Search results for: multiple rare variants
4338 Reliability Assessment and Failure Detection in a Complex Human-Machine System Using Agent-Based and Human Decision-Making Modeling
Authors: Sanjal Gavande, Thomas Mazzuchi, Shahram Sarkani
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In a complex aerospace operational environment, identifying failures in a procedure involving multiple human-machine interactions are difficult. These failures could lead to accidents causing loss of hardware or human life. The likelihood of failure further increases if operational procedures are tested for a novel system with multiple human-machine interfaces and with no prior performance data. The existing approach in the literature of reviewing complex operational tasks in a flowchart or tabular form doesn’t provide any insight into potential system failures due to human decision-making ability. To address these challenges, this research explores an agent-based simulation approach for reliability assessment and fault detection in complex human-machine systems while utilizing a human decision-making model. The simulation will predict the emergent behavior of the system due to the interaction between humans and their decision-making capability with the varying states of the machine and vice-versa. Overall system reliability will be evaluated based on a defined set of success-criteria conditions and the number of recorded failures over an assigned limit of Monte Carlo runs. The study also aims at identifying high-likelihood failure locations for the system. The research concludes that system reliability and failures can be effectively calculated when individual human and machine agent states are clearly defined. This research is limited to the operations phase of a system lifecycle process in an aerospace environment only. Further exploration of the proposed agent-based and human decision-making model will be required to allow for a greater understanding of this topic for application outside of the operations domain.Keywords: agent-based model, complex human-machine system, human decision-making model, system reliability assessment
Procedia PDF Downloads 1684337 Collocation Errors Made by Saudi Learners of English
Authors: Pakenam Shiha, Nadine Lacsina
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Systematic and in-depth analysis of ESL learners’ lexical errors, in general, and of collocation errors, in particular, are relatively rare. Analysis as such proves crucial in understanding how ESL learners construct and use these fixed expressions. Collocational competence of ESL learners is necessary for achieving a native-like proficiency level, which is one of the objectives of foundation programs. This study aims to examine the collocational competence of 50 Saudi foundation program students and identify the collocation errors that they often make. Furthermore, using a questionnaire, the challenges that students encounter in learning collocations and the ways in which their L1 affects their ability to recognize these expressions are identified. To identify the lexical errors and the collocational competence of the students a collocation test was administered. The 150-item lexical collocation test consists of verb-noun and adjective-noun structures. Results of the study reveal that there is a significant difference between the scores of students in the verb-noun and adjective-noun structures. The majority of errors were recorded in the adjective-noun structures due to the students’ L1 influence on the English collocations and the inability to distinguish between synonyms. Moreover, some challenges that students encountered were problems in translation, non-exposure to certain collocations, and degree of L1-L2 difference. All in all, the findings of this study can be interpreted in relation to the student's proficiency level and L2 instruction. Other findings of the study provide insights into language pedagogy—specifically strategies to help students learn collocations more effectively.Keywords: collocations, ESL, applied linguistics, lexical collocations
Procedia PDF Downloads 1224336 Rural Nurses as a Consistent Resource
Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal
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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.Keywords: rural nurse, alone, burnout, multiple tasks
Procedia PDF Downloads 694335 Upconversion Nanoparticles for Imaging and Controlled Photothermal Release of Anticancer Drug in Breast Cancer
Authors: Rishav Shrestha, Yong Zhang
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The Anti-Stoke upconversion process has been used extensively for bioimaging and is recently being used for photoactivated therapy in cancer utilizing upconversion nanoparticles (UCNs). The UCNs have an excitation band at 980nm; 980nm laser excitation used to produce UV/Visible emissions also produce a heating effect. Light-to-heat conversion has been observed in nanoparticles(NPs) doped with neodymium(Nd) or ytterbium(Yb)/erbium(Er) ions. Despite laser-induced heating in Rare-earth doped NPs being proven to be a relatively efficient process, only few attempts to use them as photothermal agents in biosystems have been made up to now. Gold nanoparticles and carbon nanotubes are the most researched and developed for photothermal applications. Both have large heating efficiency and outstanding biocompatibility. However, they show weak fluorescence which makes them harder to track in vivo. In that regard, UCNs are attractive due to their excellent optical features in addition to their light-to-heat conversion and excitation by NIR, for imaging and spatiotemporally releasing drugs. In this work, we have utilized a simple method to coat Nd doped UCNs with thermoresponsive polymer PNIPAM on which 4-Hydroxytamoxifen (4-OH-T) is loaded. Such UCNs demonstrate a high loading efficiency and low leakage of 4-OH-T. Encouragingly, the release of 4-OH-T can be modulated by varying the power and duration of the NIR. Such UCNs were then used to demonstrate imaging and controlled photothermal release of 4-OH-T in MCF-7 breast cancer cells.Keywords: cancer therapy, controlled release, photothermal release, upconversion nanoparticles
Procedia PDF Downloads 4224334 Easy Way of Optimal Process-Storage Network Design
Authors: Gyeongbeom Yi
