

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Introduction: Recognition of the presence of extra capsular spread (ECS) has been a major change in the TNM 8th edition published by the American Joint Committee on Cancer in 2018. Irrespective of the size or number of lymph nodes, the presence of ECS makes N3b disease a stage IV disease. The objective of this retrospective observational study was to conduct a comparative analysis of survival outcomes in patients with lymph node-positive cutaneous head and neck squamous cell carcinoma (CHNSCC) based on their TNM 7th and TNM 8th editions classification. Materials and Methods: From January 2010 to December 2020, 71 patients with CHNSCC were identified from our centre’s database who were treated with radical surgery and adjuvant radiotherapy. All histopathological reports were reviewed, and comprehensive nodal mapping was performed. The data were collected retrospectively and survival outcomes were compared using TNM 7th and 8th editions. Results: The median age of the whole group of 71 patients was 78 years, range 54 – 94 years, 63 were male and 8 female. In total, 2246 lymph nodes were analysed; 195 were positive for cancer. ECS was present in 130 lymph nodes, which led to a change in TNM staging. The details on N-stage as per TNM 7th edition was as follows; pN1 = 23, pN2a = 14, pN2b = 32, pN2c = 0, pN3 = 2. After incorporating the TNM 8th edition criterion (presence of ECS), the details on N-stage were as follows; pN1 = 6, pN2a = 5, pN2b = 3, pN2c = 0, pN3a = 0, pN3b = 57. This showed an increase in overall stage. According to TNM 7th edition, there were 23 patients were with stage III and remaining 48 patients, stage IV. As per TNM 8th edition, there were only 6 patients with stage III as compared to 65 patients with stage IV. For all patients, 2-year disease specific survival (DSS) and overall survival (OS) were 70% and 46%. 5-year DSS and OS rates were 66% and 20% respectively. Comparing the survival between stage III and stage IV of the two cohorts using both TNM 7th and 8th editions, there is an obvious greater survival difference between the stages if TNM 8th staging is used. However, meaningful statistics were not possible as the majority of patients (n = 65) were with stage IV and only 6 patients were stage III in the TNM 8th cohort. Conclusion: Our study provides a comprehensive analysis on lymph node data mapping in this specific patient population. It shows a better differentiation between stage III and stage IV in the TNM 8th edition as compared to TNM 7th however meaningful statistics were not possible due to the imbalance of patients in the sub-cohorts of the groups.

Keywords: cutaneous head and neck squamous cell carcinoma, extra capsular spread, neck lymphadenopathy, TNM 7th and 8th editions

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Authors: Asawari Ajay Avhad

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The Soil and Water Assessment Tool (SWAT) is a hydrological model designed to predict the complex interactions within natural and human-altered watersheds. This research applies the SWAT model to the Ulhas River basin, a small watershed undergoing urbanization and characterized by bowl-like topography. Three simulation scenarios (LC17, LC22, and LC27) are investigated, each representing different land use and land cover (LULC) configurations, to assess the impact of urbanization on runoff. The LULC for the year 2027 is generated using the MOLUSCE Plugin of QGIS, incorporating various spatial factors such as DEM, Distance from Road, Distance from River, Slope, and distance from settlements. Future climate data is simulated within the SWAT model using historical data spanning 30 years. A susceptibility map for runoff across the basin is created, classifying runoff into five susceptibility levels ranging from very low to very high. Sub-basins corresponding to major urban settlements are identified as highly susceptible to runoff. With consideration of future climate projections, a slight increase in runoff is forecasted. The reliability of the methodology was validated through the identification of sub-basins known for experiencing severe flood events, which were determined to be highly susceptible to runoff. The susceptibility map successfully pinpointed these sub-basins with a track record of extreme flood occurrences, thus reinforcing the credibility of the assessment methodology. This study suggests that the methodology employed could serve as a valuable tool in flood management planning.

Keywords: future land use impact, flood management, run off prediction, ArcSWAT

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Authors: Antoine Villa, Moustapha Mohamedou, Florence Pilliere, Catherine Verdun-Esquer, Mathieu Molimard, Mohamed Sidatt Cheikh El Moustaph, Mireille Canal-Raffin

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Context: In Mauritania, the activity of the National Center of Oncology (NCO) has steadily risen leading to an increase in the handling of antineoplastic drugs (AD) by healthcare professionals. In this context, the AD contamination of those professionals is a major concern for occupational physicians. It has been evaluated using biological monitoring of occupational exposure (BMOE). Methods: The intervention took place in 2015, in 2 care units, and evaluated nurses preparing and/or infusing AD and agents in charge of hygiene. Participants provided a single urine sample, at the end of the week, at the end of their shift. Five molecules were sought using specific high sensitivity methods (UHPLC-MS/MS) with very low limits of quantification (LOQ) (cyclophosphamide (CP), Ifosfamide (IF), methotrexate (MTX): 2.5ng/L; doxorubicin (Doxo): 10ng/L; α-fluoro-β-alanine (FBAL, 5-FU metabolite): 20ng/L). A healthcare worker was considered as 'contaminated' when an AD was detected at a urine concentration equal to or greater than the LOQ of the analytical method or at trace concentration. Results: Twelve persons participated (6 nurses, 6 agents in charge of hygiene). Twelve urine samples were collected and analyzed. The percentage of contamination was 66.6% for all participants (n=8/12), 100% for nurses (6/6) and 33% for agents in charge of hygiene (2/6). In 62.5% (n=5/8) of the contaminated workers, two to four of the AD were detected in the urine. CP was found in the urine of all contaminated workers. FBAL was found in four, MTX in three and Doxo in one. Only IF was not detected. Urinary concentrations (all drugs combined) ranged from 3 to 844 ng/L for nurses and from 3 to 44 ng/L for agents in charge of hygiene. The median urinary concentrations were 87 ng/L, 15.1 ng/L and 4.4 ng/L for FBAL, CP and MTX, respectively. The Doxo urinary concentration was found 218ng/L. Discussion: There is no current biological exposure index for the interpretation of AD contamination. The contamination of these healthcare professionals is therefore established by the detection of one or more AD in urine. These urinary contaminations are higher than the LOQ of the analytical methods, which must be as low as possible. Given the danger of AD, the implementation of corrective measures is essential for the staff. Biological monitoring of occupational exposure is the most reliable process to identify groups at risk, tracing insufficiently controlled exposures and as an alarm signal. These results show the necessity to educate professionals about the risks of handling AD and/or to care for treated patients.

