Search results for: seismic records

Authors: Simon Shibru, Karen Vancampenhout, Jozef Deckers, Herwig Leirs

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We investigated the population size of the endemic and endangered Swayne’s Hartebeest (Alcelaphus buselaphus swaynei) in Nech Sar National Park from 2012 to 2014 and document the major threats why the species is on the verge of local extinction. The park was once known for its abundant density of Swayne’s Hartebeest. We used direct total count methods for a census. We administered semi-structured interviews and open-ended questionnaires with senior scouts who are the member of the local communities. Historical records were obtained to evaluate the population trends of the animals since 1974. The density of the animal decreased from 65 in 1974 to 1 individual per 100 km2 in 2014 with a decline of 98.5% in the past 40 years. The respondents agreed that the conservation status of the park was in its worst condition ever now with only 2 Swayne’s Hartebeest left, with a rapid decline from 4 individuals in 2012 and 12 individuals in 2009. Mainly hunting and habitat loss, but also the unsuitable season of reproduction and shortage of forage as minor factors were identified as threats for a local extinction of the Swayne’s Hartebeests. On the other hand, predation, fire, disease, and ticks were not considered a cause for the declining trend. Hunting happens mostly out of some kind of revenge since the local community thought that they were pushed out from the land because of the presence of Swayne's Hartebeest in the area. Respondents agreed that the revenge action of the local communities was in response to their unwillingness to be displaced from the park in 1982/3. This conflict situation is resulting from the exclusionary wildlife management policy of the country. We conclude that the human interventions in general and illegal hunting, in particular, pushed the Swayne’s Hartebeest to a point of local extinction. Therefore, we recommend inclusive wildlife management approach for continuing existence of the park together with its natural resources so that sustainable use of the resources is in place.

Keywords: hunting, habitat destruction, local extinction, Nech Sar National Park, Swayne’s Hartebeest

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Authors: Aymen Arfaoui, Abdelkader Soumaya, Ali Kadri, Noureddine Ben Ayed

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The major contractional events characterized by strike-slip faulting, folding, and thrusting occurred in the Eocene, Late Miocene, and Quaternary along with the NE Tunisian domain between Bou Kornine-Ressas- Msella and Cap Bon Peninsula. During the Plio-Quaternary, the Grombalia and Mornag grabens show a maximum of collapse in parallelism with the NNW-SSE SHmax direction and developed as 3rd order extensive regions within a regional compressional regime. Using available tectonic and geophysical data supplemented by new fault-kinematic observations, we show that Cenozoic deformations are dominated by first order N-S faults reactivation, this sinistral wrench system is responsible for the formation of strike-slip duplexes, thrusts, folds, and grabens. Based on our new structural interpretation, the major faults of N-S Axis, Bou Kornine-Ressas-Messella (MRB), and Hammamet-Korbous (HK) form an N-S first order restraining stepover within a left-lateral strike-slip duplex. The N-S master MRB fault is dominated by contractional imbricate fans, while the parallel HK fault is characterized by a trailing of extensional imbricate fans. The Eocene and Miocene compression phases in the study area caused sinistral strike-slip reactivation of pre-existing N-S faults, reverse reactivation of NE-SW trending faults, and normal-oblique reactivation of NW-SE faults, creating a NE-SW to N-S trending system of east-verging folds and overlaps. Seismic tomography images reveal a key role for the lithospheric subvertical tear or STEP fault (Slab Transfer Edge Propagator) evidenced below this region on the development of the MRB and the HK relay zone. The presence of extensive syntectonic Pliocene sequences above this crustal scale fault may be the result of a recent lithospheric vertical motion of this STEP fault due to the rollback and lateral migration of the Calabrian slab eastward.

Keywords: Tunisia, strike-slip fault, contractional duplex, tectonic stress, restraining stepover, STEP fault

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Authors: Israel B. Bitton

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“Memory” is associated with various phenomena, from physical to mental, personal to collective and historical to cultural. As part of a broader exploration of memory studies in philosophy and science (slated for academic publication October 2021), this specific study employs analytical methods of cognitive psychology and philosophy of memory to theorize that A) the primary human will (drive) is to significance, in that every human action and expression can be rooted in a most primal desire to be cosmically significant (however that is individually perceived); and B) that the will to significance manifests as the will to memorability, an innate desire to be remembered by others after death. In support of these broad claims, a review of various popular culture “touchpoints”—historic and contemporary records spanning literature, film and television, traditional news media, and social media—is presented to demonstrate how this very theory is repeatedly and commonly expressed (and has been for a long time) by many popular public figures as well as “everyday people.” Though developed before COVID, the crisis only increased the theory’s relevance: so many people were forced to die alone, leaving them and their loved ones to face even greater existential angst than what ordinarily accompanies death since the usual expectations for one’s “final moments” were shattered. To underscore this issue of, and response to, what can be considered a sociocultural “memory gap,” this study concludes with a summary of several projects launched by journalists at the height of the pandemic to document the memorable human stories behind COVID’s tragic warped speed death toll that, when analyzed through the lens of Viktor E. Frankl’s psychoanalytical perspective on “existential meaning,” shows how countless individuals were robbed of the last wills and testaments to their self-significance and memorability typically afforded to the dying and the aggrieved. The resulting insight ought to inform how government and public health officials determine what is truly “non-essential” to human health, physical and mental, at times of crisis.

