Search results for: multidisciplinary approach
14046 Exploring the Potentials of Adapting Philosophical Principles as a Generative Source for Islamic Creative Expression
Authors: Tamadher Alfahal
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Faith and art practice in traditional Islam had a profound rapport that is lost today. From practicing the principles of faith throughout everyday life, art was found as an expressive tool for Islamic revelation, worship, and the contemplative remembrance of God. Today, this rapport between Islamic art and spirituality has diminished; and the cosmological and metaphysical ideas that were the core of creative practices lost their imminence in people's lives. Hence, the cultural and religious practice of Islamic societies became separate from the creative production. In an attempt to revisit this rapport, it is sought to investigate the possibility of creating a set of principles for contemporary Islamic art and design through collaborative practice-led research. The research will aim to regenerate the potentials of Islamic philosophy for creative expressions, particularly in design studies. The outcomes will be manifested through different mediums such as: reflexive mind maps and visuals by the researcher, and various methods of participatory art practice aim to validate the philosophical concepts as design principles as a way to disseminate knowledge. This paper will focus on showcasing the key findings and the research approach for generating philosophical concepts as design principles. Using secondary evidence from literature, it will show examples of transforming textual findings into visuals that will be extensively explored through multidisciplinary collaborative sessions (these are scheduled to be conducted between February and April 2017).Keywords: creative process, design pedagogy, design thinking, Islamic art, Islamic designs, Islamic philosophy
Procedia PDF Downloads 26414045 COVID-19-Related Posttraumatic Distress Syndrome among Jordanian Nurses during the Pandemic
Authors: Mohammed Qutishat, Loai Abu Sharour, Kholoud Al-Damery, Ibtisam Al Harthy, Sulaiman Al-Sabei
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Background: The 2019 coronavirus outbreak (COVID-19) has been declared a pandemic and has greatly affected both patients and healthcare workers. This study was conducted to explore the extent of posttraumatic stress disorder (PTSD) experiences among nurses as a result of the COVID-19 pandemic in Jordan. Method: This study used a cross-sectional study design with a convenience sampling approach. A sample of 259 participants completed the study questionnaires, including a sociodemographic questionnaire and the posttraumatic stress disorder checklist for DSM‐5, between May and July 2020. Result: The prevalence of PTSD among the study participants was 37.1%. The majority of study participants who exhibited PTSD symptoms presented the lowest level of PTSD (17%). The results indicated significant differences in overall COVID-19-related PTSD according to the participant’s age (F = 14.750, P = .000), gender (F = 30.340, P = .000), level of education (F = 51.983, P =.000), years of experience (F = 52.33, P = .000), place of work (F = 19.593, P = .000), and working position (F = 11.597, P = .000), as determined by one-way ANOVA. Conclusion: Nurses must be qualified and accredited to cope with reported PTSD cases and their consequences in relation to COVID-19 outbreaks. Close collaboration with a multidisciplinary team is required to recognise, manage, and encourage safety literacy among health care professionals and individuals diagnosed with or suspected of PTSD due to COVID-19 outbreaks or any other viral outbreaks.Keywords: PTSD, nursing, coronavirus, pandemic, infectious disease
Procedia PDF Downloads 13014044 The Correlation between Territory Planning and Logistics Development: Methodological Approach
Authors: Ebtissem Sassi, Abdellatif Benabdelhafid, Sami Hammami
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Congestion, pollution and space misuse are the major risks in the hinterland. Management of these risks is a major issue for all the actors intervening in territory management. A good mastery of these risks is based on the consideration of environmental and physical constraints since the implementation of a policy integrates simultaneously an efficient use, territorial resources, and financial resources which become increasingly rare. Yet, this balance can be difficult to establish simultaneously by all the actors. Indeed, every actor has often the tendency to favor these objectives in detriment to others. In this framework, we have fixed the objective of designing and achieving a model which will centralize multidisciplinary data and serve the analysis tool as well as a decision support tool. In this article, we will elaborate some methodological axes allowing the good management of the territory system through (i) determination of the structural factors of the decision support system, (ii) integration of methods tools favoring the territorial decisional process. Logistics territory geographic information system is a model dealing with this issue. The objective of this model is to facilitate the exchanges between the actors around a common question which was the research subject of human sciences researchers (geography, economy), nature sciences (ecology) as well as finding an optimal solution for simultaneous responses to all these objectives.Keywords: complexity, territory, logistics, territory planning, conceptual model, GIS, MCA
Procedia PDF Downloads 13614043 A Time-Reducible Approach to Compute Determinant |I-X|
Authors: Wang Xingbo
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Computation of determinant in the form |I-X| is primary and fundamental because it can help to compute many other determinants. This article puts forward a time-reducible approach to compute determinant |I-X|. The approach is derived from the Newton’s identity and its time complexity is no more than that to compute the eigenvalues of the square matrix X. Mathematical deductions and numerical example are presented in detail for the approach. By comparison with classical approaches the new approach is proved to be superior to the classical ones and it can naturally reduce the computational time with the improvement of efficiency to compute eigenvalues of the square matrix.Keywords: algorithm, determinant, computation, eigenvalue, time complexity
Procedia PDF Downloads 41514042 Development of in vitro Fertilization and Emerging Legal Issues
Authors: Malik Imtiaz Ahmad