Keywords: antineoplastic drugs, Mauritania, biological monitoring of occupational exposure, contamination

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Authors: Salwa Mohammad Alawneh

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The ongoing humanitarian crises spur rapid and unpredicted refugee influxes resulting in demographic changes in cities. Regarding different urban systems are vulnerable in refugee neighborhoods. With the consequent social, economic, and spatial challenges, cities must respond with a more durable and sustainable approach based on urban resilience. The paper systematically approaches urban resilience to contribute to refugee spaces by reflecting on the overall urban systems of their neighborhoods. The research will review the urban resilience literature to develop an evaluation framework. The developed framework applies urban resilience more holistically in refugee neighborhoods and expands to the urban systems of social, economic, and spatial. However, the main highlight of this paper is the resilient spatial structure in refugee neighborhoods to face the internal and complex stress of refugee waves and their demographic changes. Finding a set of resilient spatial measurements and focusing on urban forms at a neighborhood scale provide vulnerability reduction and enhance adaptation capacity. As a model example, the paper applies these measurements and facilitates geospatial technologies to one of the refugee neighborhoods in Amman, Jordan, namely Al-Jubilee. The application in Al-Jubilee helps to demonstrate a road map towards a developmental pattern in design and planning by different decision-makers of inter-governmental and humanitarian organizations. In this regard, urban resilience improves the humanitarian assistantship of refugee settings beyond providing the essential needs. In conclusion, urban resilience responds to the different challenges of refugee neighborhoods by supporting urban stability, improving livability, and maintaining both urban functions and security.

Keywords: urban resilience of refugee, resilient urban form, refugee neighborhoods, humanitarian assistantship, refugee in Jordan

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Authors: M. Magrini, D. Moroni, G. Palazzese, G. Pieri, D. Azzarelli, A. Spada, L. Fanucci, O. Salvetti

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Railway crossings are complex entities whose optimal management cannot be addressed unless with the help of an intelligent transportation system integrating information both on train and vehicular flows. In this paper, we propose an integrated system named SIMPLE (Railway Safety and Infrastructure for Mobility applied at level crossings) that, while providing unparalleled safety in railway level crossings, collects data on rail and road traffic and provides value-added services to citizens and commuters. Such services include for example alerts, via variable message signs to drivers and suggestions for alternative routes, towards a more sustainable, eco-friendly and efficient urban mobility. To achieve these goals, SIMPLE is organized as a System of Systems (SoS), with a modular architecture whose components range from specially-designed radar sensors for obstacle detection to smart ETSI M2M-compliant camera networks for urban traffic monitoring. Computational unit for performing forecast according to adaptive models of train and vehicular traffic are also included. The proposed system has been tested and validated during an extensive trial held in the mid-sized Italian town of Montecatini, a paradigmatic case where the rail network is inextricably linked with the fabric of the city. Results of the tests are reported and discussed.

Keywords: Intelligent Transportation Systems (ITS), railway, railroad crossing, smart camera networks, radar obstacle detection, real-time traffic optimization, IoT, ETSI M2M, transport safety

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Authors: Geir Kirkebøen

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Most patients with serious diagnoses want to know their prognosis, in particular their expected survival time. As part of the informed consent process, physicians are legally obligated to communicate such information to patients. However, there is no established (evidence based) ‘best practice’ for how to do this. The two questions explored in this study are: How do physicians communicate expected survival time to patients, and how should it be done? We explored the first, descriptive question in a study with Norwegian oncologists as participants. The study had a scenario and a survey part. In the scenario part, the doctors should imagine that a patient, recently diagnosed with a serious cancer diagnosis, has asked them: ‘How long can I expect to live with such a diagnosis? I want an honest answer from you!’ The doctors should assume that the diagnosis is certain, and that from an extensive recent study they had optimal statistical knowledge, described in detail as a right-skewed survival curve, about how long such patients with this kind of diagnosis could be expected to live. The main finding was that very few of the oncologists would explain to the patient the variation in survival time as described by the survival curve. The majority would not give the patient an answer at all. Of those who gave an answer, the typical answer was that survival time varies a lot, that it is hard to say in a specific case, that we will come back to it later etc. The survey part of the study clearly indicates that the main reason why the oncologists would not deliver the mortality prognosis was discomfort with its uncertainty. The scenario part of the study confirmed this finding. The majority of the oncologists explicitly used the uncertainty, the variation in survival time, as a reason to not give the patient an answer. Many studies show that patients want realistic information about their mortality prognosis, and that they should be given hope. The question then is how to communicate the uncertainty of the prognosis in a realistic and optimistic – hopeful – way. Based on psychological research, our hypothesis is that the best way to do this is by explicitly describing the variation in survival time, the (usually) right skewed survival curve of the prognosis, and emphasize to the patient the (small) possibility of being a ‘lucky outlier’. We tested this hypothesis in two scenario studies with lay people as participants. The data clearly show that people prefer to receive expected survival time as a median value together with explicit information about the survival curve’s right skewedness (e.g., concrete examples of ‘positive outliers’), and that communicating expected survival time this way not only provides people with hope, but also gives them a more realistic understanding compared with the typical way expected survival time is communicated. Our data indicate that it is not the existence of the uncertainty regarding the mortality prognosis that is the problem for patients, but how this uncertainty is, or is not, communicated and explained.