Keywords: cognitive psychology, covid, neuroscience, philosophy of memory

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Authors: Arif Anwar Surani, Salman Ali, Asif Surani, Sohaib Zahid, Akbar Shoukat Ali, Zeeshan-Ul-Hassan Usmani, Joseph Varon, Salim Surani

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Objective: Terrorism and suicidal bomb blast attacks are commonplace in Karachi, Pakistan. During the years 2000 to 2007, there were over 60 bomb explosions resulting in more than 1500 casualties. These explosions produce a wide variety of external injuries. We undertook this study to evaluate pattern of external injury produced after bomb blast attacks and to compare injury profile resulting from explosions in open versus semi-confined blast environments. Method: A retrospective, cross-sectional, study was conducted to review injuries sustained after bomb blast attacks in Karachi, Pakistan, from January 2000 to October 2007. Emergency medical records and medico legal certificates of patients presented to three major public sector hospitals of Karachi were evaluated using self-design proforma. Results: Data of 481 victims meet inclusion criteria and were incorporated for final analysis. Of these, 63.6% were injured in open spaces and 36.4% were injured in semi-confined blast environments. Lacerations were commonly encountered as external injury (47.7%) followed by penetrating wounds (15.3%). Lower and upper extremities were most commonly affected (38.6% and 19% respectively). Open and semi-confined blast environments produced a specific injury pattern and profile (p=<0.001). Conclusions: Bomb blast attacks in Karachi produce an external injury pattern consistent with other studies, with exception of an increased frequency in penetrating wounds. Semi-confined blast environments were associated with severe injuries. Further studies are required to better classify injuries and their severity based on standardized scoring systems. Effective emergency response systems must be designed to cope with mass causalities following bomb explosions.

Keywords: bomb blast attacks, injury pattern, external injury, open space, semi-confined space, blast environment

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Authors: Rohit Shrivastava, Stefan Luding

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A mechanical wave is propagation of vibration with transfer of energy and momentum. Studying the energy as well as spectral energy characteristics of a propagating wave through disordered granular media can assist in understanding the overall properties of wave propagation through inhomogeneous materials like soil. The study of these properties is aimed at modeling wave propagation for oil, mineral or gas exploration (seismic prospecting) or non-destructive testing for the study of internal structure of solids. The study of Energy content (Kinetic, Potential and Total Energy) of a pulse propagating through an idealized one-dimensional discrete particle system like a mass disordered granular chain can assist in understanding the energy attenuation due to disorder as a function of propagation distance. The spectral analysis of the energy signal can assist in understanding dispersion as well as attenuation due to scattering in different frequencies (scattering attenuation). The selection of one-dimensional granular chain also helps in studying only the P-wave attributes of the wave and removing the influence of shear or rotational waves. Granular chains with different mass distributions have been studied, by randomly selecting masses from normal, binary and uniform distributions and the standard deviation of the distribution is considered as the disorder parameter, higher standard deviation means higher disorder and lower standard deviation means lower disorder. For obtaining macroscopic/continuum properties, ensemble averaging has been used. Interpreting information from a Total Energy signal turned out to be much easier in comparison to displacement, velocity or acceleration signals of the wave, hence, indicating a better analysis method for wave propagation through granular materials. Increasing disorder leads to faster attenuation of the signal and decreases the Energy of higher frequency signals transmitted, but at the same time the energy of spatially localized high frequencies also increases. An ordered granular chain exhibits ballistic propagation of energy whereas, a disordered granular chain exhibits diffusive like propagation, which eventually becomes localized at long periods of time.

Keywords: discrete elements, energy attenuation, mass disorder, granular chain, spectral energy, wave propagation

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Authors: Hee-Young Song

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Background and objectives: In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations proposed a multidimensional assessment of patients’ conditions that included both functional parameters and patient-reported outcomes, with the aim to provide a comprehensive assessment of the disease, thus meeting both the needs of the patient and the role of the physician. However, few studies have evaluated patient-reported outcomes as well as objective functional assessments among individuals with chronic obstructive pulmonary disease (COPD) in clinical practice in Korea. This study was undertaken to explore the relationship between functional status assessed by the 6-minute walking distance (MWD) test and subjective health status reported by stable patients with COPD residing in community. Methods: A cross-sectional descriptive study was conducted with 118 stable COPD patients aged 69.4 years old and selected by a convenient sampling from an outpatient department of pulmonology in a tertiaryhospitals. The 6-MWD test was conducted according to standardized instructions. Participants also completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI). Medical records were reviewed to obtain disease-related characteristics including duration of the disease and forced expiratory volume in 1 second (FEV1). Data were analyzed using PASW statistics 20.0. Results: Mean FEV1% of participants was 63.51% and mean 6-MWD and CAT scores were 297.54m and 17.7, respectively. The 6-MWD and CAT showed significant negative correlations (r= -.280, p=.002); FEV1 and CAT did as well correlations (r= -.347, p < .001). Conclusions: Findings suggest that the better functional status an individual with COPD has, the better subjective health status is, and provide the support for using patient-reported outcomes along with functional parameters to facilitate comprehensive assessment of COPD patients in real clinical practices.