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The purpose of this study is to introduce the analytic solution for determining the optimal capacity (lot-size) of a multiproduct, multistage production and inventory system to meet the finished product demand. Reasonable decision-making about the capacity of processes and storage units is an important subject for industry. The industrial solution for this subject is to use the classical economic lot sizing method, EOQ/EPQ (Economic Order Quantity/Economic Production Quantity) model, incorporated with practical experience. However, the unrealistic material flow assumption of the EOQ/EPQ model is not suitable for chemical plant design with highly interlinked processes and storage units. This study overcomes the limitation of the classical lot sizing method developed on the basis of the single product and single stage assumption. The superstructure of the plant considered consists of a network of serially and/or parallelly interlinked processes and storage units. The processes involve chemical reactions with multiple feedstock materials and multiple products as well as mixing, splitting or transportation of materials. The objective function for optimization is minimizing the total cost composed of setup and inventory holding costs as well as the capital costs of constructing processes and storage units. A novel production and inventory analysis method, PSW (Periodic Square Wave) model, is applied. The advantage of the PSW model comes from the fact that the model provides a set of simple analytic solutions in spite of a realistic description of the material flow between processes and storage units. The resulting simple analytic solution can greatly enhance the proper and quick investment decision for plant design and operation problem confronted in diverse economic situations.Keywords: analytic solution, optimal design, process-storage network
Procedia PDF Downloads 3314333 Methodology for the Integration of Object Identification Processes in Handling and Logistic Systems
Authors: L. Kiefer, C. Richter, G. Reinhart
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The uprising complexity in production systems due to an increasing amount of variants up to customer innovated products leads to requirements that hierarchical control systems are not able to fulfil. Therefore, factory planners can install autonomous manufacturing systems. The fundamental requirement for an autonomous control is the identification of objects within production systems. In this approach an attribute-based identification is focused for avoiding dose-dependent identification costs. Instead of using an identification mark (ID) like a radio frequency identification (RFID)-Tag, an object type is directly identified by its attributes. To facilitate that it’s recommended to include the identification and the corresponding sensors within handling processes, which connect all manufacturing processes and therefore ensure a high identification rate and reduce blind spots. The presented methodology reduces the individual effort to integrate identification processes in handling systems. First, suitable object attributes and sensor systems for object identification in a production environment are defined. By categorising these sensor systems as well as handling systems, it is possible to match them universal within a compatibility matrix. Based on that compatibility further requirements like identification time are analysed, which decide whether the combination of handling and sensor system is well suited for parallel handling and identification within an autonomous control. By analysing a list of more than thousand possible attributes, first investigations have shown, that five main characteristics (weight, form, colour, amount, and position of subattributes as drillings) are sufficient for an integrable identification. This knowledge limits the variety of identification systems and leads to a manageable complexity within the selection process. Besides the procedure, several tools, as an example a sensor pool are presented. These tools include the generated specific expert knowledge and simplify the selection. The primary tool is a pool of preconfigured identification processes depending on the chosen combination of sensor and handling device. By following the defined procedure and using the created tools, even laypeople out of other scientific fields can choose an appropriate combination of handling devices and sensors which enable parallel handling and identification.Keywords: agent systems, autonomous control, handling systems, identification
Procedia PDF Downloads 1774332 Anti-Parasite Targeting with Amino Acid-Capped Nanoparticles Modulates Multiple Cellular Processes in Host
Authors: Oluyomi Stephen Adeyemi, Kentaro Kato
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Toxoplasma gondii is the etiological agent of toxoplasmosis, a common parasitic disease capable of infecting a range of hosts, including nearly one-third of the human population. Current treatment options for toxoplasmosis patients are limited. In consequence, toxoplasmosis represents a large global burden that is further enhanced by the shortcomings of the current therapeutic options. These factors underscore the need for better anti-T. gondii agents and/or new treatment approach. In the present study, we sought to find out whether preparing and capping nanoparticles (NPs) in amino acids, would enhance specificity toward the parasite versus the host cell. The selection of amino acids was premised on the fact that T. gondii is auxotrophic for some amino acids. The amino acid-nanoparticles (amino-NPs) were synthesized, purified and characterized following established protocols. Next, we tested to determine the anti-T. gondii activity of the amino-NPs using in vitro experimental model of infection. Overall, our data show evidence that supports enhanced and excellent selective action against the parasite versus the host cells by amino-NPs. The findings are promising and provide additional support that warrants exploring the prospects of NPs as alternative anti-parasite agents. In addition, the anti-parasite action by amino-NPs indicates that nutritional requirement of parasite may represent a viable target in the development of better alternative anti-parasite agents. Furthermore, data suggest the anti-parasite mechanism of the amino-NPs involves multiple cellular processes including the production of reactive oxygen species (ROS), modulation of hypoxia-inducing factor-1 alpha (HIF-1α) as well as the activation of kynurenine pathway. Taken together, findings highlight further, the prospects of NPs as alternative source of anti-parasite agents.Keywords: drug discovery, infectious diseases, mode of action, nanomedicine
Procedia PDF Downloads 1124331 Factors Affecting Online Health Seeking Behaviors in Middle-Income Class Filipino Adults
Authors: Reinzo Vittorio B. Cardenas, Heather Venice L. Abogado, Andrea Therese V. Afable, Rhea D. Avillanoza, Marie Abegail P. Ayagan, Catherine D. Bantayan