Keywords: cancer patients, decision psychology, doctor-patient communication, mortality prognosis

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Authors: Taleb Lotfi, Benarbia Maheidine, Allam Hamza, Boutira Fatima, Boukerche Abdelbaki

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Introduction and purpose of the study: This is a retrospective single-center study with an analytical aim to determine the prognostic factors for relapse in patients treated with radiotherapy after total laryngectomy with lymph node dissection for laryngeal cancer at the Emir Abdelkader cancer center in Oran (Algeria). Material and methods: During the study period from January 2014 to December 2018, eighty-nine patients (n=89) with squamous cell carcinoma of the larynx were treated with postoperative radiotherapy. Relapse-free survival was studied in the univariate analysis according to pre-treatment criteria using Kaplan-Meier survival curves. We performed a univariate analysis to identify relapse factors. Statistically significant factors have been studied in the multifactorial analysis according to the Cox model. Results and statistical analysis: The average age was 62.7 years (40-86 years). It was a squamous cell carcinoma in all cases. Postoperatively, the tumor was classified as pT3 and pT4 in 93.3% of patients. Histological lymph node involvement was found in 36 cases (40.4%), with capsule rupture in 39% of cases, while the limits of surgical excision were microscopically infiltrated in 11 patients (12.3%). Chemotherapy concomitant with radiotherapy was used in 67.4% of patients. With a median follow-up of 57 months (23 to 104 months), the probabilities of relapse-free survival and five-year overall survival are 71.2% and 72.4%, respectively. The factors correlated with a high risk of relapse were locally advanced tumor stage pT4 (p=0.001), tumor site in case of subglottic extension (p=0.0003), infiltrated surgical limits R1 (p=0.001), l lymph node involvement (p=0.002), particularly in the event of lymph node capsular rupture (p=0.0003) as well as the time between surgery and adjuvant radiotherapy (p=0.001). However, in the subgroup analysis, the major prognostic factors for disease-free survival were subglottic tumor extension (p=0.001) and time from surgery to adjuvant radiotherapy (p=0.005). Conclusion: Combined surgery and postoperative radiation therapy are effective treatment modalities in the management of laryngeal cancer. Close cooperation of the entire cervicofacial oncology team is essential, expressed during a multidisciplinary consultation meeting, with the need to respect the time between surgery and radiotherapy.

Keywords: laryngeal cancer, laryngectomy, postoperative radiotherapy, survival

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Authors: Andrew Fife, Jean-Francois Esculier, Codi Ramsey, Kim Hebert-Losier

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Objectives: We aimed to identify how an evidence-based educational video influences how runners select shoes, and perceive shoe comfort, satisfaction, and performance over three months in comparison with a control video. Design: Two groups participated in a double-blind randomised controlled trial. Method: Fifty-six runners were randomly assigned to view one of two video presentations prior to purchasing new shoes for road running in speciality stores. Runners completed a survey with regards to their own shoes and one in reference to the new shoes purchased at three timepoints: before first use, onemonth post-purchase, and three-months post-purchase. Perceived shoe comfort, satisfaction, and performance were assessed using 100 mm visual analogue scales. Factors that influenced their shoe purchase were ranked in order of importance. Results: Comfort and satisfaction were not significantly different between groups and timepoints. The perceived performance of new shoes (75.6 mm) was significantly greater than own shoes (mean: 67.6 mm) before first use, but ratings returned to own-shoe levels one month later in both groups. The group receiving the evidence-based presentation reported their purchased shoes as being influenced more by the video (55.4 mm) than the control group (21.8 mm), although both chose the same brand and model as previously worn over half of the time. Runners in both groups prioritised fit, comfort, and choosing similar shoes to the ones they previously used. Conclusions: In contrast to expectations, the evidence-based educational video did not appear to influence running shoe selection, or overall perceived shoe comfort, satisfaction, or performance.

Keywords: comfort, consumer behaviour, consciousness, education, running, shoes

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Authors: W. Hajuthman, R. Warner, S. Rahman, M. Abraham, H. Helliwell, D. Bodiwala