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The development of In Vitro Fertilization (IVF) has revolutionized the field of reproductive medicine, offering hope to myriad individuals and couples facing infertility issues. IVF, a process involving the fertilization of eggs with sperm outside the body, has evolved over decades from an experimental procedure to a mainstream medical practice. The study sought to understand the evolution of IVF from its early stages to its present status as a groundbreaking fertility treatment. It also aimed to analyze the legal complexities surrounding IVF, including issues like embryo ownership, surrogacy agreements, and custody disputes. This research focused on the multidisciplinary approach involving both medical and legal fields. It aimed to explore the historical evolution of IVF, its techniques, and legal challenges concerning family law, health law, and privacy policies it has given rise to in modern times. This research aimed to provide insights into the intersection of medical technology and the law, offering valuable knowledge for policymakers, legal experts, and individuals involved in IVF. The study utilized various methods, including a thorough literature review, a historical analysis of IVF’s evolution, an examination of legal cases, and a review of emerging regulations. These approaches aimed to provide a comprehensive understanding of IVF and its modern legal issues, facilitating a holistic exploration of the subject matter.Keywords: in vitro fertilization development, IVF techniques evolution, legal issues in IVF, IVF legal frameworks, ethical dilemmas in IVF
Procedia PDF Downloads 3714041 The Construction of Malaysian Airline Tragedies in Malaysian and British Online News: A Multidisciplinary Study
Authors: Theng Theng Ong
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This study adopts a multidisciplinary method by combining the corpus-based discourse analysis study and language attitude study to explore the construction of Malaysia airline tragedies: MH370, MH17 and QZ8501 in the selected Malaysian and United Kingdom (UK) online news. The study aims to determine the ways in which Malaysian Airline tragedies MH370, MH17 and QZ8501 are linguistically defined and constructed in terms of keyword and collocation. The study also seeks to identify the types of discourse that are presented in the new articles. The differences or similarities in terms of keywords, topics or issues covered by the selected Malaysian and UK news media will also be examined. Finally, the language attitude study will be carried out to examine the Malaysia and UK university students’ attitudes toward the keywords, topics or issues covered by the selected Malaysian and UK news media pertaining to Malaysian Airline tragedies MH370, MH17 and QZ8501. The analysis is divided into two parts with the first part focusing on corpus-based discourse analysis on the media text. The second part of the study is to investigate Malaysians and UK news readers’ attitudes towards the online news being reported by the Malaysian and UK news media pertaining to the Airline tragedies. The main findings of corpus-based discourse analysis are essential in designing the questions in the questionnaires and interview and therefore led to the identification of the attitudes among Malaysian and UK news. This study adopts a multidisciplinary method by combining the corpus-based discourse analysis study and language attitude study to explore the construction of Malaysia airline tragedies: MH370, MH17 and QZ8501 in the selected Malaysian and United Kingdom (UK) online news. The study aims to determine the ways in which Malaysian Airline tragedies MH370, MH17 and QZ8501 are linguistically defined and constructed in terms of keyword and collocation. The study also seeks to identify the types of discourse that are presented in the new articles. The differences or similarities in terms of keywords, topics or issues covered by the selected Malaysian and UK news media will also be examined. Finally, the language attitude study will be carried out to examine the Malaysia and UK university students’ attitudes toward the keywords, topics or issues covered by the selected Malaysian and UK news media pertaining to Malaysian Airline tragedies MH370, MH17 and QZ8501. The analysis is divided into two parts with the first part focusing on corpus-based discourse analysis on the media text. The second part of the study is to investigate Malaysians and UK news readers’ attitudes towards the online news being reported by the Malaysian and UK news media pertaining to the Airline tragedies. The main findings of corpus-based discourse analysis are essential in designing the questions in the questionnaires and interview and therefore led to the identification of the attitudes among Malaysian and UK news.Keywords: corpus linguistics, critical discourse analysis, news media, tragedies study
Procedia PDF Downloads 33514040 Enhancing Communicative Skills for Students in Automatics
Authors: Adrian Florin Busu
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The communicative approach, or communicative language teaching, used for enhancing communicative skills in students in automatics is a modern teaching approach based on the concept of learning a language through having to communicate real meaning. In the communicative approach, real communication is both the objective of learning and the means through which it takes place. This approach was initiated during the 1970’s and quickly became prominent, as it proposed an alternative to the previous systems-oriented approaches. In other words, instead of focusing on the acquisition of grammar and vocabulary, the communicative approach aims at developing students’ competence to communicate in the target language with an enhanced focus on real-life situations. To put it in an nutshell, CLT considers using the language to be just as important as actually learning the language.Keywords: communication, approach, objective, learning
Procedia PDF Downloads 16114039 The Russian Preposition 'за': A Cognitive Linguistic Approach
Authors: M. Kalyuga
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Prepositions have long been considered to be one of the major challenges for second language learners, since they have multiple uses that differ greatly from one language to another. The traditional approach to second language teaching supplies students with a list of uses of a preposition that they have to memorise and no explanation is provided. Contrary to the traditional grammar approach, the cognitive linguistic approach offers an explanation for the use of prepositions and provides strategies to comprehend and learn prepositions that would be otherwise seem obscure. The present paper demonstrates the use of the cognitive approach for the explanation of prepositions through the example of the Russian preposition 'за'. The paper demonstrates how various spatial and non-spatial uses of this preposition are linked together through metaphorical and metonymical mapping. The diversity of expressions with за is explained by the range of spatial scenes this preposition is associated with.Keywords: language teaching, Russian, preposition 'за', cognitive approach