Keywords: chronic obstructive pulmonary disease, COPD assessment test, functional status, patient-reported outcomes

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Authors: Leszek Szpakowski, Daniel Celiński, Sławomir Pilip, Grzegorz Michalak

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The aim of the study was to analyse the usefulness of the 'E-rescuer' pilot project planned to be implemented in a chosen area of Eastern Poland in the cases of suspected sudden cardiac arrests in the extra-urban areas. Inventing an application allowing to dispatch simultaneously both Medical Emergency Teams and the E-rescuer to the place of the accident is the crucial assumption of the mentioned pilot project. The E-rescuer is defined to be the trained person able to take effective basic life support and to use automated external defibrillator. Having logged in using a smartphone, the E-rescuer's readiness is reported online to provide cardiopulmonary resuscitation exactly at the given location. Due to the accurately defined location of the E-rescuer, his arrival time is possible to be precisely fixed, and the substantive support through the displayed algorithms is capable of being provided as well. Having analysed the medical records in the years 2015-2016, cardiopulmonary resuscitation was considered to be effective when an early indication of circulation was provided, and the patient was taken to hospital. In the mentioned term, there were 2.291 cases of a sudden cardiac arrest. Cardiopulmonary resuscitation was taken in 621 patients in total including 205 people in the urban area and 416 in the extra-urban areas. The effectiveness of cardiopulmonary resuscitation in the extra-urban areas was much lower (33,8%) than in the urban (50,7%). The average ambulance arrival time was respectively longer in the extra-urban areas, and it was 12,3 minutes while in the urban area 3,3 minutes. There was no significant difference in the average age of studied patients - 62,5 and 64,8 years old. However, the average ambulance arrival time was 7,6 minutes for effective resuscitations and 10,5 minutes for ineffective ones. Hence, the ambulance arrival time is a crucial factor influencing on the effectiveness of cardiopulmonary resuscitation, especially in the extra-urban areas where it is much longer than in the urban. The key role of trained E-rescuers being nearby taking basic life support before the ambulance arrival can effectively support Emergency Medical Services System in Poland.

Keywords: basic life support, bystander, effectiveness, resuscitation

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Authors: S. V. Ukwungwu, A. J. Abbas, G. G. Nasr

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The increasing high price of natural gas and oil with attendant increase in energy demand on world markets in recent years has stimulated interest in recovering residual oil saturation across the globe. In order to meet the energy security, efforts have been made in developing new technologies of enhancing the recovery of oil and gas, utilizing techniques like CO2 flooding, water injection, hydraulic fracturing, surfactant flooding etc. Surfactant flooding however optimizes production but poses risk to the environment due to their toxic nature. Amongst proven records that have utilized other type of bacterial in producing biosurfactants for enhancing oil recovery, this research uses a technique to combine biosurfactants that will achieve a scale of EOR through lowering interfacial tension/contact angle. In this study, three biosurfactants were produced from three Bacillus species from freeze dried cultures using sucrose 3 % (w/v) as their carbon source. Two of these produced biosurfactants were screened with the TEMCO Pendant Drop Image Analysis for reduction in IFT and contact angle. Interfacial tension was greatly reduced from 56.95 mN.m-1 to 1.41 mN.m-1 when biosurfactants in cell-free culture (Bacillus licheniformis) were used compared to 4. 83mN.m-1 cell-free culture of Bacillus subtilis. As a result, cell-free culture of (Bacillus licheniformis) changes the wettability of the biosurfactant treatment for contact angle measurement to more water-wet as the angle decreased from 130.75o to 65.17o. The influence of microbial treatment on crushed rock samples was also observed by qualitative wettability experiments. Treated samples with biosurfactants remained in the aqueous phase, indicating a water-wet system. These results could prove that biosurfactants can effectively change the chemistry of the wetting conditions against diverse surfaces, providing a desirable condition for efficient oil transport in this way serving as a mechanism for EOR. The environmental friendly effect of biosurfactants applications for industrial purposes play important advantages over chemically synthesized surfactants, with various possible structures, low toxicity, eco-friendly and biodegradability.

Keywords: bacillus, biosurfactant, enhanced oil recovery, residual oil, wettability

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Authors: Seyran Naghdi

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Background: Orphan drug development is limited by very high costs attributed to the research and development and small size market. How health policymakers address this challenge to consider both supply and demand sides need to be explored for directing the policies and plans in the right way. The price is an important signal for pharmaceutical companies’ profitability and the patients’ accessibility as well. Objective: This study aims to find out the orphan drugs' price-setting patterns and approaches in health systems through a systematic review of the available evidence. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was used. MedLine, Embase, and Web of Sciences were searched via appropriate search strategies. Through Medical Subject Headings (MeSH), the appropriate terms for pricing were 'cost and cost analysis', and it was 'orphan drug production', and 'orphan drug', for orphan drugs. The critical appraisal was performed by the Joanna-Briggs tool. A Cochrane data extraction form was used to obtain the data about the studies' characteristics, results, and conclusions. Results: Totally, 1,197 records were found. It included 640 hits from Embase, 327 from Web of Sciences, and 230 MedLine. After removing the duplicates, 1,056 studies remained. Of them, 924 studies were removed in the primary screening phase. Of them, 26 studies were included for data extraction. The majority of the studies (>75%) are from developed countries, among them, approximately 80% of the studies are from European countries. Approximately 85% of evidence has been produced in the recent decade. Conclusions: There is a huge variation of price-setting among countries, and this is related to the specific pharmacological market structure and the thresholds that governments want to intervene in the process of pricing. On the other hand, there is some evidence on the availability of spaces to reduce the very high costs of orphan drugs development through an early agreement between pharmacological firms and governments. Further studies need to focus on how the governments could incentivize the companies to agree on providing the drugs at lower prices.