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Context: Prostate cancer is a prevalent cancer in males in Europe and the US, with diagnosis primarily relying on PSA testing, mpMRI, and subsequent biopsies. However, this diagnostic strategy may lead to complications for patients. Research Aim: The aim of this study is to assess compliance with trust guidelines for antibiotic prophylaxis in patients undergoing transperineal template biopsies of the prostate and evaluate the rate of post-procedure complications. Methodology: This study is conducted retrospectively over an 8-month period. Data collection includes patient demographics, compliance with trust guidelines, associated risk factors, and post-procedure complications such as infection, haematuria, and urinary retention. Findings: The audit includes 100 patients with a median age of 66.11. The compliance with pre-procedure antibiotics was 98%, while compliance with antibiotic prophylaxis recommended by trust guidelines was 68%. Among the patients, 3% developed post-procedure sepsis, with 2 requiring admission for intravenous antibiotics. No evident risk factors were identified in these cases. Additionally, post-procedure urinary retention occurred in 3% of patients and post-procedure haematuria in 2%. Theoretical Importance: This study highlights the increasing use of transperineal template biopsies across UK centres and suggests that having a standardized protocol and compliance with guidelines can reduce confusion, ensure appropriate administration of antibiotics, and mitigate post-procedure complications. Data Collection and Analysis Procedures: Data for this study is collected retrospectively, involving the extraction and analysis of relevant information from patient records over the specified 8-month period. Question Addressed: This study addresses the following research questions: (1) What is the compliance rate with trust guidelines for antibiotic prophylaxis in transperineal template biopsies of the prostate? (2) What is the rate of post-procedure complications, such as infection, haematuria, and urinary retention? Conclusion: Transperineal template biopsies are becoming increasingly prevalent in the UK. Implementing a standardized protocol and ensuring compliance with guidelines can reduce confusion, ensure proper administration of antibiotics, and potentially minimize post-procedure complications. Additionally, considering that studies show no difference in outcomes when prophylactic antibiotics are not used, the reminder to follow trust guidelines may prompt a re-evaluation of antibiotic prescribing practices.

Keywords: prostate, transperineal template biopsies of prostate, antibiotics, complications, microbiology, guidelines

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Authors: Jamshed Ahmad, Abdul Wahid Khan, Javed Ali Khan

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Managing software quality requirements change management is a difficult task in the field of software engineering. Avoiding incoming changes result in user dissatisfaction while accommodating to many requirement changes may delay product delivery. Poor requirements management is solely considered the primary cause of the software failure. It becomes more challenging in global software outsourcing. Addressing success factors in quality requirement change management is desired today due to the frequent change requests from the end-users. In this research study, success factors are recognized and scrutinized with the help of a systematic literature review (SLR). In total, 16 success factors were identified, which significantly impacted software quality requirement change management. The findings show that Proper Requirement Change Management, Rapid Delivery, Quality Software Product, Access to Market, Project Management, Skills and Methodologies, Low Cost/Effort Estimation, Clear Plan and Road Map, Agile Processes, Low Labor Cost, User Satisfaction, Communication/Close Coordination, Proper Scheduling and Time Constraints, Frequent Technological Changes, Robust Model, Geographical distribution/Cultural differences are the key factors that influence software quality requirement change. The recognized success factors and validated with the help of various research methods, i.e., case studies, interviews, surveys and experiments. These factors are then scrutinized in continents, database, company size and period of time. Based on these findings, requirement change will be implemented in a better way.

Keywords: global software development, requirement engineering, systematic literature review, success factors

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Authors: Lina Wu, Ye Li, Jia Liu

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We are interested in solving Liouville-type problems to explore constancy properties for maps or differential forms on Riemannian manifolds. Geometric structures on manifolds, the existence of constancy properties for maps or differential forms, and energy growth for maps or differential forms are intertwined. In this article, we concentrate on discovery of solutions to Liouville-type problems where manifolds are Euclidean spaces (i.e. flat Riemannian manifolds) and maps become real-valued functions. Liouville-type results of vanishing properties for functions are obtained. The original work in our research findings is to extend the q-energy for a function from finite in L^q space to infinite in non-L^q space by applying p-balanced technique where q = p = 2. Calculation skills such as Hölder's Inequality and Tests for Series have been used to evaluate limits and integrations for function energy. Calculation ideas and computational techniques for solving Liouville-type problems shown in this article, which are utilized in Euclidean spaces, can be universalized as a successful algorithm, which works for both maps and differential forms on Riemannian manifolds. This innovative algorithm has a far-reaching impact on research work of solving Liouville-type problems in the general settings involved with infinite energy. The p-balanced technique in this algorithm provides a clue to success on the road of q-energy extension from finite to infinite.

Keywords: differential forms, holder inequality, Liouville-type problems, p-balanced growth, p-harmonic maps, q-energy growth, tests for series

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Authors: Mike Wei, Nebu Koshy, Koen van Besien, Giorgio Inghirami, Steven M. Horwitz

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T-cell prolymphocytic leukemia (T-PLL) is a rare hematologic disease characterized by a T-cell phenotype, rapid progression, and poor prognosis with median survival of less than a year. Alemtuzumab-based chemotherapy has increased the rate of complete remissions but these are often short-lived, and allogeneic transplant is considered the only curative therapy. In recent studies, JAK3 activating mutations have been identified in T-cell cancers, with T-PLL having the highest rate of JAK3 mutations (30 – 42%). As such, T-PLL is a model disease for evaluating the utility of JAK3 inhibitors. We present a case of a 64-year-old man with relapsed-refractory T-PLL. He was initially treated with alemtuzumab and obtained complete response and was consolidated with matched unrelated donor stem cell transplant. His disease stayed in remission for approximately 1.5 years before relapse, which was then treated with a clinical trial of romidepsin-lenalidomide (partial responses then progression at 6 months) and later alemtuzumab. Due to complications of myelosuppression and CMV reactivation, his treatment was interrupted leading to disease progression. The doubling time of lymphocyte count was approximately 20 days and over a span of 60 days the lymphocyte count rose from 8 x 109/L to 68 x 109/L. Exon sequencing showed a JAK3 mutation. The patient consented to and was treated with FDA-approved tofacitinib (initially 5 mg BID, increased to 10 mg BID after 15 days of treatment). An initial decrease in lymphocyte count was followed by progression. In vitro treatment of the patient’s cells showed modest effects of tofacitinib and ruxolitinib as single agents, in the range of doxorubicin, but synergy between the agents. After 40 days of treatment with tofacitinib and with a lymphocyte count of 150 x 109/L, ruxolitinib (5mg BID) was added. Over the 60 days since dual inhibition was started, the lymphocyte count has stabilized. The patient has remained completely asymptomatic during treatment with tofacitinib and ruxolitinib. Neutrophil count has remained normal. Platelet count and hemoglobin have however declined from ~50 x109/L to ~30 x109/L and from 11 g/dL to 8.1 g/dL respectively, since the introduction of ruxolitinib. The stabilization in lymphocyte count confirms the clinical activity of JAK inhibitors in T-PLL as suggested by the presence of JAK3 mutations and by in-vitro assays. It also suggests clinical synergy between ruxolitinib and tofacitinib in this setting. Prospective studies of JAK inhibitors in PLL patients with formal dose-finding studies are needed.