Procedia PDF Downloads 45214038 Discourse Analysis: Where Cognition Meets Communication
Authors: Iryna Biskub
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The interdisciplinary approach to modern linguistic studies is exemplified by the merge of various research methods, which sometimes causes complications related to the verification of the research results. This methodological confusion can be resolved by means of creating new techniques of linguistic analysis combining several scientific paradigms. Modern linguistics has developed really productive and efficient methods for the investigation of cognitive and communicative phenomena of which language is the central issue. In the field of discourse studies, one of the best examples of research methods is the method of Critical Discourse Analysis (CDA). CDA can be viewed both as a method of investigation, as well as a critical multidisciplinary perspective. In CDA the position of the scholar is crucial from the point of view exemplifying his or her social and political convictions. The generally accepted approach to obtaining scientifically reliable results is to use a special well-defined scientific method for researching special types of language phenomena: cognitive methods applied to the exploration of cognitive aspects of language, whereas communicative methods are thought to be relevant only for the investigation of communicative nature of language. In the recent decades discourse as a sociocultural phenomenon has been the focus of careful linguistic research. The very concept of discourse represents an integral unity of cognitive and communicative aspects of human verbal activity. Since a human being is never able to discriminate between cognitive and communicative planes of discourse communication, it doesn’t make much sense to apply cognitive and communicative methods of research taken in isolation. It is possible to modify the classical CDA procedure by means of mapping human cognitive procedures onto the strategic communicative planning of discourse communication. The analysis of the electronic petition 'Block Donald J Trump from UK entry. The signatories believe Donald J Trump should be banned from UK entry' (584, 459 signatures) and the parliamentary debates on it has demonstrated the ability to map cognitive and communicative levels in the following way: the strategy of discourse modeling (communicative level) overlaps with the extraction of semantic macrostructures (cognitive level); the strategy of discourse management overlaps with the analysis of local meanings in discourse communication; the strategy of cognitive monitoring of the discourse overlaps with the formation of attitudes and ideologies at the cognitive level. Thus, the experimental data have shown that it is possible to develop a new complex methodology of discourse analysis, where cognition would meet communication, both metaphorically and literally. The same approach may appear to be productive for the creation of computational models of human-computer interaction, where the automatic generation of a particular type of a discourse could be based on the rules of strategic planning involving cognitive models of CDA.Keywords: cognition, communication, discourse, strategy
Procedia PDF Downloads 25514037 Concept Mapping to Reach Consensus on an Antibiotic Smart Use Strategy Model to Promote and Support Appropriate Antibiotic Prescribing in a Hospital, Thailand
Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa
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Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams
Procedia PDF Downloads 12114036 Study of the Transport of ²²⁶Ra Colloidal in Mining Context Using a Multi-Disciplinary Approach
Authors: Marine Reymond, Michael Descostes, Marie Muguet, Clemence Besancon, Martine Leermakers, Catherine Beaucaire, Sophie Billon, Patricia Patrier
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²²⁶Ra is one of the radionuclides resulting from the disintegration of ²³⁸U. Due to its half-life (1600 y) and its high specific activity (3.7 x 1010 Bq/g), ²²⁶Ra is found at the ultra-trace level in the natural environment (usually below 1 Bq/L, i.e. 10-13 mol/L). Because of its decay in ²²²Rn, a radioactive gas with a shorter half-life (3.8 days) which is difficult to control and dangerous for humans when inhaled, ²²⁶Ra is subject to a dedicated monitoring in surface waters especially in the context of uranium mining. In natural waters, radionuclides occur in dissolved, colloidal or particular forms. Due to the size of colloids, generally ranging between 1 nm and 1 µm and their high specific surface areas, the colloidal fraction could be involved in the transport of trace elements, including radionuclides in the environment. The colloidal fraction is not always easy to determine and few existing studies focus on ²²⁶Ra. In the present study, a complete multidisciplinary approach is proposed to assess the colloidal transport of ²²⁶Ra. It includes water sampling by conventional filtration (0.2µm) and the innovative Diffusive Gradient in Thin Films technique to measure the dissolved fraction (<10nm), from which the colloidal fraction could be estimated. Suspended matter in these waters were also sampled and characterized mineralogically by X-Ray Diffraction, infrared spectroscopy and scanning electron microscopy. All of these data, which were acquired on a rehabilitated former uranium mine, allowed to build a geochemical model using the geochemical calculation code PhreeqC to describe, as accurately as possible, the colloidal transport of ²²⁶Ra. Colloidal transport of ²²⁶Ra was found, for some of the sampling points, to account for up to 95% of the total ²²⁶Ra measured in water. Mineralogical characterization and associated geochemical modelling highlight the role of barite, a barium sulfate mineral well known to trap ²²⁶Ra into its structure. Barite was shown to be responsible for the colloidal ²²⁶Ra fraction despite the presence of kaolinite and ferrihydrite, which are also known to retain ²²⁶Ra by sorption.Keywords: colloids, mining context, radium, transport
Procedia PDF Downloads 15714035 Emergency Multidisciplinary Continuing Care Case Management
Authors: Mekroud Amel
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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies receivedKeywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care
Procedia PDF Downloads 8014034 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor
Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan
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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease
Procedia PDF Downloads 25914033 Comparing the Quality of Electronic and Paper Do-Not-Resucscitate Forms in Hosptail
Authors: Anmol Patel