Keywords: orphan drugs, orphan drug production, pricing, costs, cost analysis

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: Samrawit Tamrat Gebretsadik

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Recurrent wheezing is a common respiratory symptom among children, often indicative of underlying airway inflammation and hyperreactivity. Understanding the prevalence and associated factors of recurrent wheezing in specific age groups is crucial for targeted interventions and improved respiratory health outcomes. This study aimed to investigate the prevalence and associated factors of recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College in Ethiopia. A cross-sectional study design was employed, involving structured interviews with parents/guardians, medical records review, and clinical examination of children. Data on demographic characteristics, environmental exposures, family history of respiratory diseases, and socioeconomic status were collected. Logistic regression analysis was used to identify factors associated with recurrent wheezing. The study included X 6-year-old children, with a prevalence of recurrent wheezing found to be Y%. Environmental exposures, including tobacco smoke exposure (OR = Z, 95% CI: X-Y), indoor air pollution (OR = Z, 95% CI: X-Y), and presence of pets at home (OR = Z, 95% CI: X-Y), were identified as significant risk factors for recurrent wheezing. Additionally, a family history of asthma or allergies (OR = Z, 95% CI: X-Y) and low socioeconomic status (OR = Z, 95% CI: X-Y) were associated with an increased likelihood of recurrent wheezing. The impact of recurrent wheezing on the quality of life of affected children and their families was also assessed. Children with recurrent wheezing experienced a higher frequency of respiratory symptoms, increased healthcare utilization, and decreased physical activity compared to their non-wheezing counterparts. In conclusion, recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College is associated with various environmental, genetic, and socioeconomic factors. These findings underscore the importance of targeted interventions aimed at reducing exposure to known triggers and improving respiratory health outcomes in this population. Future research should focus on longitudinal studies to further elucidate the causal relationships between risk factors and recurrent wheezing and evaluate the effectiveness of preventive strategies.

Keywords: wheezing, inflammation, respiratory, crucial

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Authors: Nicole M. Martino

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Reinforced concrete bridge deck condition assessments primarily use visual inspection methods, where an inspector looks for and records locations of cracks, potholes, efflorescence and other signs of probable deterioration. Sounding is another technique used to diagnose the condition of a bridge deck, however this method listens for damage within the subsurface as the surface is struck with a hammer or chain. Even though extensive procedures are in place for using these inspection techniques, neither one provides the inspector with a comprehensive understanding of the internal condition of a bridge deck – the location where damage originates from.  In order to make accurate estimates of repair locations and quantities, in addition to allocating the necessary funding, a total understanding of the deck’s deteriorated state is key. The research presented in this paper collected infrared thermography and ground penetrating radar data from reinforced concrete bridge decks without an asphalt overlay. These decks were of various ages and their condition varied from brand new, to in need of replacement. The goals of this work were to first verify that these nondestructive evaluation methods could identify similar areas of healthy and damaged concrete, and then to see if combining the results of both methods would provide a higher confidence than if the condition assessment was completed using only one method. The results from each method were presented as plan view color contour plots. The results from one of the decks assessed as a part of this research, including these plan view plots, are presented in this paper. Furthermore, in order to answer the interest of transportation agencies throughout the United States, this research developed a step-by-step guide which demonstrates how to collect and assess a bridge deck using these nondestructive evaluation methods. This guide addresses setup procedures on the deck during the day of data collection, system setups and settings for different bridge decks, data post-processing for each method, and data visualization and quantification.

Keywords: bridge deck deterioration, ground penetrating radar, infrared thermography, NDT of bridge decks

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Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

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Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

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Authors: Eman Ismail, Adnan Masri

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Energy dissipation in ductile moment frames occurs mainly through plastic hinge rotations in its members (beams and columns). Generally, plastic hinge locations are pre-determined and limited to the beam ends, where columns are designed to remain elastic in order to avoid premature instability (aka story mechanisms) with the exception of column bases, where a base is 'fixed' in order to provide higher stiffness and stability and to form a plastic hinge. Plastic hinging at steel column bases in ductile moment frames using conventional base connection details is accompanied by several complications (thicker and heavily stiffened connections, larger embedment depths, thicker foundation to accommodate anchor rod embedment, etc.). An encased composite base connection is proposed where a segment of the column beginning at the base up to a certain point along its height is encased in reinforced concrete with headed shear studs welded to the column flanges used to connect the column to the concrete encasement. When the connection is flexurally loaded, stresses are transferred to a reinforced concrete encasement through the headed shear studs, and thereby transferred to the foundation by reinforced concrete mechanics, and axial column forces are transferred through the base-plate assembly. Horizontal base reactions are expected to be transferred by the direct bearing of the outer and inner faces of the flanges; however, investigation of this mechanism is not within the scope of this research. The inelastic and cyclic behavior of the connection will be investigated where it will be subjected to reversed cyclic loading, and rotational ductility will be observed in cases of yielding mechanisms where yielding occurs as flexural yielding in the beam-column, shear yielding in headed studs, and flexural yielding of the reinforced concrete encasement. The findings of this research show that the connection is capable of achieving satisfactory levels of ductility in certain conditions given proper detailing and proportioning of elements.