Keywords: tofacitinib, ruxolitinib, T-cell prolymphocytic leukemia, JAK3

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Authors: Aouissi Nora, Meksem Leila

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This work focused on the study of air pollution generated by the transport sector in the region of Annaba. Our study is based on two parts: the first one concerns an epidemiological investigation in the area of Annaba situated in the east Algerian coast, which deals with the development of the fleet and its impact on public health. To get a more precise idea of the impact of road traffic on public health, we consulted the computing center office of the National Social Insurance Fund. The information we were given by this office refers to the number of reported asthma and heart disease after medical examination during the period 2006-2010. The second part was devoted to the study of the toxicity of exhaust gases on some physical and biochemical parameters of durum wheat (Triticum durum Desf.). After germination and three-leaf stage, the pots are placed in a box of volume (0,096 m3) having an input which is linked directly to the exhaust pipe of a truck, and an outlet to prevent asphyxiation plant. The experience deals with 30 pots: 10 pots are exposed for 5 minutes to exhaust smoke; the other 10 are exposed for 15 minutes, and the remaining 10 for 30 minutes. The epidemiological study shows that the levels of pollutants emitted by the fleet are responsible for the increase of people respiratory and cardiovascular diseases. As for biochemical analyses of vegetation, they clearly show the toxicity of pollutants emitted by the exhaust gases, with an increase in total protein, proline and stimulation of detoxification enzyme (catalase).

Keywords: air pollution, toxicity, epidemiology, biochemistry

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Authors: Mehves Isiklar Ekici, Ceyda Tuna Kirsaclioglu, Zarife Kuloglu, Aydan Kansu

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Malnutrition is an important cause of morbidity and mortality as it accounts for 45% of child deaths under the age of 5 worldwide. Therefore, early recognition and effective treatment of failure to thrive and malnutrition are important. In this study, it was aimed to retrospectively evaluate the nutritional support treatment approaches (nutrition education and diet enrichment / use of enteral nutrition products) applied in children followed up with growth failure without underlying organic causes, and to compare the efficacy of nutritional support treatments. In this study, children aged 1 month to 18 years diagnosed with growth failure who were followed up for at least 12 months between January 2011 and February 2020, were included. Anthropometric measurements at baseline and during follow-up, type of nutritional support therapy and treatment compliance were evaluated based on the retrospective records. 119 children (median age:3.2, 69 girls) were included in the study. Nutrition education and dietary enrichment were provided to 28% of the patients (Group 1). In addition to dietary education and recommendations, enteral nutrition supplements was given in 78% of them (Group 2). Compliance to the treatment rates of the patients in Group 1 and Group 2 were not significantly different at both 6th and 12th month controls. At the end of the follow up children who comply with the treatment in Group 1 had significant increase in weight for age z scores (-1.74 vs 0.05, respectively, p=0.019) and body mass index z scores (-1.47 vs -0.53, respectively, p=0.034) compared with baseline measurements. Similar to Group 1, in Group 2 children with treatment compliance, had a significant increase in weight for age z scores (-2.24 vs. -0.54, respectively, p=0.00) and body mass index z scores (-2.27 vs. -1.06, respectively, p=0.00) compared with baseline measurements. The rate of patients with severe malnutrition decreased from 15% to 12%, for moderate malnutrition decreased from 54% to 33%. Moreover, it was observed that this decrease in the rate of patients with both severe and moderate malnutrition was more prominent in patients under 3 years of age. Although there was a significant increase in anthropometric measurements with treatment in both groups, there was no significant difference in between two groups terms of change in anthropometric measurements (p>0.05), therefore effectiveness. Failure to thrive and malnutrition in infancy and childhood cause health problems that can affect adult life. To conclude, nutritional education - dietary enrichment. recommendations and use of enteral nutrition supplements were both proven beneficial in this study. Researchers are willing to underline that the most important part of the treatment is to include the family to the process to ensure the treatment compliance.