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As the Internet provides fast and reliable health-related information, the tendency to self-diagnose increases to further understand medical jargon in a diagnosis with a physician and decreases costly consultation fees. The study aimed to explore and understand the factors affecting online health-seeking behaviors in middle-income class adults in Metro Manila. The study was conducted from March to April of 2021 with a sample size of 200 individuals aged 20 to 49 years old. The study was delivered via an online survey that used a questionnaire adapted from the research of Lee et al. (2015). Specifically, the survey consisted of three sections: assessing web-based health-seeking behaviors, consultation with health professionals, and participants' hesitancy to consult with physicians, which used a mix of a 5-point Likert-type scale with multiple responses and multiple-choice options. The results showed that the age and educational attainment of the respondents had a negative effect while presenting a positive effect of socio-economic status on health-seeking behavior. Lastly, there was a significant effect of participant’s hesitancy for professional consultation on their health-seeking behavior. The results gleaned from the study indicated that various individual and socio-economic factors might significantly affect one’s health-seeking behaviors. Although hesitancy had a significant effect on the spectrum of health-seeking behaviors, this does not imply that certain factors are specifically related to an individual’s tendency to seek health information. This information instead becomes essential in understanding the patient-physician relationship and giving patients a more holistic treatment.Keywords: health-seeking behavior, health information, Internet, physician consultation
Procedia PDF Downloads 2164330 Using Multiomic Plasma Profiling From Liquid Biopsies to Identify Potential Signatures for Disease Diagnostics in Late-Stage Non-small Cell Lung Cancer (NSCLC) in Trinidad and Tobago
Authors: Nicole Ramlachan, Samuel Mark West
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Lung cancer is the leading cause of cancer-associated deaths in North America, with the vast majority being non-small cell lung cancer (NSCLC), with a five-year survival rate of only 24%. Non-invasive discovery of biomarkers associated with early-diagnosis of NSCLC can enable precision oncology efforts using liquid biopsy-based multiomics profiling of plasma. Although tissue biopsies are currently the gold standard for tumor profiling, this method presents many limitations since these are invasive, risky, and sometimes hard to obtain as well as only giving a limited tumor profile. Blood-based tests provides a less-invasive, more robust approach to interrogate both tumor- and non-tumor-derived signals. We intend to examine 30 stage III-IV NSCLC patients pre-surgery and collect plasma samples.Cell-free DNA (cfDNA) will be extracted from plasma, and next-generation sequencing (NGS) performed. Through the analysis of tumor-specific alterations, including single nucleotide variants (SNVs), insertions, deletions, copy number variations (CNVs), and methylation alterations, we intend to identify tumor-derived DNA—ctDNA among the total pool of cfDNA. This would generate data to be used as an accurate form of cancer genotyping for diagnostic purposes. Using liquid biopsies offer opportunities to improve the surveillance of cancer patients during treatment and would supplement current diagnosis and tumor profiling strategies previously not readily available in Trinidad and Tobago. It would be useful and advantageous to use this in diagnosis and tumour profiling as well as to monitor cancer patients, providing early information regarding disease evolution and treatment efficacy, and reorient treatment strategies in, timethereby improving clinical oncology outcomes.Keywords: genomics, multiomics, clinical genetics, genotyping, oncology, diagnostics
Procedia PDF Downloads 1614329 Physiological Response of Water-Restricted Xhosa Goats Supplemented with Vitamin C
Authors: O.F. Akinmoladun, F.N. Fon, C.T. Mpendulo, O. Okoh
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The sustainability of livestock production is under threat as a result of water scarcity, fluctuating precipitation, and high environmental temperature. These combined stressors have impacted negatively on general animal production and welfare, necessitating a very reliable and cost-effective management practices, especially in arid and water-limited regions of the world. Instead of the above, this study was designed to investigate the growth performance and physiological response of water-restricted Xhosa ear-lobe goats fed diets supplemented with single or multiple vitamin C (VC) during summer. The total forty-eight goats used for the experiment were balanced for body weight and randomly assigned to the seven treatment groups (seven goats/treatment): GI (W100%); GII (W70%); GIII (W50%); GIV (W70%+3g/day VC); GV ((W50% +3g/day VC); GVI (W70%+3g/d VC+extra 5g on every eight-day); GVII (W50%+3g/d VC+extra 5g on every eight-day). The design was a complete randomized design and VC was administered per os. At the end of the 75-day feeding trial, GIII (W50%) animals were the most affected (P<0.05) and the effect was more pronounced in their body condition scores (BCs). Weight loss and depression in feed intake due to water restriction (P<0.05) were attenuated by VC treated groups (GIV-GVII). Changes in body thermal gradient (BTG) and rectal temperature (RcT) were similar (P>0.05) across the various experimental groups. The attenuation effect of VC was significant in responses to respiratory rate (RR) and cortisol. Supplementation of VC (either single or multiple) did not significantly (P>0.05) improve water restriction effect on body condition scores (BCs) and FAMACHA©. The current study found out that Xhosa ear lobe goats can adapt to the prevailing bioclimatic changes and limited water intake. However, supplementation of vitamin C can be beneficial at modulating these stressful stimuli. Continuous consistencies in the outcome of vitamin C on water-stressed animals can help validate recommendations especially to farmers in the arid and water-limited regions across the globe.Keywords: vitamin C, Xhosa ear-lobe, thermotolerance, water stress
Procedia PDF Downloads 1314328 Assessment of Population Trends of Birds at Taunsa Barrage Wildlife Sanctuary, Pakistan
Authors: Fehmeada Bibi, Shafqat Nawaz Qaisrani, Masood Akhtar, Zulfiqar Ali
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Population trends learning is an important tool for conservation programs in rare as well as in common species of birds. A study was conducted to assess annual decline in species of birds and to identify the causes of this decline at Taunsa Barrage wildlife Sanctuary, Punjab, Pakistan. Data were collected by direct census method during wintering and breeding periods (2001 to 2002 and 2008 to 2011). The results indicated an increasing trend in 157, whereas a decreasing trend in 14 species of birds. Among the species with declining trend, there was a 92% decrease in White-backed Vulture (Gyps bengalensis), 60% in Greater Painted Snipe (Rostratula benghalensis), 57% in Garganey (Anas querquedula), Pallas’s Fish Eagle and Long-legged Buzzard (Buteo rufinus) 50% each, 41% in Grey Heron (Ardea cinerea), 39% in Little Cormorant (Phalacrocorax niger), 37% in Gadwall (Anas strepera), 33% in Marsh Harrier (Circus aeruginosus), 30% in Black Drongo (Dicrurus macrocercus) and 26% in Red-crested Pochard (Netta rufina) population. Habitat exploitation, hunting and grazing were found the main causes of this decline. In conclusion, conservation and management of the study area is foremost to interests of declining bird population. It is suggested, therefore, to take immediate steps for the protection of the sanctuary to conserve the declining population of birds.Keywords: population trends, wildlife sanctuary, bird, habitat exploitation