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Cardiopulmonary resuscitation is medical intervention which should be considered for all inpatients; with a patient centred approach, open communication and accurate documentation of clinical decisions. National enquiries have shown that in a significant number of cases CPR was attempted when it was considered inappropriate. In these circumstances attempting to prevent a natural death and subjecting a patient to trauma at the end of life would deprive them of a dignified death. Anticipatory “do not attempt CPR (DNACPR)” decisions aim to prevent this for those considered appropriate. As a legal document, these forms are required to be completed accurately and thoroughly. The aim of this study was to evaluate the difference in quality of DNACPR forms completed using electronic versus paper formats. A retrospective review of DNACPR forms and related documentation was completed in two District General Hospitals in South-East England, one of which uses electronic forms, while the other uses paper red forms. 50 completed forms from each hospital were analysed to assess for legibility, and quality of completion of all subsections of the form, including communications with family, relatives and the Multidisciplinary team. The hospital using paper forms showed a 40-44% rate of completion of sections relating to communication with patients and family, compared to 70% with the hospital using electronic forms. Similar trends were observed with other sections of the form. Conclusion: This study suggests that the implementation of electronic DNACPR forms significantly improves clinical practice and promotes better open communication with patients, family and the MDT.Keywords: DNACPR, resuscitation, DNAR, patient communication
Procedia PDF Downloads 7914032 Educational Sport and Quality of Life for Children and Teenagers from Brazilian Northeast
Authors: Ricardo Hugo Gonzalez, Amanda Figueiredo Vasconcelos, Francisco Loureiro Neto Monteiro, Yara Luiza Freitas Silva, Ana Cristina Lindsay, Márcia Maria Tavares Machado
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The use of sport as an integration mean is a very important tool regarding the social involvement of children and teenagers in a vulnerability situation. This study aims to report the experiences of a multidisciplinary program that intends to improve the quality of life of children and teenagers in Fortaleza, in the Northeast of Brazil. More than 400 children and teenagers aging 11 and 16 years participated in this study. Poor communities experience many particular difficulties in the urban centers such as violence, poor housing conditions, unemployment, lack in health care and deficient physical education in school. Physical education, physiotherapy, odontology, medicine and pharmacy students are responsible for the activities in the project supervised by a general coordinator and a counselor teacher of each academic unit. There are classes about team sports like basketball and soccer. Lectures about sexual behavior and sexually transmitted diseases are ministered beside the ones about oral health education, basic life support education, first aids, use and care with pharmaceuticals and orientations about healthy nutrition. In order to get the children’s family closer, monthly informative lectures are ministered. There is also the concern about reflecting the actions and producing academic paperwork such as graduation final projects and books. The number of participants has oscillated lately, and one of the causes is the lack of practicing physical activities and sports regularly. However, 250 teenagers have participated regularly for at least two years. These teenagers have shown a healthier lifestyle and a better physical fitness profile. The resources for maintaining the project come from the Pro-Reitoria of Extension, Federal University of Ceara, as well as from the PROEXT/MEC, Federal Government. Actions of this nature need to be done thinking for long periods so the effects results can become effective. Public and private investments are needed due to low socioeconomic families who are most vulnerable and have fewer opportunities to enhance to health prevention services.Keywords: children and teenagers, health, multidisciplinary program, quality of life
Procedia PDF Downloads 24314031 Fabrication of Textile-Based Radio Frequency Metasurfaces
Authors: Adria Kajenski, Guinevere Strack, Edward Kingsley, Shahriar Khushrushahi, Alkim Akyurtlu
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Radio Frequency (RF) metasurfaces are arrangements of subwavelength elements interacting with electromagnetic radiation. These arrangements affect polarization state, amplitude, and phase of impinged radio waves; for example, metasurface designs are used to produce functional passband and stopband filters. Recent advances in additive manufacturing techniques have enabled the low-cost, rapid fabrication of ultra-thin metasurface elements on flexible substrates such as plastic films, paper, and textiles. Furthermore, scalable manufacturing processes promote the integration of fabric-based RF metasurfaces into the market of sensors and devices within the Internet of Things (IoT). The design and fabrication of metasurfaces on textiles require a multidisciplinary team with expertise in i) textile and materials science, ii) metasurface design and simulation, and iii) metasurface fabrication and testing. In this presentation, we will discuss RF metasurfaces on fabric with an emphasis on how the materials, including fabric and inks, along with fabrication techniques, affect the RF performance. We printed metasurfaces using a direct-write approach onto various woven and non-woven fabrics, as well as on fabrics coated with either thermoplastic or thermoset coatings. Our team also performed a range of tests on the printed structures, including different inks and their curing parameters, wash durability, abrasion resistance, and RF performance over time.Keywords: electronic textiles, metasurface, printed electronics, flexible
Procedia PDF Downloads 19514030 HPPDFIM-HD: Transaction Distortion and Connected Perturbation Approach for Hierarchical Privacy Preserving Distributed Frequent Itemset Mining over Horizontally-Partitioned Dataset
Authors: Fuad Ali Mohammed Al-Yarimi
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Many algorithms have been proposed to provide privacy preserving in data mining. These protocols are based on two main approaches named as: the perturbation approach and the Cryptographic approach. The first one is based on perturbation of the valuable information while the second one uses cryptographic techniques. The perturbation approach is much more efficient with reduced accuracy while the cryptographic approach can provide solutions with perfect accuracy. However, the cryptographic approach is a much slower method and requires considerable computation and communication overhead. In this paper, a new scalable protocol is proposed which combines the advantages of the perturbation and distortion along with cryptographic approach to perform privacy preserving in distributed frequent itemset mining on horizontally distributed data. Both the privacy and performance characteristics of the proposed protocol are studied empirically.Keywords: anonymity data, data mining, distributed frequent itemset mining, gaussian perturbation, perturbation approach, privacy preserving data mining