Keywords: enteral nutrition supplements, failure to thrive, malnutrition, nutritional education

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Authors: Abdul Walusansa

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In this paper, paper notes and coins were collected from general public in Kampala City where ready-to-eat food can be served, in order to survey for bacterial contamination. The total bacterial number and potentially pathogenic organisms loading on currency were tested. All isolated potential pathogens were also tested for antibiotic resistance against four most commonly prescribed antibiotics. 1. The bacterial counts on one hundred paper notes sample were ranging between 6～10918/cm cm-2,the median was 141/ cm-2, according to the data it was much higher than credit cards and Australian notes which were made of polymer. The bacterial counts on sixty coin samples were ranging between 2～380/cm-2, much less than paper notes. 2. Coliform (65.6%), E. coli (45.9%), S. aureus (41.7%), B. cereus (67.7%), Salmonella (19.8%) were isolated on one hundred paper notes. Coliform (22.4%), E. coli (5.2%), S. aureus (24.1%), B. cereus (34.5%), Salmonella (10.3%) were isolated from sixty coin samples. These results suggested a high rate of potential pathogens contamination of paper notes than coins. 3. Antibiotic resistances are commonly in most of the pathogens isolated on currency. Ampicillin resistance was found in 60%of Staphylococcus aureus isolated on currency, as well as 76.6% of E. coil and 40% of Salmonella. Erythromycin resistance was detected in 56.6% of S. aureus and in 80.0% of E. coli. All the pathogens isolated were sensitive to Norfloxacin, Salmonella and S. aureus also sensitive to Cefaclor. In this paper, we also studied the antimicrobial capability of metal coins, coins collected from different countries were tested for the ability to inhibit the growth of E. sakazakii, S. aureus, E. coli, L. monocytogenes and S. typhimurium. 1) E. sakazakii appeared very sensitive to metal coins, the second is S. aureus, but E. coli, L. monocytogenes and S. typhimurium are more resistant to these metal coin samples. 2) Coins made of Nickel-brass alloy and Copper-nickel alloy showed a better effect in anti-microbe than other metal coins, especially the ability to inhibited the growth of E. sakazakii and S. aureus, all the inhibition zones produced on nutrient agar are more than 20.6 mm. Aluminium-bronze alloy revealed weak anti-microbe activity to S. aureus and no effect to kill other pathogens. Coins made of stainless steel also can’t resist bacteria growth. 3) Surprisingly, one cent coins of USA which were made of 97.5% Zinc and 2.5% Cu showed a significant antimicrobial capability, the average inhibition zone of these five pathogens is 45.5 mm.

Keywords: antibiotic sensitivity, bacteria, currency, coins, parasites

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Authors: Adebowale T. Odeyemi, Oluwafemi A. Ajenifuja

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The leachate samples collected from Erifun dumpsite along Federal Polythenic road, Ado-Ekiti, Ekiti State, were subjected to bacteriological and mineral analyses. The bacteriological estimation and isolation were done using serial dilution and pour plating techniques. Antibiotic susceptibility test was done using agar disc diffusion technique. Atomic Absorption Spectophotometry method was used to analyze the heavy metal contents in the leachate samples. The bacterial and coliform counts ranged from 4.2 × 105 CFU/ml to 2.97 × 106 CFU/ml and 5.0 × 104 CFU/ml to 2.45 x 106 CFU/ml, respectively. The isolated bacteria and percentage of occurrence include Bacillus cereus (22%), Enterobacter aerogenes (18%), Staphylococcus aureus (16%), Proteus vulgaris (14%), Escherichia coli (14%), Bacillus licheniformis (12%) and Klebsiella aerogenes (4%). The mineral value ranged as follow; iron (21.30mg/L - 25.60mg/L), zinc (1.80mg/L - 5.60mg/L), copper (1.00mg/L - 2.60mg/L), chromium (0.50mg/L - 1.30mg/L), candium (0.20mg/L - 1.30mg/L), nickel (0.20mg/L - 0.80mg/L), lead (0.05mg/L-0.30mg/L), cobalt (0.03mg/L - 0.30mg/L) and in all samples manganese was not detected. The entire organisms isolated exhibited a high level of resistance to most of the antibiotics used. There is an urgent need for awareness to be created about the present situation of the leachate in Erifun, on the need for treatment of the nearby stream and other water sources before they can be used for drinking and other domestic use. In conclusion, a good method of waste disposal is required in those communities to prevent leachate formation, percolation, and runoff into water bodies during the raining season.

Keywords: antibiotic susceptibility, dumpsite, bacteriological analysis, heavy metal

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Authors: Macky Kato, Takeshi Sato, Mizuki Nakajima

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One major problem related to the use of smartphones is texting while simultaneously engaging in other things, resulting in serious road accidents. Apart from texting while driving being one of the most dangerous behaviors, texting while walking is also dangerous because it narrows the pedestrians’ field of vision. However, many of pedestrian text while walking very habitually. Smartphone users often overlook the potential harm associated with this behavior even while crossing roads. The successful texting while walking make them think that they are safe. The purpose of this study is to reveal of the influence of peripheral vision to the stability of walking trajectory with texting while walking. In total, 9 healthy male university students participated in the experiment. Their mean age was 21.4 years, and standard deviation was 0.7 years. They attempted to walk 10 m in three conditions. First one is the control (CTR) condition, with no phone and no restriction. The second one is the texting while walking (TWG) with no restrictions. The third one is restriction condition (PRS), with phone restricted by experimental peripheral goggles. The horizontal distances (HDS) and directions are measured as the scale of horizontal stability. The longitudinal distances (LDS) between the footprints were measured as the scale of the walking rhythm. The results showed that the HDS of the footprints from the straight line increased as the participants walked in the TWG and PRS conditions. In the PRS condition, this tendency was particularly remarkable. In addition, the LDS between the footprints decreased in the order of the CTR, TWG, and PRS conditions. The ANOVA results showed significant differences in the three conditions with respect to HDS. The differences among these conditions showed that the narrowing of the Pedestrian's vision because of smartphone use influences the walking trajectory and rhythm. It can be said that the pedestrians seem to use their peripheral vision marginally on texting while walking. Therefore, we concluded that the texting while walking narrows the peripheral vision so danger to increase the risk of the accidents.