Procedia PDF Downloads 2754327 The out of Proportion - Pulmonary Hypertension in Indians with Chronic Lung Disease
Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale
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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.Keywords: COPD, pulmonary hypertension, chronic lung disease, India
Procedia PDF Downloads 3574326 Flow Behavior of a ScCO₂-Stimulated Geothermal Reservoir under in-situ Stress and Temperature Conditions
Authors: B. L. Avanthi Isaka, P. G. Ranjith
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The development of technically-sound enhanced geothermal systems (EGSs) is identified as a viable solution for world growing energy demand with immense potential, low carbon dioxide emission and importantly, as an environmentally friendly option for renewable energy production. The use of supercritical carbon dioxide (ScCO₂) as the working fluid in EGSs by replacing traditional water-based method is promising due to multiple advantages prevail in ScCO₂-injection for underground reservoir stimulation. The evolution of reservoir stimulation using ScCO₂ and the understanding of the flow behavior of a ScCO₂-stimulated geothermal reservoir is vital in applying ScCO₂-EGSs as a replacement for water-based EGSs. The study is therefore aimed to investigate the flow behavior of a ScCO₂-fractured rock medium at in-situ stress and temperature conditions. A series of permeability tests were conducted for ScCO₂ fractured Harcourt granite rock specimens at 90ºC, under varying confining pressures from 5–60 MPa using the high-pressure and high-temperature tri-axial set up which can simulate deep geological conditions. The permeability of the ScCO₂-fractured rock specimens was compared with that of water-fractured rock specimens. The results show that the permeability of the ScCO₂-fractured rock specimens is one order higher than that of water-fractured rock specimens and the permeability exhibits a non-linear reduction with increasing confining pressure due to the stress-induced fracture closure. Further, the enhanced permeability of the ScCO₂-induced fracture with multiple secondary branches was explained by exploring the CT images of the rock specimens. However, a single plain fracture was induced under water-based fracturing.Keywords: supercritical carbon dioxide, fracture permeability, granite, enhanced geothermal systems
Procedia PDF Downloads 1474325 Global and Diffuse Solar Radiation Studies over Seven Cities of Sindh, Pakistan for Power Generation
Authors: M. A. Ahmed, Sidra A. Shaik
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Global and diffuse solar radiation on horizontal surface over seven cities of Sindh namely Karachi, Hyderabad, Chore, Padidan, Nawabshah, Rohri and Jacobabad were carried out using sunshine hour data of the area to assess the feasibility of solar energy utilization at Sindh province. The result obtained shows a variation of direct and diffuse component of solar radiation in summer and winter months in southern Sindh (50% direct and 50% diffuse for Karachi, and Hyderabad) where there is a large variation in direct and diffuse component of solar radiation in summer and winter months in northern region (80% direct and 20% diffuse for Rohri and Jacobabad). In southern Sindh, the contribution of diffuse solar radiation is higher during the monsoon months (July and August). The sky remains clear during September to June. In northern Sindh (Rohri and Jacobabad) the contribution of diffuse solar radiation is low even in monsoon months i,e in July and August. The Kt value for northern Sindh indicates a clear sky. In northern part of the Sindh percentage of diffuse radiation does not exceed more than 20%. The appearance of cloud is rare. From the point of view of power generation, the estimated values indicate that northern part of Sindh has high solar potential while the southern part has low solar potential.Keywords: global and diffuse solar radiation, solar potential, Province of Sindh, solar radiation studies for power generation
Procedia PDF Downloads 3174324 A Framework for Assessing and Implementing Ecological-Based Adaptation Solutions in Urban Areas of Shanghai
Authors: Xin Li
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The uncertainty and the complexity of the urban environment combining with the threat of climate change are contributing factors to the vulnerability in multiple-dimensions in Chinese megacities, especially in Shanghai. The urban area occupied high valuable technological infrastructure and density buildings is under the threats of climate change and can provide insufficient ecological service to remain the trade-off on urban sustainable development. Urban ecological-based adaptation (UEbA) combines practices and theoretical work and integrates ecological services into multiple-layers of urban environment planning in order to reduce the impact of the complexity and uncertainty. To understand and to respond to the challenges in the urban level, this paper considers Shanghai as the research objective. It is necessary that its urban adaptation strategies should be reflected and contain the concept and knowledge of EbA. In this paper, we firstly use software to illustrates the visualizing patterns and trends of UEBA research in the current 10 years. Specifically, Citespace software was used for interpreting the significant hubs, landmarks points of peer-reviewed literature on the context of ecological service research in recent 10 years. Secondly, 135 evidence-based EbA literature were reviewed for categorizing the methodologies and framework of evidence-based EbA by the systematic map protocol. Finally, a conceptual framework combined with culture, economic and social components was developed in order to assess the current adaptation strategies in Shanghai. This research founds that the key to reducing urban vulnerability does not only focus on co-benefit arguments but also should pay more attention to the concept of trade-off. This research concludes that the designed framework can provide key knowledge and indicates the essential gap as a valuable tool against climate variability in the process of urban adaptation in Shanghai.Keywords: urban ecological-based adaptation, climate change, sustainable development, climate variability
Procedia PDF Downloads 1554323 Hygrothermal Assessment of Internally Insulated Prefabricated Concrete Wall in Polish Climatic Condition