Procedia PDF Downloads 50514029 Integration of Building Information Modeling Framework for 4D Constructability Review and Clash Detection Management of a Sewage Treatment Plant
Authors: Malla Vijayeta, Y. Vijaya Kumar, N. Ramakrishna Raju, K. Satyanarayana
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Global AEC (architecture, engineering, and construction) industry has been coined as one of the most resistive domains in embracing technology. Although this digital era has been inundated with software tools like CAD, STADD, CANDY, Microsoft Project, Primavera etc. the key stakeholders have been working in siloes and processes remain fragmented. Unlike the yesteryears’ simpler project delivery methods, the current projects are of fast-track, complex, risky, multidisciplinary, stakeholder’s influential, statutorily regulative etc. pose extensive bottlenecks in preventing timely completion of projects. At this juncture, a paradigm shift surfaced in construction industry, and Building Information Modeling, aka BIM, has been a panacea to bolster the multidisciplinary teams’ cooperative and collaborative work leading to productive, sustainable and leaner project outcome. Building information modeling has been integrative, stakeholder engaging and centralized approach in providing a common platform of communication. A common misconception that BIM can be used for building/high rise projects in Indian Construction Industry, while this paper discusses of the implementation of BIM processes/methodologies in water and waste water industry. It elucidates about BIM 4D planning and constructability reviews of a Sewage Treatment Plant in India. Conventional construction planning and logistics management involves a blend of experience coupled with imagination. Even though the excerpts or judgments or lessons learnt gained from veterans might be predictive and helpful, but the uncertainty factor persists. This paper shall delve about the case study of real time implementation of BIM 4D planning protocols for one of the Sewage Treatment Plant of Dravyavati River Rejuvenation Project in India and develops a Time Liner to identify logistics planning and clash detection. With this BIM processes, we shall find that there will be significant reduction of duplication of tasks and reworks. Also another benefit achieved will be better visualization and workarounds during conception stage and enables for early involvement of the stakeholders in the Project Life cycle of Sewage Treatment Plant construction. Moreover, we have also taken an opinion poll of the benefits accrued utilizing BIM processes versus traditional paper based communication like 2D and 3D CAD tools. Thus this paper concludes with BIM framework for Sewage Treatment Plant construction which will achieve optimal construction co-ordination advantages like 4D construction sequencing, interference checking, clash detection checking and resolutions by primary engagement of all key stakeholders thereby identifying potential risks and subsequent creation of risk response strategies. However, certain hiccups like hesitancy in adoption of BIM technology by naïve users and availability of proficient BIM trainers in India poses a phenomenal impediment. Hence the nurture of BIM processes from conception, construction and till commissioning, operation and maintenance along with deconstruction of a project’s life cycle is highly essential for Indian Construction Industry in this digital era.Keywords: integrated BIM workflow, 4D planning with BIM, building information modeling, clash detection and visualization, constructability reviews, project life cycle
Procedia PDF Downloads 12214028 Impact of Interdisciplinary Therapy Allied to Online Health Education on Cardiometabolic Parameters and Inflammation Factor Rating in Obese Adolescents
Authors: Yasmin A. M. Ferreira, Ana C. K. Pelissari, Sofia De C. F. Vicente, Raquel M. Da S. Campos, Deborah C. L. Masquio, Lian Tock, Lila M. Oyama, Flavia C. Corgosinho, Valter T. Boldarine, Ana R. Dâmaso
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The prevalence of overweight and obesity is growing around the world and currently considered a global epidemic. Food and nutrition are essential requirements for promoting health and protecting non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate the inflammation and oxidative stress in obese individuals. Few studies have investigated the dietary Inflammation Factor Rating (IFR) in obese adolescents. The IFR was developed to characterize an individual´s diet on anti- to pro-inflammatory score. This evaluation contributes to investigate the effects of inflammatory diet in metabolic profile in several individual conditions. Objectives: The present study aims to investigate the effects of a multidisciplinary weight loss therapy on inflammation factor rating and cardiometabolic risk in obese adolescents. Methods: A total of 26 volunteers (14-19 y.o) were recruited and submitted to 20 weeks interdisciplinary therapy allied to health education website- Ciclo do Emagrecimento®, including clinical, nutritional, psychological counseling and exercise training. The body weight was monitored weekly by self-report and photo. The adolescents answered a test to evaluate the knowledge of the topics covered in the videos. A 24h dietary record was applied at the baseline and after 20 weeks to assess the food intake and to calculate IFR. A negative IFR suggests that diet may have inflammatory effects and a positive IFR indicates an anti-inflammatory effect. Statistical analysis was performed using the program STATISTICA version 12.5 for Windows. The adopted significant value was α ≤ 5 %. Data normality was verified with the Kolmogorov Smirnov test. Data were expressed as mean±SD values. To analyze the effects of intervention it was applied test t. Pearson´s correlations test was performed. Results: After 20 weeks of treatment, body mass index (BMI), body weight, body fat (kg and %), abdominal and waist circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. Moreover, it was found an improvement of inflammation factor rating from -427,27±322,47 to -297,15±240,01, suggesting beneficial effects of nutritional counselling. Considering the correlations analysis, it was found that pro-inflammatory diet is associated with increase in the BMI, very low-density lipoprotein cholesterol (VLDL), triglycerides, insulin and insulin resistance index (HOMA-IR); while an anti-inflammatory diet is associated with improvement of HDL-c and insulin sensitivity Check index (QUICKI). Conclusion: The 20-week blended multidisciplinary therapy was effective to reduce body weight, anthropometric circumferences and improve inflammatory markers in obese adolescents. In addition, our results showed that an increase in inflammatory profile diet is associated with cardiometabolic parameters, suggesting the relevance to stimulate anti-inflammatory diet habits as an effective strategy to treat and control of obesity and related comorbidities. Financial Support: FAPESP (2017/07372-1) and CNPq (409943/2016-9)Keywords: cardiometabolic risk, inflammatory diet, multidisciplinary therapy, obesity
