Search results for: aircraft safety
2253 Evaluating the Efficacy of Tasquinimod in Covid-19
Authors: Raphael Udeh, Luis García De Guadiana Romualdo, Xenia Dolje-Gore
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Background: Quite disturbing is the huge public health impact of COVID-19: As at today [25th March 2021, the COVID-19 global burden shows over 123 million cases and over 2.7 million deaths worldwide. Rationale: Recent evidence shows calprotectin’s potential as a therapeutic target, stating that tasquinimod, from the Quinoline-3-Carboxamide family is capable of blocking the interaction between calprotectin and TLR4. Hence preventing the cytokine release syndrome, that heralds the functional exhaustion in COVID-19. Early preclinical studies showed that tasquinimod inhibit tumor growth and prevent angiogenesis/cytokine storm. Phase I – III clinical studies in prostate cancer showed it has a good safety profile with good radiologic progression free survival but no effect on overall survival. Rationale/hypothesis: Strategic endeavors have been amplified globally to assess new therapeutic interventions for COVID-19 management – thus the clinical and antiviral efficacy of tasquinimod in COVID-19 remains to be explored. Hence the primary objective of this trial will be to evaluate the efficacy of tasquinimod in the treatment of adult patients with severe COVID-19 infections. Therefore, I hypothesise that among adults with COVID19 infection, tasquinimod will reduce the severe respiratory distress associated with COVID-19 compared to placebo, over a 28-day study period. Method: The setting is in Europe. Design – a randomized, placebo-controlled, phase II double-blinded trial. Trial lasts for 28 days from randomization, Tasquinimod capsule given as 0.5mg daily 1st fortnight, then 1mg daily 2nd fortnight. I0 outcome - assessed using six-point ordinal scale alongside eight 20 outcomes. 125 participants to be enrolled, data collection at baseline and subsequent data points, and safety reporting monitored via serological profile. Significance: This work could potentially establish tasquinimod as an effective and safe therapeutic agent for COVID-19 by reducing the severe respiratory distress, related time to recovery, time on oxygen/admission. It will also drive future research – as in larger multi-centre RCT.Keywords: Calprotectin, COVID-19, Phase II Trial, Tasquinimod
Procedia PDF Downloads 1962252 Phytochemical Screening and Toxicological Studies of Aqueous Stem Bark Extract of Boswellia papyrifera (DEL) in Albino Rats
Authors: Y. Abdulmumin, K. I. Matazu, A. M. Wudil, A. J. Alhassan, A. A. Imam
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Phytochemical analysis of Boswellia papryfera confirms the presence of various phytochemicals such as alkaloids, flavonoids, tannins, saponins and cardiac glycosides in its aqueous stem bark extract at different concentration, with tannins being the highest (0.611 ± 0.002 g %). Acute toxicity test (LD50,oral, rat) of the extract showed no mortality at up to 5000 mg/kg and the animals were found active and healthy. The extract was declared as practically non-toxic, this suggest the safety of the extract in traditional medicine.Keywords: acute toxicity, aqueous extract, boswellia papryfera, phytochemicals, stem bark extract
Procedia PDF Downloads 4272251 Randomized Trial of Tian Jiu Therapy in San Fu Days for Patients with Chronic Asthma
Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li
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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial
Procedia PDF Downloads 3142250 Studying the Effect of Different Sizes of Carbon Fiber on Locally Developed Copper Based Composites
Authors: Tahir Ahmad, Abubaker Khan, Muhammad Kamran, Muhammad Umer Manzoor, Muhammad Taqi Zahid Butt