Authors: D. Kaczorek
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Internal insulation of external walls is often problematic due to increased moisture content in the wall and interstitial or surface condensation risk. In this paper, the hygrothermal performance of prefabricated, concrete, large panel, external wall typical for WK70 system, commonly used in Poland in the 70’s, with inside, additional insulation was investigated. Thermal insulation board made out of hygroscopic, natural materials with moisture buffer capacity and extruded polystyrene (EPS) board was used as interior insulation. Experience with this natural insulation is rare in Poland. The analysis was performed using WUFI software. First of all, the impact of various standard boundary conditions on the behavior of the different wall assemblies was tested. The comparison of results showed that the moisture class according to the EN ISO 13788 leads to too high values of total moisture content in the wall since the boundary condition according to the EN 15026 should be usually applied. Then, hygrothermal 1D-simulations were conducted by WUFI Pro for analysis of internally added insulation, and the weak point like the joint of the wall with the concrete ceiling was verified using 2D simulations. Results showed that, in the Warsaw climate and the indoor conditions adopted in accordance with EN 15026, in the tested wall assemblies, regardless of the type of interior insulation, there would not be any problems with moisture - inside the structure and on the interior surface.Keywords: concrete large panel wall, hygrothermal simulation, internal insulation, moisture related issues
Procedia PDF Downloads 1654322 From Cultural Diversity to Cultural Diplomacy: The Practice of Normative Power Europe
Authors: Tzuli Lin
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This paper aims to explore that the EU and Member State (UK) converges on cultural diplomacy to constitute an influential European external relations. It will address the development of EU cultural diplomacy and practice at Member state level. It also discusses the EU and Member States suffering in cultural resource overlapped. In contrast to the literature on the EU external relations, studies of the cultural dimension are rare. Thus, this paper will utilise the broad policy papers to explore how the cultural diversity among the Member States and the EU has a constructive progress at European level but not at Member State level. It can be argued that cultural component is the pivotal strategy for the stagnated EU external relations since the Euro crisis. The EU recognises that if it wants to promote the trade relations from the inside of Europe to outside, it requires the broad culture context among its traditional diplomacy, which brings the cultural component into a significant role. Even though in the area of Member State level, they share the fundamental value and idea, it does not elaborate Member States regarding the EU as a representative of European cultural diplomacy. In theory and practice, the discourse of Normative Power Europe (NPE) can be the analytic framework to construct the research of cultural diplomacy in Europe. NPE is an idea of the EU’s global role and spreading its norms to others. Moreover, Member States’ national interest has supreme priority rather than the EU. Therefore, this paper will utilise the UK as a case study to explore that cultural diplomacy shows fragmentation at European level. In the result, this paper will illustrate that the EU and the UK have mutual recognised each other as a partner not a leader.Keywords: EU cultural diplomacy, cultural policy, cultural diversity, normative power
Procedia PDF Downloads 3154321 Scoping Review of Biological Age Measurement Composed of Biomarkers
Authors: Diego Alejandro Espíndola-Fernández, Ana María Posada-Cano, Dagnóvar Aristizábal-Ocampo, Jaime Alberto Gallo-Villegas
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Background: With the increase in life expectancy, aging has been subject of frequent research, and therefore multiple strategies have been proposed to quantify the advance of the years based on the known physiology of human senescence. For several decades, attempts have been made to characterize these changes through the concept of biological age, which aims to integrate, in a measure of time, structural or functional variation through biomarkers in comparison with simple chronological age. The objective of this scoping review is to deepen the updated concept of measuring biological age composed of biomarkers in the general population and to summarize recent evidence to identify gaps and priorities for future research. Methods: A scoping review was conducted according to the five-phase methodology developed by Arksey and O'Malley through a search of five bibliographic databases to February 2021. Original articles were included with no time or language limit that described the biological age composed of at least two biomarkers in those over 18 years of age. Results: 674 articles were identified, of which 105 were evaluated for eligibility and 65 were included with information on the measurement of biological age composed of biomarkers. Articles from 1974 of 15 nationalities were found, most observational studies, in which clinical or paraclinical biomarkers were used, and 11 different methods described for the calculation of the composite biological age were informed. The outcomes reported were the relationship with the same measured biomarkers, specified risk factors, comorbidities, physical or cognitive functionality, and mortality. Conclusions: The concept of biological age composed of biomarkers has evolved since the 1970s and multiple methods of its quantification have been described through the combination of different clinical and paraclinical variables from observational studies. Future research should consider the population characteristics, and the choice of biomarkers against the proposed outcomes to improve the understanding of aging variables to direct effective strategies for a proper approach.Keywords: biological age, biological aging, aging, senescence, biomarker
Procedia PDF Downloads 1864320 Enhancing Self-Assessment and Management Potentials by Modifying Option Selections on Hartman’s Personality Test
Authors: Daniel L. Clinciu, IkromAbdulaev, Brian D. Oscar