Procedia PDF Downloads 19414027 Training Program for Kindergarden Teachers on Learning through Project Approach
Authors: Dian Hartiningsih, Miranda Diponegoro, Evita Eddie Singgih
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In facing the 21st century, children need to be prepared in reaching their optimum development level which encompasses all aspect of growth and to achieve the learning goals which include not only knowledge and skill, but also disposition and feeling. Teachers as the forefront of education need to be equipped with the understanding and skill of a learning method which can prepare the children to face this 21st century challenge. Project approach is an approach which utilizes active learning which is beneficial for the children. Subject to this research are kindergarten teachers at Dwi Matra Kindergarten and Kirana Preschool. This research is a quantitative research using before and after study design. The result suggest that through preliminary training program on learning with project approach, the kindergarten teachers ability to explain project approach including understanding, benefit and stages of project approach have increased significantly, the teachers ability to design learning with project approach have also improved significantly. The result of learning design that the teachers had made shows a remarkable result for the first stage of the project approach; however the second and third design result was not as optimal. Challenges faced in the research will be elaborated further in the research discussion.Keywords: project approach, teacher training, learning method, kindergarten
Procedia PDF Downloads 33314026 Knowledge Management in the Tourism Industry in Project Management Paradigm
Authors: Olga A. Burukina
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Tourism is a complex socio-economic phenomenon, partly regulated by national tourism industries. The sustainable development of tourism in a region, country or in tourist destination depends on a number of factors (political, economic, social, cultural, legal and technological), the understanding and correct interpretation of which is invariably anthropocentric. It is logical that for the successful functioning of a tour operating company, it is necessary to ensure its sustainable development. Sustainable tourism is defined as tourism that fully considers its current and future economic, social and environmental impacts, taking into account the needs of the industry, the environment and the host communities. For the business enterprise, sustainable development is defined as adopting business strategies and activities that meet the needs of the enterprise and its stakeholders today while protecting, sustaining and enhancing the human and natural resources that will be needed in the future. In addition to a systemic approach to the analysis of tourist destinations, each tourism project can and should be considered as a system characterized by a very high degree of variability, since each particular case of its implementation differs from the previous and subsequent ones, sometimes in a cardinal way. At the same time, it is important to understand that this variability is predominantly of anthropogenic nature (except for force majeure situations that are considered separately and afterwards). Knowledge management is the process of creating, sharing, using and managing the knowledge and information of an organization. It refers to a multidisciplinary approach to achieve organisational objectives by making the best use of knowledge. Knowledge management is seen as a key systems component that allows obtaining, storing, transferring, and maintaining information and knowledge in particular, in a long-term perspective. The study aims, firstly, to identify (1) the dynamic changes in the Italian travel industry in the last 5 years before the COVID19 pandemic, which can be considered the scope of force majeure circumstances, (2) the impact of the pandemic on the industry and (3) efforts required to restore it, and secondly, how project management tools can help to improve knowledge management in tour operating companies to maintain their sustainability, diminish potential risks and restore their pre-pandemic performance level as soon as possible. The pilot research is based upon a systems approach and has employed a pilot survey, semi-structured interviews, prior research analysis (aka literature review), comparative analysis, cross-case analysis, and modelling. The results obtained are very encouraging: PM tools can improve knowledge management in tour operating companies and secure the more sustainable development of the Italian tourism industry based on proper knowledge management and risk management.Keywords: knowledge management, project management, sustainable development, tourism industr
Procedia PDF Downloads 15814025 The Limits of the Effectiveness of Digital Advertising: Demonstration by the Economic Approach of Measuring Advertising Effectiveness
Authors: Barkaoui Asma
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In our article, we use the economic approach of measuring advertising effectiveness to show the margin of advertising spread gained through digital communication. For economists, profit maximization depends on determining the optimal advertising budget. For this, they use the theories of the marginalist current to determine when the maximum level of benefits is reached. Using the economic approach we show the significant return on investment for advertisers. We then discuss the risks of perception of advertising pressure by consumers.Keywords: digital advertising, economic approach, effectiveness, pressure
Procedia PDF Downloads 30414024 Intensive Multidisciplinary Feeding Intervention for a Toddler with In-Utero Drug Exposure
Authors: Leandra Prempeh, Emily Malugen