Keywords: peripheral vision, stability, texting while walking, walking trajectory

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Authors: Danzhao Cheng, Eugene Ch'ng

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Virtual Reality technologies can reconstruct cultural heritage objects and sites to a level of realism. Concentrating mostly on documenting authentic data and accurate representations of tangible contents, current virtual heritage is limited to accumulating visually presented objects. Such constructions, however, are fragmentary and may not convey the inherent significance of heritage in a meaningful way. In order to contextualise fragmentary historical contents where history can be told, a strategy is to create a guided narrative via role-playing. Such an approach can strengthen the logical connections of cultural elements and facilitate creative synthesis within the virtual world. This project successfully reconstructed the Ningbo Sanjiangkou VR site in Yuan Dynasty combining VR technology and role-play game approach. The results with 80 pairs of participants suggest that VR role-playing can be beneficial in a number of ways. Firstly, it creates thematic interactivity which encourages users to explore the virtual heritage in a more entertaining way with task-oriented goals. Secondly, the experience becomes highly engaging since users can interpret a historical context through the perspective of specific roles that exist in past societies. Thirdly, personalisation allows open-ended sequences of the expedition, reinforcing user’s acquisition of procedural knowledge relative to the cultural domain. To sum up, role-playing in VR poses great potential for experiential learning as it allows users to interpret a historical context in a more entertaining way.

Keywords: experiential learning, maritime silk road, role-playing, virtual heritage, virtual reality

Procedia PDF Downloads 157

Authors: Marcio Freire Cruz, Naoaki Ono, Shigehiko Kanaya, Carlos Arthur Mattos Teixeira Cavalcante

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The systems that record patient care information, known as Electronic Medical Record (EMR) and those that monitor vital signs of patients, such as heart rate, body temperature, and blood pressure have been extremely valuable for the effectiveness of the patient’s treatment. Several kinds of research have been using data from EMRs and vital signs of patients to predict illnesses. Among them, we highlight those that intend to predict, classify, or, at least identify patterns, of sepsis illness in patients under vital signs monitoring. Sepsis is an organic dysfunction caused by a dysregulated patient's response to an infection that affects millions of people worldwide. Early detection of sepsis is expected to provide a significant improvement in its treatment. Preceding works usually combined medical, statistical, mathematical and computational models to develop detection methods for early prediction, getting higher accuracies, and using the smallest number of variables. Among other techniques, we could find researches using survival analysis, specialist systems, machine learning and deep learning that reached great results. In our research, patients are modeled as points moving each hour in an n-dimensional space where n is the number of vital signs (variables). These points can reach a sepsis target point after some time. For now, the sepsis target point was calculated using the median of all patients’ variables on the sepsis onset. From these points, we calculate for each hour the position vector, the first derivative (velocity vector) and the second derivative (acceleration vector) of the variables to evaluate their behavior. And we construct a prediction model based on a Long Short-Term Memory (LSTM) Network, including these derivatives as explanatory variables. The accuracy of the prediction 6 hours before the time of sepsis, considering only the vital signs reached 83.24% and by including the vectors position, speed, and acceleration, we obtained 94.96%. The data are being collected from Medical Information Mart for Intensive Care (MIMIC) Database, a public database that contains vital signs, laboratory test results, observations, notes, and so on, from more than 60.000 patients.

Keywords: dynamic analysis, long short-term memory, prediction, sepsis

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Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

Procedia PDF Downloads 163

Authors: Min Woo Park, Jin Do Chung, Kyu Yeol Kim, Byoung Uk Im, Jang Woo Kim, Hae Yeul Ryu

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Nine representative species of trees among all the street trees were selected to estimate the absorption amount of carbon dioxide emitted from street trees in Seoul calculating the biomass, amount of carbon saved, and annual absorption amount of carbon dioxide in each of the species. Planting distance of street trees in Seoul was 1,851,180 m, the number of planting lines was 1,287, the number of planted trees was 284,498 and 46 species of trees were planted as of 2013. According to the result of plugging the quantity of species of street trees in Seoul on the absorption amount of each of the species, 120,097 ton of biomass, 60,049.8 ton of amount of carbon saved, and 11,294 t CO2/year of annual absorption amount of carbon dioxide were calculated. Street ratio mentioned on the road statistics in Seoul in 2022 is 23.13%. If the street trees are assumed to be increased in the same rate, the number of street trees in Seoul was calculated to be 294,823. The planting distance was estimated to be 1,918,360 m, and the annual absorption amount of carbon dioxide was measured to be 11,704 t CO2/year. Plans for improving the annual absorption amount of carbon dioxide from street trees were established based on the expected amount of absorption. First of all, it is to improve the annual absorption amount of carbon dioxide by increasing the number of planted street trees after adjusting the planting distance of street trees. If adjusting the current planting distance to 6 m, it was turned out that 12,692.7 t CO2/year was absorbed on an annual basis. Secondly, it is to change the species of trees to tulip trees that represent high absorption rate. If increasing the proportion of tulip trees to 30% up to 2022, the annual absorption rate of carbon dioxide was calculated to be 17804.4 t CO2/year.