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Various personality profile tests are used to identify personality strengths and limits in individuals, helping both individuals and managers to optimize work and team effort in organizations. One such test, Hartman’s personality profile emphasizes four driving "core motives" influenced or affected by both strengths and limitations. The driving core motives are classified into four colors: Red-motivated by power; Blue-discipline and loyalty; White-peace; and Yellow–fun loving. Two shortcomings of Hartman’s personality test are noted; 1) only one choice for every item/situation allowed and 2) selection of a choice even if not applicable. A test taker may be as much nurturing as he is opinionated but since “opinionated” seems less attractive the individual would likely select nurturing, causing a misidentification in personality strengths and limits. Since few individuals have a "strong" personality, it is difficult to assess their true personality strengths and limits allowing either only one choice or requiring unwanted choices, undermining the potential of the test. We modified Hartman’s personality profile allowing test takers to make either multiple choices for any item/situation or leave them blank when not applying. Sixty-eight participants (38 males and 30 females), 17-49 years old, from countries in Asia, Europe, N. America, CIS, Africa, Latin America, and Oceania were included. 58 participants (85.3%) reported the modified test, allowing either multiple or no choices better identified their personality strengths and limits, while 10 participants (14.7%) expressed the original (one choice version) is sufficient. The overall results show our modified test enhanced the identification and balance of personality strengths and limits, aiding test takers, managers, and firms to better understand personality strengths and limits, particularly useful in making task-related, teamwork, and management decisions.Keywords: organizational behavior, personality tests, personality limitations, personality strengths, task management, team work
Procedia PDF Downloads 3624319 Exploring Teachers’ Professional Identity in the Context of the Current Political Conflict in Palestine
Authors: Bihan Qaimari
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In many areas of the world there are political conflicts the consequences of which have an inevitable impact on the educational system. Palestine is one such country where the experience of political conflict, going back over many years, has had a devastating effect on the development and maintenance of a stable educational environment for children and their teachers. Up to now there have been few studies that have focussed on the effects of living and working in a war zone on the professional identity of teachers. The aim of this study is to explore how the formation of Palestinian teachers’ professional identity is affected by their experience of the current political conflict its impact on the school social culture. In order to gain an in-depth understanding of the impact of political violence on the formation of the professional identity of Palestinian teachers, a qualitative multiple case-study approach was adopted which draws on sociocultural theories of identity formation. An initial study was first conducted in six schools and this was followed by an in-depth study of teachers working in three further primary schools. Data sources included participant observation, a research diary, semi-structured group and individual interviews. Grounded theory, constant-comparative methods, and discourse analysis procedures were used to interpret the data. The findings suggest that the Palestinian primary school teachers negotiate multiple conflicting identities through their every day experiences of political conflict and the schools’ social culture. This tension is formed as a result of the historical cultural meaning that teachers construct about themselves and within the current unstable and unsettling conditions that exist in their country. In addition, the data indicate that the geographical location of the schools in relation of their proximity to the events of the political conflict also had an influence on the degree of tension inherent in teachers’ professional identity. The study makes significant theoretical, practical, and methodical contributions to the study of the formation of teachers’ professional identity in countries affected by political conflict.Keywords: identity, political conflict, Palestine, teacher's professional identity
Procedia PDF Downloads 4124318 Consequences of Youth Bulge in Pakistan
Authors: Muhammad Farooq, Muhammad Idrees
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The present study has been designed to explore the causes and effects of Youth Bulge in Pakistan. However, youth bulge is a part of population segment which create problem for the whole society. The youth bulge is a common phenomenon in many developing countries, and in particular, in the least developed countries. It is often due to a stage of development where a country achieves success in reducing infant mortality but mothers still have a high fertility rate. The result is that a large share of the population is comprised of children and young adults, and today’s children are tomorrow’s young adults. Youth often play a prominent role in political violence and the existence of a “youth bulge” has been associated with times of political crisis. The population pyramid of Pakistan represents a large youth proportion and our government did not use that youth in positive way and did not provide them opportunity for development, this situation creates frustration in youth that leads them towards conflict, unrest and violence. This study will be focus on the opportunity and motives of the youth bulge situation in Pakistan in the lens of youth bulge theory. Moreover, it will give some suggestions to utilize youth in the development activities and avoid youth bulge situation in Pakistan. The present research was conducted in the metropolitan entities of Punjab, Pakistan. A sample of 300 respondents was taken from three randomly selected metropolitan entities (Faisalabad, Lahore and Rawalpindi) of Punjab Province of Pakistan. Information regarding demography, household, locality and other socio-cultural variables related to causes and effects of youth bulge in the state was collected through a well structured interview schedule. Mean, Standard Deviation and frequency distribution were used to check the measure of central tendency. Multiple linear regression was also applied to measure the influence of various independent variables on the response variable.Keywords: youth bulge, violence, conflict, social unrest, crime, metropolitan entities, mean, standard deviation, multiple linear regression
Procedia PDF Downloads 4594317 Mature Cystic Teratomas of Ovary: A Series of 19 Cases with Rare Malignant Transformation in Three
Authors: Parveen Kundu, Nitika Chawla, Ruchi Agarwal, Swaran Kaur