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Prenatal drug exposure can have a molecular impact on the hypothalamic and reward genes that regulate feeding behavior. This can impact feeding regulation, resulting in feeding difficulties and growth failure. This was potentially seen in “McKayla,” a 19- month old girl with a history of in-utero drug exposure, patent ductus arteriosus, and gastroesophageal reflux disease who presented for intensive day treatment feeding therapy. She was diagnosed with Avoidant Restrictive Food Intake Disorder, described as total food refusal and meeting 100% of her caloric needs from a gastrostomy tube. The primary goals during intensive feeding therapy were to increase her oral intake and decrease her reliance on supplementation with formula. Several behavioral antecedent manipulations were implemented to establish consistent responding and make progress towards treatment goals. This included multiple modified bolus placements (using underloaded and Nuk brush), reinforcement contingencies, and variety fading before stability was finally achieved. Following, increasing retention of bites then increasing volume and variety were goals targeted. From treatment onset to the last 3 days of treatment, McKayla's rate of rapid acceptance of bite presentations increased significantly from 33.33% to 93.13%, rapid swallowing went from 0.00% to 92.32%, and her percentage of inappropriate mealtime behavior and expels decreased from 58.33% and 100% to 2.31% and 7.68%, respectively. Overall, the treatment team successfully introduced and increased the bite size of 7 pureed foods, generalize the treatment to caregivers with high integrity, and began facilitating tube weaning. She was receiving about 33.42% of her needs by mouth at the time of discharge. Other nutritional concerns addressed during treatment included drinking a nutritionally complete drink out of an open cup and age appropriate growth. McKayla continued to have emesis almost daily, as was her baseline before starting treatment; however, the frequency during mealtime decreased. Overall, McKayla responded well to treatment. She had a very slow response to treatment and required a lot of antecedent manipulations to establish consistent responding. As the literature suggests, [drug]-exposed neonates, like McKayla, may be at increased risk for nutritional and growth challenges that may persist throughout development. This supports the need for longterm follow-up of infant growth.Keywords: behavioral intervention, feeding problems, in-utero drug exposure, intensive multidisciplinary intervention
Procedia PDF Downloads 6614023 A Framework for Rating Synchronous Video E-Learning Applications
Authors: Alex Vakaloudis, Juan Manuel Escano-Gonzalez
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Setting up a system to broadcast live lectures on the web is a procedure which on the surface does not require any serious technical skills mainly due to the facilities provided by popular learning management systems and their plugins. Nevertheless, producing a system of outstanding quality is a multidisciplinary and by no means a straightforward task. This complicatedness may be responsible for the delivery of an overall poor experience to the learners, and it calls for a formal rating framework that takes into account the diverse aspects of an architecture for synchronous video e-learning systems. We discuss the specifications of such a framework which at its final stage employs fuzzy logic technique to transform from qualitative to quantitative results.Keywords: synchronous video, fuzzy logic, rating framework, e-learning
Procedia PDF Downloads 56114022 Deep Learning Based-Object-classes Semantic Classification of Arabic Texts
Authors: Imen Elleuch, Wael Ouarda, Gargouri Bilel
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We proposes in this paper a Deep Learning based approach to classify text in order to enrich an Arabic ontology based on the objects classes of Gaston Gross. Those object classes are defined by taking into account the syntactic and semantic features of the treated language. Thus, our proposed approach is a hybrid one. In fact, it is based on the one hand on the object classes that represents a knowledge based-approach on classification of text and in the other hand it uses the deep learning approach that use the word embedding-based-approach to classify text. We have applied our proposed approach on a corpus constructed from an Arabic dictionary. The obtained semantic classification of text will enrich the Arabic objects classes ontology. In fact, new classes can be added to the ontology or an expansion of the features that characterizes each object class can be updated. The obtained results are compared to a similar work that treats the same object with a classical linguistic approach for the semantic classification of text. This comparison highlight our hybrid proposed approach that can be ameliorated by broaden the dataset used in the deep learning process.Keywords: deep-learning approach, object-classes, semantic classification, Arabic
Procedia PDF Downloads 8814021 Human Trafficking the Kosovar Perspective of Fighting the Phenomena through Police and Civil Society Cooperation
Authors: Samedin Mehmeti
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The rationale behind this study is considering combating and preventing the phenomenon of trafficking in human beings from a multidisciplinary perspective that involves many layers of the society. Trafficking in human beings is an abhorrent phenomenon highly affecting negatively the victims and their families in both human and material aspect, sometimes causing irreversible damages. The longer term effects of this phenomenon, in countries with a weak economic development and extremely young and dynamic population, such as Kosovo, without proper measures to prevented and control can cause tremendous damages in the society. Given the fact that a complete eradication of this phenomenon is almost impossible, efforts should be concentrated at least on the prevention and controlling aspects. Treating trafficking in human beings based on traditional police tactics, methods and proceedings cannot bring satisfactory results. There is no doubt that a multi-disciplinary approach is an irreplaceable requirement, in other words, a combination of authentic and functional proactive and reactive methods, techniques and tactics. Obviously, police must exercise its role in preventing and combating trafficking in human beings, a role sanctioned by the law, however, police role and contribution cannot by any means considered complete if all segments of the society are not included in these efforts. Naturally, civil society should have an important share in these collaborative and interactive efforts especially in preventive activities such as: awareness on trafficking risks and damages, proactive engagement in drafting appropriate legislation and strategies, law enforcement monitoring and direct or indirect involvement in protective and supporting activities which benefit the victims of trafficking etc.Keywords: civil society, cooperation, police, human trafficking
Procedia PDF Downloads 36414020 Review on Quaternion Gradient Operator with Marginal and Vector Approaches for Colour Edge Detection
Authors: Nadia Ben Youssef, Aicha Bouzid