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Metal Matrix Composites (MMC) is a class of weight efficient structural materials that are becoming popular in engineering applications especially in electronic, aerospace, aircraft, packaging and various other industries. This study focuses on the development of carbon fiber reinforced copper matrix composite. Keeping in view the vast applications of metal matrix composites,this specific material is produced for its unique mechanical and thermal properties i.e. high thermal conductivity and low coefficient of thermal expansion at elevated temperatures. The carbon fibers were not pretreated but coated with copper by electroless plating in order to increase the wettability of carbon fiber with the copper matrix. Casting is chosen as the manufacturing route for the C-Cu composite. Four different compositions of the composite were developed by varying the amount of carbon fibers by 0.5, 1, 1.5 and 2 wt. % of the copper. The effect of varying carbon fiber content and sizes on the mechanical properties of the C-Cu composite is studied in this work. The tensile test was performed on the tensile specimens. The yield strength decreases with increasing fiber content while the ultimate tensile strength increases with increasing fiber content. Rockwell hardness test was also performed and the result followed the increasing trend for increasing carbon fibers and the hardness numbers are 30.2, 37.2, 39.9 and 42.5 for sample 1, 2, 3 and 4 respectively. The microstructures of the specimens were also examined under the optical microscope. Wear test and SEM also done for checking characteristic of C-Cu marix composite. Through casting may be a route for the production of the C-Cu matrix composite but still powder metallurgy is better to follow as the wettability of carbon fiber with matrix, in that case, would be better.Keywords: copper based composites, mechanical properties, wear properties, microstructure
Procedia PDF Downloads 3642249 Cannabis for the Treatment of Drug Resistant Epilepsy in Children
Authors: Sarah E. Casey
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Epilepsy is the most common neurological disorder in children and approximately one-third of children with epilepsy have seizures that are uncontrolled on anticonvulsants alone. Cannabidiol is shown to be an effective treatment at reducing the amount of breakthrough seizures experienced by children with drug resistant epilepsy. Improvements in quality of life and overall condition were noted during cannabidiol treatment. Adverse side effects were experienced and were generally mild to moderate in nature. Additional double-blind, controlled studies with a more diverse sample population and standardized dosing are needed to ensure the efficacy and safety of cannabidiol use in children with drug resistant epilepsy.Keywords: cannabis, drug resistant epilepsy, children, epilepsy
Procedia PDF Downloads 2232248 The Analgesic Impact of Adding Intrathecal Ketamine to Spinal Anaesthesia for Hip or Knee Arthroplasty: A Clinical Audit
Authors: Carl Ashworth, Matthys Campher
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Spinal anaesthesia has been identified as the “gold standard” for primary elective total hip and knee arthroplasty, which is most commonly performed using longer-acting local anaesthetics, such as hyperbaric bupivacaine, to prolong the duration of anaesthesia and analgesia suitable for these procedures. Ketamine is known to have local anaesthetic effects with potent analgesic properties and has been evaluated as a sole anaesthetic agent via intrathecal administration; however, the use of intrathecal ketamine as an adjunct to intrathecal hyperbaric bupivacaine, morphine, and fentanyl has not been extensively studied. The objective of this study was to identify the potential analgesic effects of the addition of intrathecal ketamine to spinal anaesthesia and to compare the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine. The medical records of patients who underwent elective hip- or knee arthroplasty under spinal anaesthesia performed by an individual anaesthetist with either intrathecal hyperbaric bupivacaine, morphine and fentanyl or intrathecal hyperbaric bupivacaine, morphine, fentanyl and ketamine between June 4, 2020, and June 4, 2022, were retrospectively reviewed. These encounters were reviewed and analyzed from a perioperative pain perspective, with the primary outcome measure as the oral morphine equivalent (OME) usage in the 48 hours post-spinal anaesthesia, and secondary outcome measures including time to breakthrough analgesia, self-reported pain scores at rest and during movement at 24 and 48 hours after surgery, adverse effects of analgesia, complications, and length of stay. There were 26 patients identified who underwent TKR between June 4, 2020, and June 4, 2022, and 25 patients who underwent THR with the same conditions. It was identified that patients who underwent traditional spinal anaesthesia with the addition of ketamine for elective hip- or knee arthroplasty had a lower mean total OME in the 48 hours immediately post-spinal anaesthesia yet had a shorter time to breakthrough analgesia administration. The proposed mechanism of action for intrathecal ketamine as an additive to traditional spinal anaesthesia for elective hip- or knee arthroplasty is that it may prolong and attenuate the analgesic effect of traditional spinal anaesthesia. There were no significant differences identified in comparing the efficacy and safety of adding intrathecal ketamine to spinal anaesthesia for hip- or knee arthroplasty with spinal anaesthesia for hip- or knee arthroplasty without intrathecal ketamine.Keywords: anaesthesia, spinal, intra-thecal, ketamine, spinal-morphine, bupivacaine