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Background: Mature cystic teratoma is a benign, most common tumor of the ovary occurring mostly in young and middle-aged females. This study consists of 19 cases of mature cystic teratomas which were received in the Department Of Pathology over a period of two years. There were malignant transformations observed in three cases, which makes it very important for pathologists to thoroughly examine the entire specimen of mature cystic teratomas. Material and Methods: Nineteen reported cases of mature cystic teratomas were received in Deptt. Of Pathology, BPS GMC Khanpur Kalan, Sonepat, over a two-year period from November 2020 to October 2022 and reviewed retrospectively. Data regarding age, size, laterality, gross, morphological features, and surgery performed were retrieved from pathological archives. Results: In our study, the most common age of presentation was the 20-40 year age group. The most common presenting complaint was fullness in the abdomen or abdominal distension. Four out of 19 cases studied cases presented with bilateral ovarian cysts. Tumor size ranged from 6 to 20 cm in diameter. In seven cases, cysts were greater than or equal to 10 cm in diameter. Three cases showed malignant transformation. Conclusion: It is very important to thoroughly examine the contralateral ovary to rule out bilateral presentation. A furthermost thorough examination is advised in tumors of size >10 cm and in tumors with solid areas to rule out any malignant transformation.Keywords: teratoma, ovary, malignant, transformation
Procedia PDF Downloads 874316 The Psychological Impact of War Trauma on Refugees
Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis
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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.Keywords: psychiatric disorders, refugees, war survivors, war trauma
Procedia PDF Downloads 2004315 Contribution of mTOR to Oxidative/Nitrosative Stress via NADPH Oxidase System Activation in Zymosan-Induced Systemic Inflammation in Rats
Authors: Seyhan Sahan-Firat, Meryem Temiz-Resitoglu, Demet Sinem Guden, Sefika Pinar Kucukkavruk, Bahar Tunctan, Ayse Nihal Sari, Zumrut Kocak
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We hypothesized that mTOR inhibition may prevent the multiple organ failures following severe multiple tissue injury associated with increased NADPH oxidase system activity occur in zymosan-induced systemic inflammation. Therefore, we investigated the role of mTOR in oxidative/nitrosative stress associated with increase in NADPH oxidase activity in zymosan-induced systemic inflammation model in rats. Male Wistar rats received saline (4 ml/kg, i.p.) and zymosan (500 mg/kg, i.p.) at time 0. Saline, or zymosan-treated rats were given rapamycin (1 mg/kg, i.p.) 1 h after saline or zymosan injections. Rats were sacrified 4 h after zymosan challenge and kidney, heart, thoracic aorta, and superior mesenteric artery were collected. NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels were measured in tissue samples. Zymosan administration caused an increase in NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels in kidney, heart, thoracic aorta, and superior mesenteric artery. These changes caused by zymosan reversed by rapamycin, a selective mTOR inhibitor. Rapamycin alone had no effect on the parameters measured. Our results demonstrated that zymosan-induced oxidative/nitrosative stress presumably due to enhanced activity of NADPH oxidase, expression of p22phox, gp91phox, and p47phox and production of peroxynitrite were mediated by mTOR. [This work was financially supported by Research Foundation of Mersin University (2016-2-AP3-1900)].Keywords: oxidative stress, mTOR, nitrosative stress, zymosan
Procedia PDF Downloads 3144314 Dislocation Density-Based Modeling of the Grain Refinement in Surface Mechanical Attrition Treatment
Authors: Reza Miresmaeili, Asghar Heydari Astaraee, Fereshteh Dolati
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In the present study, an analytical model based on dislocation density model was developed to simulate grain refinement in surface mechanical attrition treatment (SMAT). The correlation between SMAT time and development in plastic strain on one hand, and dislocation density evolution, on the other hand, was established to simulate the grain refinement in SMAT. A dislocation density-based constitutive material law was implemented using VUHARD subroutine. A random sequence of shots is taken into consideration for multiple impacts model using Python programming language by utilizing a random function. The simulation technique was to model each impact in a separate run and then transferring the results of each run as initial conditions for the next run (impact). The developed Finite Element (FE) model of multiple impacts describes the coverage evolution in SMAT. Simulations were run to coverage levels as high as 4500%. It is shown that the coverage implemented in the FE model is equal to the experimental coverage. It is depicted that numerical SMAT coverage parameter is adequately conforming to the well-known Avrami model. Comparison between numerical results and experimental measurements for residual stresses and depth of deformation layers confirms the performance of the established FE model for surface engineering evaluations in SMA treatment. X-ray diffraction (XRD) studies of grain refinement, including resultant grain size and dislocation density, were conducted to validate the established model. The full width at half-maximum in XRD profiles can be used to measure the grain size. Numerical results and experimental measurements of grain refinement illustrate good agreement and show the capability of established FE model to predict the gradient microstructure in SMA treatment.Keywords: dislocation density, grain refinement, severe plastic deformation, simulation, surface mechanical attrition treatment
Procedia PDF Downloads 1364313 Exploring the Relationships between Cyberbullying Perceptions and Facebook Attitudes of Turkish Students
Authors: Yavuz Erdoğan, Hidayet Çiftçi
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Cyberbullying, a phenomenon among adolescents, is defined as actions that use information and communication technologies such as social media to support deliberate, repeated, and hostile behaviour by an individual or group. With the advancement in communication and information technology, cyberbullying has expanded its boundaries among students in schools. Thus, parents, psychologists, educators, and lawmakers must become aware of the potential risks of this phenomenon. In the light of these perspectives, this study aims to investigate the relationships between cyberbullying perception and Facebook attitudes of Turkish students. A survey method was used for the study and the data were collected by “Cyberbullying Perception Scale”, “Facebook Attitude Scale” and “Personal Information Form”. For this purpose, study has been conducted during 2014-2015 academic year, with a total of 748 students with 493 male (%65.9) and 255 female (%34.1) from randomly selected high schools. In the analysis of data Pearson correlation and multiple regression analysis, multivariate analysis of variance (MANOVA) and Scheffe post hoc test has been used. At the end of the study, the results displayed a negative correlation between Turkish students’ Facebook attitudes and cyberbullying perception (r=-.210; p<0.05). In order to identify the predictors of students’ cyberbullying perception, multiple regression analysis was used. As a result, significant relations were detected between cyberbullying perception and independent variables (F=5.102; p<0.05). Independent variables together explain 11.0% of the total variance in cyberbullying scores. The variables that significantly predict the students’ cyberbullying perception are Facebook attitudes (t=-5.875; p<0.05), and gender (t=3.035; p<0.05). In order to calculate the effects of independent variables on students’ Facebook attitudes and cyberbullying perception MANOVA was conducted. The results of the MANOVA indicate that the Facebook attitudes and cyberbullying perception were significantly differed according to students’ gender, age, educational attainment of the mother, educational attainment of the father, income of the family and daily usage of internet.Keywords: facebook, cyberbullying, attitude, internet usage