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Gradient estimation is one of the most fundamental tasks in the field of image processing in general, and more particularly for color images since that the research in color image gradient remains limited. The widely used gradient method is Di Zenzo’s gradient operator, which is based on the measure of squared local contrast of color images. The proposed gradient mechanism, presented in this paper, is based on the principle of the Di Zenzo’s approach using quaternion representation. This edge detector is compared to a marginal approach based on multiscale product of wavelet transform and another vector approach based on quaternion convolution and vector gradient approach. The experimental results indicate that the proposed color gradient operator outperforms marginal approach, however, it is less efficient then the second vector approach.Keywords: gradient, edge detection, color image, quaternion
Procedia PDF Downloads 23514019 A Comparative Study of Sampling-Based Uncertainty Propagation with First Order Error Analysis and Percentile-Based Optimization
Authors: M. Gulam Kibria, Shourav Ahmed, Kais Zaman
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In system analysis, the information on the uncertain input variables cause uncertainty in the system responses. Different probabilistic approaches for uncertainty representation and propagation in such cases exist in the literature. Different uncertainty representation approaches result in different outputs. Some of the approaches might result in a better estimation of system response than the other approaches. The NASA Langley Multidisciplinary Uncertainty Quantification Challenge (MUQC) has posed challenges about uncertainty quantification. Subproblem A, the uncertainty characterization subproblem, of the challenge posed is addressed in this study. In this subproblem, the challenge is to gather knowledge about unknown model inputs which have inherent aleatory and epistemic uncertainties in them with responses (output) of the given computational model. We use two different methodologies to approach the problem. In the first methodology we use sampling-based uncertainty propagation with first order error analysis. In the other approach we place emphasis on the use of Percentile-Based Optimization (PBO). The NASA Langley MUQC’s subproblem A is developed in such a way that both aleatory and epistemic uncertainties need to be managed. The challenge problem classifies each uncertain parameter as belonging to one the following three types: (i) An aleatory uncertainty modeled as a random variable. It has a fixed functional form and known coefficients. This uncertainty cannot be reduced. (ii) An epistemic uncertainty modeled as a fixed but poorly known physical quantity that lies within a given interval. This uncertainty is reducible. (iii) A parameter might be aleatory but sufficient data might not be available to adequately model it as a single random variable. For example, the parameters of a normal variable, e.g., the mean and standard deviation, might not be precisely known but could be assumed to lie within some intervals. It results in a distributional p-box having the physical parameter with an aleatory uncertainty, but the parameters prescribing its mathematical model are subjected to epistemic uncertainties. Each of the parameters of the random variable is an unknown element of a known interval. This uncertainty is reducible. From the study, it is observed that due to practical limitations or computational expense, the sampling is not exhaustive in sampling-based methodology. That is why the sampling-based methodology has high probability of underestimating the output bounds. Therefore, an optimization-based strategy to convert uncertainty described by interval data into a probabilistic framework is necessary. This is achieved in this study by using PBO.Keywords: aleatory uncertainty, epistemic uncertainty, first order error analysis, uncertainty quantification, percentile-based optimization
Procedia PDF Downloads 24114018 Coastal Water Characteristics along the Saudi Arabian Coastline
Authors: Yasser O. Abualnaja1, Alexandra Pavlidou2, Taha Boksmati3, Ahmad Alharbi3, Hammad Alsulmi3, Saleh Omar Maghrabi3, Hassan Mowalad3, Rayan Mutwalli3, James H. Churchill4, Afroditi Androni2, Dionysios Ballas2, Ioannis Hatzianestis2, Harilaos Kontoyiannis2, Angeliki Konstantinopoulou2, Georgios Krokkos1, 5, Georgios Pappas2, Vassilis P. Papadopoulos2, Konstantinos Parinos2, Elvira Plakidi2, Eleni Rousselaki2, Dimitris Velaoras2, Panagiota Zachioti2, Theodore Zoulias2, Ibrahim Hoteit5.
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The coastal areas along the Kingdom of Saudi Arabia on both the Red Sea and Arabian Gulf have been witnessing in the past decades an unprecedented economic growth and a rapid increase in anthropogenic activities. Therefore, the Saudi Arabian government has decided to frame a strategy for sustainable development of the coastal and marine environments, which comes in the context of the Vision 2030, aimed at providing the first comprehensive ‘Status Quo Assessment’ of the Kingdom’s coastal and marine environments. This strategy will serve as a baseline assessment for future monitoring activities; this baseline is relied on scientific evidence of the drivers, pressures, and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressures of the hotspots analysis, which was developed following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. Ten hotspot sites were identified, eight in the Red Sea and two in the Arabian Gulf. Thus, multidisciplinary research cruises were conducted throughout the Red Sea and the Arabian Gulf coastal and marine environments in June/July 2021 and September 2021, respectively, in order to understand the relative impact of hydrography and the various pressures on the quality of seawater and sediments. The main objective was to record the physical and biogeochemical parameters along the coastal waters of the Kingdom, tracing the dispersion of contaminants related to specific pressures. The assessment revealed the effect of hydrography on the trophic status of the southern marine coastal areas of the Red Sea. Jeddah Lagoon system seems to face significant eutrophication and pollution challenges, whereas sediments are enriched in some heavy metals in many areas of the Red Sea and the Arabian Gulf. This multidisciplinary research in the Red Sea and the Arabian Gulf coastal waters will pave the way for future detailed environmental monitoring strategies for the Saudi Arabian marine environment.Keywords: arabian gulf, contaminants, hotspot, red sea
Procedia PDF Downloads 11314017 Treatment of Papillary Thyroid Carcinoma Metastasis to the Sternum: A Case Report
Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.
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Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib
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