Keywords: seismic design, plastic mechanisms steel structure, moment frame, composite construction

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Authors: Ricky A. J. Syngkon, Santi Gopal Maji

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Decent work and inclusive economic growth, social development, environmental protection, eradication of poverty and hunger as well as clean water and sanitation are the rudiments of 2030 agenda of sustainable development goals of the United Nations. On the other hand, spirituality is deeply entwined in the fabric of daily lives that helps in shaping attitudes, opinions, and behaviors of common people and ensuring quality of lives and overall sustainable development through protection of environment and natural resources. Mawlynnong, a small village in North-Eastern part of India, is a vivid example of how spirituality influences the development of sense of community leading to upliftment of the economic conditions of the people. Mawlynnong as a small hamlet has been in existence for a couple of centuries and it was acknowledged as the cleanest village of Asia in 2004 by BBC and National Geographic and subsequently endorsed by UNESCO in 2006. Consequently, it has attracted large number of tourists over the years from India and other parts of the world. This paper tries to explore how spirituality leads to a sense of community and the economic benefits for the people. Further, this paper also tries to find out the answer whether such an informal collective effort is sustainable or not for achieving solidarity economy. The study is based on both primary and secondary data collected from the local people and the State Government records. The findings of the study indicate that over the last one and a half decade the tourist footfall has increased to a great extent in Mawlynnong and this has brought about a paradigm shift in the occupational structure of its inhabitants from plantation to service sector particularly tourism and tourism related activities. As a result, from the economic standpoint, it is observed that life is much better off now as compared to before. But from the socio-cultural standpoint, the study finds a drift in terms of the cohesiveness and community bonding which was the hallmark of this village. This drift puts a question mark about the sustainability of such practices and consequently the development of solidarity economy.

Keywords: spirituality, sense of community, economic welfare, solidarity economy, Mawlynnong village

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Authors: Xiping Wang，Shuran Yao, Liqin Dai

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Many studies report the winter is getting warmer and the minimum air temperature is obviously rising as the important climate warming evidences. The exacerbated air temperature fluctuation tending to bring more severe weather variation is another important consequence of recent climate change which induced more disasters to crop growth in quite a certain regions. Hebei Province is an important winter wheat growing province in North of China that recently endures more winter freezing injury influencing the local winter wheat crop management. A winter wheat freezing injury assessment Bayesian Network framework was established for the objectives of estimating, assessing and predicting winter wheat freezing disasters in Hebei Province. In this framework, the freezing disasters was classified as three severity degrees (SI) among all the three types of freezing, i.e., freezing caused by severe cold in anytime in the winter, long extremely cold duration in the winter and freeze-after-thaw in early season after winter. The factors influencing winter wheat freezing SI include time of freezing occurrence, growth status of seedlings, soil moisture, winter wheat variety, the longitude of target region and, the most variable climate factors. The climate factors included in this framework are daily mean and range of air temperature, extreme minimum temperature and number of days during a severe cold weather process, the number of days with the temperature lower than the critical temperature values, accumulated negative temperature in a potential freezing event. The Bayesian Network model was evaluated using actual weather data and crop records at selected sites in Hebei Province using real data. With the multi-stage influences from the various factors, the forecast and assessment of the event-based target variables, freezing injury occurrence and its damage to winter wheat production, were shown better scoped by Bayesian Network model.

Keywords: bayesian networks, climatic change, freezing Injury, winter wheat

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Authors: Sabir Hussain, Muhammad Naeem, Yousif Aldryhim, Susan E. Halbert, Qingjun Wu

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Plant viruses annually cause severe economic losses in crop production and globally, different aphid species are responsible for the transmission of such viruses. Additionally, aphids are also serious pests of trees, and agricultural crops. Al Bahah Province, Kingdom of Saudi Arabia (KSA) has a high native and introduced plant species with a temperate climate that provides ample habitats for aphids. In this study, we surveyed virus-transmitting aphids from the Province to highlight their spatial distributions and hot spot areas for their target control strategies. During our fifteen month's survey in Al Bahah Province, three hundred and seventy samples of aphids were collected using both beating sheets and yellow water pan traps. Consequently, fifty-four aphid species representing 30 genera belonging to four families were recorded from Al Bahah Province. Alarmingly, 35 aphid species from our records are virus transmitting species. The most common virus transmitting aphid species based on number of collecting samples, were Macrosiphum euphorbiae (Thomas, 1878), Brachycaudus rumexicolens (Patch, 1917), Uroleucon sonchi (Linnaeus, 1767), Brachycaudus helichrysi (Kaltenbach, 1843), and Myzus persicae (Sulzer, 1776). The numbers of samples for the forementioned species were 66, 24, 23, 22, and 20, respectively. The widest range of plant hosts were found for M. euphorbiae (39 plant species), B. helichrysi (12 plant species), M. persicae (12 plant species), B. rumexicolens (10 plant species), and U. sonchi (9 plant species). The hottest spot areas were found in Al-Baha, Al Mekhwah and Biljarashi cities of the province on the basis of their abundance. This study indicated that Al Bahah Province has relatively rich aphid diversity due to the relatively high plant diversity in a favorable climatic condition. ArcGIS tools can be helpful for biologists to implement the target control strategies against these pests in the integrated pest management, and ultimately to save money and time.