Procedia PDF Downloads 4024312 A Comprehensive Analysis of the Phylogenetic Signal in Ramp Sequences in 211 Vertebrates
Authors: Lauren M. McKinnon, Justin B. Miller, Michael F. Whiting, John S. K. Kauwe, Perry G. Ridge
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Background: Ramp sequences increase translational speed and accuracy when rare, slowly-translated codons are found at the beginnings of genes. Here, the results of the first analysis of ramp sequences in a phylogenetic construct are presented. Methods: Ramp sequences were compared from 211 vertebrates (110 Mammalian and 101 non-mammalian). The presence and absence of ramp sequences were analyzed as a binary character in a parsimony and maximum likelihood framework. Additionally, ramp sequences were mapped to the Open Tree of Life taxonomy to determine the number of parallelisms and reversals that occurred, and these results were compared to what would be expected due to random chance. Lastly, aligned nucleotides in ramp sequences were compared to the rest of the sequence in order to examine possible differences in phylogenetic signal between these regions of the gene. Results: Parsimony and maximum likelihood analyses of the presence/absence of ramp sequences recovered phylogenies that are highly congruent with established phylogenies. Additionally, the retention index of ramp sequences is significantly higher than would be expected due to random chance (p-value = 0). A chi-square analysis of completely orthologous ramp sequences resulted in a p-value of approximately zero as compared to random chance. Discussion: Ramp sequences recover comparable phylogenies as other phylogenomic methods. Although not all ramp sequences appear to have a phylogenetic signal, more ramp sequences track speciation than expected by random chance. Therefore, ramp sequences may be used in conjunction with other phylogenomic approaches.Keywords: codon usage bias, phylogenetics, phylogenomics, ramp sequence
Procedia PDF Downloads 1624311 The Efficacy of Clobazam for Landau-Kleffner Syndrome
Authors: Nino Gogatishvili, Davit Kvernadze, Giorgi Japharidze
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Background and aims: Landau Kleffner syndrome (LKS) is a rare disorder with epileptic seizures and acquired aphasia. It usually starts in initially healthy children. The first symptoms are language regression and behavioral disturbances, and the sleep EEG reveals abnormal epileptiform activity. The aim was to discuss the efficacy of Clobazam for Landau Kleffner syndrome. Case report: We report a case of an 11-year-old boy with an uneventful pregnancy and delivery. He began to walk at 11 months and speak with simple phrases at the age of 2,5 years. At the age of 18 months, he had febrile convulsions; at the age of 5 years, the parents noticed language regression, stuttering, and serious behavioral dysfunction, including hyperactivity, temper outbursts. The epileptic seizure was not noticed. MRI was without any abnormality. Neuropsychological testing revealed verbal auditory agnosia. Sleep EEG showed abundant left fronto-temporal spikes, reaching over 85% during non-rapid eye movement sleep (non-REM sleep). Treatment was started with Clobazam. After ten weeks, EEG was improved. Stuttering and behavior also improved. Results: Since the start of Clobazam treatment, stuttering and behavior improved. Now, he is 11 years old, without antiseizure medication. Sleep EEG shows fronto-temporal spikes on the left side, over 10-49 % of non-REM sleep, bioccipital spikes, and slow-wave discharges and spike-waves. Conclusions: This case provides further support for the efficacy of Clobazam in patients with LKS.Keywords: Landau-Kleffner syndrome, antiseizure medication, stuttering, aphasia
Procedia PDF Downloads 664310 Bioprospecting of Marine Actinobacteria: The Leading Way for Industrially Important Enzymes and Bioactive Natural Products
Authors: Ramesh Subramani, Mathivanan Narayanasamy, William Aalbersberg
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It is well accepted by last 35 years of research and on-going programmes that marine environment harbours abundant and unique biodiversity, which is currently playing as an important source in bioprospecting. It has become apparent that marine microorganisms are lead in the biodiscovery. Among marine organisms, actinobacteria are a target phylum for discovering novel antibiotics against increasing the multi-drug resistant human pathogens because of these taxa representing for novel genera and species. Marine actinomycetes are a proven source of new antibiotic leads and novel enzymes with important industrial applications. A total of 183 streptomycete and 25 non-streptomycete strains were isolated from different marine samples collected from north-eastern part of the Indian Ocean. Among them, 111 isolates displayed antibacterial activity against human pathogens and 151 exhibited antifungal activity against phytopathogens. Importantly, most of them produced various extracellular enzymes and 58 of them produced exopolysaccharides. Totally eight small bioactive compounds and a thermostable alkaline protease have been purified from a selected strain, Streptomyces fungicidicus. Besides, our on-going studies on non-streptomycete strains (rare actinomycetes) are most likely promising resource for new and unique compounds against current emerging drug-resistant pathogens. We have just recognised the chemical diversity in marine microorganisms. Therefore it is worthwhile to continue the exploration of marine microorganisms for new drug leads, novel enzymes and other bioprospecting research.Keywords: bioactive compounds, industrial enzymes, marine actinobacteria, microbial metabolites, marine natural products
Procedia PDF Downloads 2794309 A Case Study of Spontaneous Heterotopic Pregnancy with Subsequent Ruptured Ectopic Pregnancy
Authors: M. Elder, L. Beech, A. Mackie
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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy
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