Keywords: absorption of carbon dioxide, source of absorbing carbon dioxide, trees in city, improving species

Procedia PDF Downloads 355

Authors: Mohammad Najmol Haque, Takeshi Maki, Jun Sasaki

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Headed stud shear connections are widely used in the junction or embedded zone of hybrid girder to achieve whole composite action with continuity that can sustain steel-concrete interfacial tensile and shear forces. In Japan, Japan Road Association (JRA) specifications are used for hybrid girder design that utilizes very low level of stud capacity than those of American Institute of Steel Construction (AISC) specifications, Japan Society of Civil Engineers (JSCE) specifications and EURO code. As low design shear strength is considered in design of connections, the time dependent shear behavior due to sustained external loading is not considered, even not fully studied. In this study, a finite element approach was used to evaluate the time dependent shear behavior for headed studs used as connections at the junction. This study clarified, how the sustained loading distinctively impacted on changing the interfacial shear of connections with time which was sensitive to lodging history, positions of flanges, neighboring studs, position of prestress bar and reinforcing bar, concrete strength, etc. and also identified a shear influence area. Stud strength was also confirmed through pushout tests. The outcome obtained from the study may provide an important basis and reference data in designing connections of hybrid girders with enhanced stud capacity with due consideration of their long-term shear behavior.

Keywords: finite element, hybrid girder, shear connections, sustained loading, time dependent behavior

Procedia PDF Downloads 126

Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

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Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

Procedia PDF Downloads 54

Authors: Balakrishna Valluru, Ruth Suckling

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A 16 year old male was found collapsed on the road following stab injuries to the chest and abdomen and was transported to the emergency department by ambulance. On arrival in the emergency department the patient was breathless and appeared pale. He was maintaining his airway with spontaneous breathing and had a heart rate of 122 beats per minute with a blood pressure of 83/63 mmHg. He was resuscitated initially with three units of packed red cells. Clinical examination identified three incisional wounds each measuring 2 cm. These were in the left para-sternal region, right infra-scapular region and left upper quadrant of the abdomen. The chest wound over the left parasternal area at the level of 4tth intercostal space was bleeding intermittently on leaning forwards and was relieving his breathlessness intermittently. CT imaging was performed to characterize his injuries and determine his management. CT scan of chest and abdomen showed moderate size haemopericardium with left sided haemopneumothorax. The patient underwent urgent surgical repair of the left ventricle and left anterior descending artery. He recovered without complications and was discharged from the hospital. This case highlights the fact that the potential to develop a life threatening cardiac tamponade was mitigated by the left parasternal stab wound. This injury fortuitously provided a pericardial window through which the bleeding from the injured left ventricle and left anterior descending artery could drain into the left hemithorax providing an opportunity for timely surgical intervention to repair the cardiac injuries.

Keywords: stab, incisional, haemo-pericardium, haemo-pneumothorax

Procedia PDF Downloads 197

Authors: Ren Moses, Emmanuel Kidando, Eren Ozguven, Yassir Abdelrazig

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Although older drivers (defined as those of age 65 and above) are less involved with speeding, alcohol use as well as night driving, they are more vulnerable to severe crashes. The major contributing factors for severe crashes include frailty and medical complications. Several studies have evaluated the contributing factors on severity of crashes. However, few studies have established the impact of travel time reliability (TTR) on road safety. In particular, the impact of TTR on senior adults who face several challenges including hearing difficulties, decreasing of the processing skills and cognitive problems in driving is not well established. Therefore, this study focuses on determining possible impacts of TTR on the traffic safety with focus on elderly drivers. Historical travel speed data from freeway links in the study area were used to calculate travel time and the associated TTR metrics that is, planning time index, the buffer index, the standard deviation of the travel time and the probability of congestion. Four-year information on crashes occurring on these freeway links was acquired. The binary logit model estimated using the Markov Chain Monte Carlo (MCMC) sampling technique was used to evaluate variables that could be influencing elderly crash severity. Preliminary results of the analysis suggest that TTR is statistically significant in affecting the severity of a crash involving an elderly driver. The result suggests that one unit increase in the probability of congestion reduces the likelihood of the elderly severe crash by nearly 22%. These findings will enhance the understanding of TTR and its impact on the elderly crash severity.

Keywords: highway safety, travel time reliability, elderly drivers, traffic modeling

Procedia PDF Downloads 482

Authors: Muzaffer Ali Yaygın, Mehmet Topçu

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This research aims to investigate morphological changes in urban patterns in urban renewal areas by using geographic information systems and to reveal pattern differences that occur before and after urban renewal processes by applying a morphological analysis. The concept of urban morphology is not involved in urban renewal and urban planning practices in Turkey. This situation destroys the structural characteristic of urban space which appears as a consequence of changes at city, street or plot level. Different approaches and renewal interventions to urban settlements, which are formed as a reflection of cultural issues, may have positive and negative results. A morphological analysis has been applied to an urban renewal area that covers 325 ha. in Konya, in which city urban renewal projects have gained speed with the increasing of economic investments in this study. The study mentions urban renewal and urban morphology relationship, varied academic approach on the urban morphology issue, urban morphology components, changes in lots pattern and numerical differences that occur on road, construction and green space ratios that are before and after the renewal project, and the results of the morphological analysis. It is seen that the built-up area has significant differences when compared to the previous situation. The amount of green areas decreased significantly in quantitative terms; the transportation systems has been changed completely; and the property ownership has been reconstructed without taking the previous situation into account. Findings show that urban renewal projects in Turkey are put into practice with a rent-oriented approach without making an in-depth analysis. The paper discusses the morphological dimension of urban renewal projects in Turkey through a case study from Konya city.

Keywords: Konya, pattern, urban morphology, urban renewal

Procedia PDF Downloads 358