Keywords: Al Bahah province, aphid-virus interaction, biodiversity, global information system

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Authors: Madrine King'endo

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This study dealt with the influence of spelling errors on English language performance among learners with dysgraphia in public primary schools in West Embu, Embu County, Kenya. The study purposed to investigate the influence of spelling errors on the English language performance among the class three pupils with dysgraphia in public primary schools. The objectives of the study were to identify the spelling errors that learners with dysgraphia make when writing English words and classify the spelling errors they make. Further, the study will establish how the spelling errors affect the performance of the language among the study participants, and suggest the remediation strategies that teachers could use to address the errors. The study could provide the stakeholders with relevant information in writing skills that could help in developing a responsive curriculum to accommodate the teaching and learning needs of learners with dysgraphia, and probably ensure training of teachers in teacher training colleges is tailored within the writing needs of the pupils with dysgraphia. The study was carried out in Embu county because the researcher did not find any study in related literature review concerning the influence of spelling errors on English language performance among learners with dysgraphia in public primary schools done in the area. Moreover, besides being relatively populated enough for a sample population of the study, the area was fairly cosmopolitan to allow a generalization of the study findings. The study assumed the sampled schools will had class three pupils with dysgraphia who exhibited written spelling errors. The study was guided by two spelling approaches: the connectionist stimulation of spelling process and orthographic autonomy hypothesis with a view to explain how participants with learning disabilities spell written words. Data were collected through interviews, pupils’ exercise books, and progress records, and a spelling test made by the researcher based on the spelling scope set for class three pupils by the ministry of education in the primary education syllabus. The study relied on random sampling techniques in identifying general and specific participants. Since the study used children in schools as participants, voluntary consent was sought from themselves, their teachers and the school head teachers who were their caretakers in a school setting.

Keywords: dysgraphia, writing, language, performance

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Authors: Sasiwan Tassana-iem, Sumattana Glangkarn

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Diabetic nephropathy is a major complication in diabetic patients whom as the glomerular filtration rate falls. The affects their quality of life and results in loss of money for kidney replacement therapy costs. There is an existing intervention, but the prevalence remains high, thus this research aims to study lessons learned in implementing programs to delay diabetic nephropathy management in primary health care. Method: The target settings are, 24 sub-district health promoting hospital in Sakon Nakhon province. Participants included the health care professionals, head of the sub-district health promoting hospital and the person responsible for managing diabetic nephropathy in each hospital (n= 50). There are 400 patients with diabetes mellitus in an area. Data were collected using questionnaires, patient records data, interviews and focus groups and analyzed by statistics and content analysis. Result: Reflection of participants that the interventions to delay diabetic nephropathy management in each area, the Ministry of Public Health has a policy to screen and manage this disease. The implementing programs aimed to provide health education, innovative teaching media used in communication to educate. Patients and caregivers had misunderstanding about the actual causes and prevention of this disease and how to apply knowledge suitable for daily life. Conclusion: The obstacles to the success of the implementing programs to delay diabetic nephropathy management in primary health care were most importantly, the patient needs self-care and should be evaluated for health literacy. This is crucial to promote health literacy; to access and understand health information as well to decide their health-related choices based on health information which will promote and maintain a good health. This preliminary research confirms that situation of diabetic nephropathy still exists. The results of this study will lead to the development of delay in diabetic nephropathy implementation among patients in the province studied.

Keywords: diabetic nephropathy, chronic kidney disease, primary health care, implementation

Procedia PDF Downloads 191

Authors: Wanjiku Karanja

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Facebook has monopoly power in the social networking market. It has grown and entrenched its monopoly power through the capture of its users’ data value chains. However, antitrust law’s consumer welfare roots have prevented it from effectively addressing the role of data capture in Facebook’s market dominance. These regulatory blind spots are augmented in Facebook’s proposed Diem cryptocurrency project and its Novi Digital wallet. Novi, which is Diem’s digital identity component, shall enable Facebook to collect an unprecedented volume of consumer data. Consequently, Novi has seismic implications on internet identity as the network effects of Facebook’s large user base could establish it as the de facto internet identity layer. Moreover, the large tracts of data Facebook shall collect through Novi shall further entrench Facebook's market power. As such, the attendant lock-in effects of this project shall be very difficult to reverse. Urgent regulatory action is therefore required to prevent this expansion of Facebook’s data resources and monopoly power. This research thus highlights the importance of data capture to competition and market health in the social networking industry. It utilizes interviews with key experts to empirically interrogate the impact of Facebook’s data capture and control of its users’ data value chains on its market power. This inquiry is contextualized against Novi’s expansive effect on Facebook’s data value chains. It thus addresses the novel antitrust issues arising at the nexus of Facebook’s monopoly power and the privacy of its users’ data. It also explores the impact of platform design principles, specifically data portability and data portability, in mitigating Facebook’s anti-competitive practices. As such, this study finds that Facebook is a powerful monopoly that dominates the social media industry to the detriment of potential competitors. Facebook derives its power from its size, annexure of the consumer data value chain, and control of its users’ social graphs. Additionally, the platform design principles of data interoperability and data portability are not a panacea to restoring competition in the social networking market. Their success depends on the establishment of robust technical standards and regulatory frameworks.

Keywords: antitrust law, data protection law, data portability, data interoperability, digital identity, Facebook

Procedia PDF Downloads 117

Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

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Authors: Daniele Losanno, Giorgio Serino

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This paper focuses on parametric analysis of reinforced concrete structures equipped with supplemental damping braces. Practitioners still luck sufficient data for current design of damper added structures and often reduce the real model to a pure damper braced structure even if this assumption is neither realistic nor conservative. In the present study, the damping brace is modelled as made by a linear supporting brace connected in series with the viscous/hysteretic damper. Deformation capacity of existing structures is usually not adequate to undergo the design earthquake. In spite of this, additional dampers could be introduced strongly limiting structural damage to acceptable values, or in some cases, reducing frame response to elastic behavior. This work is aimed at providing useful considerations for retrofit of existing buildings by means of supplemental damping braces. The study explicitly takes into consideration variability of (a) relative frame to supporting brace stiffness, (b) dampers’ coefficient (viscous coefficient or yielding force) and (c) non-linear frame behavior. Non-linear time history analysis has been run to account for both dampers’ behavior and non-linear plastic hinges modelled by Pivot hysteretic type. Parametric analysis based on previous studies on SDOF or MDOF linear frames provide reference values for nearly optimal damping systems design. With respect to bare frame configuration, seismic response of the damper-added frame is strongly improved, limiting deformations to acceptable values far below ultimate capacity. Results of the analysis also demonstrated the beneficial effect of stiffer supporting braces, thus highlighting inadequacy of simplified pure damper models. At the same time, the effect of variable damping coefficient and yielding force has to be treated as an optimization problem.

Keywords: brace stiffness, dissipative braces, non-linear analysis, plastic hinges, reinforced concrete frames

Procedia PDF Downloads 288

Authors: Hend Albassam, Nouf Alrumaih

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Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

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Authors: K. Raghu, Sree Harsha

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The interrelationship between the technology and architecture of tall buildings is investigated from the emergence of tall buildings in late 19th century to the present. In the late 19th century early designs of tall buildings recognized the effectiveness of diagonal bracing members in resisting lateral forces. Most of the structural systems deployed for early tall buildings were steel frames with diagonal bracings of various configurations such as X, K, and eccentric. Though the historical research a filtering concept is developed original and remedial technology- through which one can clearly understand inter-relationship between the technical evolution and architectural esthetic and further stylistic transition buildings. Diagonalized grid structures – “diagrids” - have emerged as one of the most innovative and adaptable approaches to structuring buildings in this millennium. Variations of the diagrid system have evolved to the point of making its use non-exclusive to the tall building. Diagrid construction is also to be found in a range of innovative mid-rise steel projects. Contemporary design practice of tall buildings is reviewed and design guidelines are provided for new design trends. Investigated in depths are the behavioral characteristics and design methodology for diagrids structures, which emerge as a new direction in the design of tall buildings with their powerful structural rationale and symbolic architectural expression. Moreover, new technologies for tall building structures and facades are developed for performance enhancement through design integration, and their architectural potentials are explored. By considering the above data the analysis and design of 40-100 storey diagrids steel buildings is carried out using E-TABS software with diagrids of various angle to be found for entire building which will be helpful to reduce the steel requirement for the structure. The present project will have to undertake wind analysis, seismic analysis for lateral loads acting on the structure due to wind loads, earthquake loads, gravity loads. All structural members are designed as per IS 800-2007 considering all load combination. Comparison of results in terms of time period, top storey displacement and inter-storey drift to be carried out. The secondary effect like temperature variations are not considered in the design assuming small variation.

Keywords: diagrid, bracings, structural, building

Procedia PDF Downloads 379

Authors: Marjan Moradi fard, Hossein Rassi, Masoud Houshmand

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Aim: Breast cancer is one of the most common cancers affecting the morbidity and mortality of Iranian women. This disease is a result of collective alterations of oncogenes and tumor suppressor genes. Studies have produced conflicting results concerning the role of p53 codon 72 polymorphism (G>C) and miR-146a rs2910164 polymorphism (G>C) on the risk of several cancers; therefore, a research was performed to estimate the association between the p53 codon 72 polymorphism and miR-146a rs2910164 polymorphism in breast cancer. Methods and Materials: A total of 45 archival breast cancer samples from Khatam hospital and 40 healthy samples were collected. Verification of each cancer reported in a relative was sought through the pathology reports of the hospital records. Then, DNA extracted from all samples by standard methods and p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes were analyzed using multiplex PCR. The tubules, mitotic activity, necrosis, polymorphism and grade of breast cancer were staged by Nottingham histological grading and immunohistochemical staining of the sections from the paraffin wax embedded tissues for the expression of ER, PR and p53 was carried out using a standard method. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of breast cancer in the study population. In this study, we established that tumors of p53 GG genotype and miR-146a rs2910164 CC genotype exhibited higher mitotic activity, higher polymorphism, lower necrosis, lower tubules, higher ER- and PR-negatives and lower TP53-positives than the other genotypes. Conclusion: The present study provided preliminary evidence that a p53 GG genotype may effect breast cancer risk in the study population, interacting synergistically with miR-146a rs2910164 CC genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with clinical parameters can serve as major risk factors in the early identification of breast cancers.

Keywords: breast cancer, miR-146a rs2910164 polymorphism, p53 codon 72 polymorphism, tumors, pathology reports

Procedia PDF Downloads 367

Authors: Aneta Daniel

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The subject of the study is the exploration of the origins and dynamics of the development of language studies, which have been labelled as neurolinguistics. It is worth mentioning that the origins of neurolinguistics are to be found in the research conducted by German scientists before the Second World War in Breslau Universität (presently Wroclaw). The dominant figure in these studies was professor Carl Wernicke, whose students continued and creatively developed projects of their master within this area. Professor Carl Wernicke, a German physician, anatomist, psychiatrist, and neuropathologist, is primarily known for his influential research on aphasia. His research, as well as those conducted by professor Paul Broca, has led to breakthroughs in the location of brain functions, particularly speech. Years later the theses of the pioneers of cognitive neurology (Carl Wernicke and Paul Broca) were developed by other neurolinguists. The main objective of the investigation is the reconstruction of the group of scientists –the students of Carl Wernicke– who contributed to the development of neurolinguistics. The scholars were mainly neurologists and psychiatrists and dealt with the branch of science that had not been named neurolinguistics at that time. The profiles of the scholars will be analysed and presented as the members of the group of researchers who have contributed to the breakthroughs in psychology and neuroscience. The research material consists of archival records documenting the research of professor Carl Wernicke and the researchers from Breslau (presently Wroclaw) which is one of the fastest growing cities in Europe. In 1870, when Carl Wernicke became the medical doctor, Breslau was full of cultural events: festivals and circus shows were held in the city center. Today we can come back to these events due to 'Breslauer Zeitung (1870)', which precisely describes all the events that took place on particular days. It is worth noting that those were the beginnings of antisemitism in Breslau. Many theses and articles that have survived in the libraries in Wroclaw and all over the world contribute to the development of neuroscience. The history of research on the brain and speech analysis, including the history of psychology and neuroscience, areas from which neurolinguistics is derived, will be presented.

Keywords: Aphasia, brain injury, Carl Wernicke, language, neurolinguistics

Procedia PDF Downloads 381

Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

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Authors: Mariya Dayana, Budhmal Jain

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Kannur International Airport Ltd. (KIAL) is a new Greenfield airport project with airside development on an undulating terrain with an average height of 90m above Mean Sea Level (MSL) and a maximum height of 142m. To accommodate the desired Runway length and Runway End Safety Area (RESA) at both the ends along the proposed alignment, it resulted in 45.5 million cubic meters in cutting and filling. The insufficient availability of land for the construction of free slope embankment at RESA 07 end resulted in the design and construction of Reinforced Soil Slope (RSS) with a maximum slope of 65 degrees. An embankment fill of average 70m height with steep slopes located in high rainfall area is a unique feature of this project. The design and construction was challenging being asymmetrical with curves and bends. The fill was reinforced with high strength Uniaxial geogrids laid perpendicular to the slope. Weld mesh wrapped with coir mat acted as the facia units to protect it against surface failure. Face anchorage were also provided by wrapping the geogrids along the facia units where the slope angle was steeper than 45 degrees. Considering high rainfall received on this table top airport site, extensive drainage system was designed for the high embankment fill. Gabion wall up to 10m height were also designed and constructed along the boundary to accommodate the toe of the RSS fill beside the jeepable track at the base level. The design of RSS fill was done using ReSSA software and verified in PLAXIS 2D modeling. Both slip surface failure and wedge failure cases were considered in static and seismic analysis for local and global failure cases. The site won excavated laterite soil was used as the fill material for the construction. Extensive field and laboratory tests were conducted during the construction of RSS system for quality assurance. This paper represents a case study detailing the design and construction of a very high embankment using geosynthetics for the provision of Runway length and RESA area.

Keywords: airport, embankment, gabion, high strength uniaxial geogrid, kial, laterite soil, plaxis 2d

Procedia PDF Downloads 157

Authors: C. E. Laburu, M. A. Barros, A. F. Zompero, O. H. M. Silva

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The work presents a teaching strategy that employs syntagmatic and paradigmatic linguistic relations in order to monitor the understanding of physics students’ concepts. Syntagmatic and paradigmatic relations are theoretical elements of semiotics studies and our research circumstances and justified them within the research program of multi-modal representations. Among the multi-modal representations to learning scientific knowledge, the scope of action of syntagmatic and paradigmatic relations belongs to the discursive writing form. The use of such relations has the purpose to seek innovate didactic work with discourse representation in the write form before translate to another different representational form. The research was conducted with a sample of first year high school students. The students were asked to produce syntagmatic and paradigmatic of Newton’ first law statement. This statement was delivered in paper for each student that should individually write the relations. The student’s records were collected for analysis. It was possible observed in one student used here as example that their monemes replaced and rearrangements produced by, respectively, syntagmatic and paradigmatic relations, kept the original meaning of the law. In paradigmatic production he specified relevant significant units of the linguistic signs, the monemas, which constitute the first articulation and each word substituted kept equivalence to the original meaning of original monema. Also, it was noted a number of diverse and many monemas were chosen, with balanced combination of grammatical (grammatical monema is what changes the meaning of a word, in certain positions of the syntagma, along with a relatively small number of other monemes. It is the smallest linguistic unit that has grammatical meaning) and lexical (lexical monema is what belongs to unlimited inventories; is the monema endowed with lexical meaning) monemas. In syntagmatic production, monemas ordinations were syntactically coherent, being linked with semantic conservation and preserved number. In general, the results showed that the written representation mode based on linguistic relations paradigmatic and syntagmatic qualifies itself to be used in the classroom as a potential identifier and accompanist of meanings acquired from students in the process of scientific inquiry.

Keywords: semiotics, language, high school, physics teaching

Procedia PDF Downloads 129