Procedia PDF Downloads 522247 Feature of Employment Injuries and Maintenance Works of Construction Machinery
Authors: Naoko Kanazawa, Tran Thi Bich Nguyet, Yoshiyuki Higuchi, Hideki Hamada
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Construction machines’ condition is maintained with the regularly inspections, preventive maintenance and repairs by skillful and qualified engineers. If an accident occurs, there will be enormous influence such as human injuries, delays in the term of construction. In this paper, we revealed the characteristics such as inspection, maintenance and repair works for construction machines, and we also clarified the trends of employment injuries based on actual data by simple and cross tabulation methods, and investigated the relation with their works, injured body parts and accident types.Keywords: construction machines, employment injuries, maintenance and repair, safety and health
Procedia PDF Downloads 3072246 Exploring Type V Hydrogen Storage Tanks: Shape Analysis and Material Evaluation for Enhanced Safety and Efficiency Focusing on Drop Test Performance
Authors: Mariam Jaber, Abdullah Yahya, Mohammad Alkhedher
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The shift toward sustainable energy solutions increasingly focuses on hydrogen, recognized for its potential as a clean energy carrier. Despite its benefits, hydrogen storage poses significant challenges, primarily due to its low energy density and high volatility. Among the various solutions, pressure vessels designed for hydrogen storage range from Type I to Type V, each tailored for specific needs and benefits. Notably, Type V vessels, with their all-composite, liner-less design, significantly reduce weight and costs while optimizing space and decreasing maintenance demands. This study focuses on optimizing Type V hydrogen storage tanks by examining how different shapes affect performance in drop tests—a crucial aspect of achieving ISO 15869 certification. This certification ensures that if a tank is dropped, it will fail in a controlled manner, ideally by leaking before bursting. While cylindrical vessels are predominant in mobile applications due to their manufacturability and efficient use of space, spherical vessels offer superior stress distribution and require significantly less material thickness for the same pressure tolerance, making them advantageous for high-pressure scenarios. However, spherical tanks are less efficient in terms of packing and more complex to manufacture. Additionally, this study introduces toroidal vessels to assess their performance relative to the more traditional shapes, noting that the toroidal shape offers a more space-efficient option. The research evaluates how different shapes—spherical, cylindrical, and toroidal—affect drop test outcomes when combined with various composite materials and layup configurations. The ultimate goal is to identify optimal vessel geometries that enhance the safety and efficiency of hydrogen storage systems. For our materials, we selected high-performance composites such as Carbon T-700/Epoxy, Kevlar/Epoxy, E-Glass Fiber/Epoxy, and Basalt/Epoxy, configured in various orientations like [0,90]s, [45,-45]s, and [54,-54]. Our tests involved dropping tanks from different angles—horizontal, vertical, and 45 degrees—with an internal pressure of 35 MPa to replicate real-world scenarios as closely as possible. We used finite element analysis and first-order shear deformation theory, conducting tests with the Abaqus Explicit Dynamics software, which is ideal for handling the quick, intense stresses of an impact. The results from these simulations will provide valuable insights into how different designs and materials can enhance the durability and safety of hydrogen storage tanks. Our findings aim to guide future designs, making them more effective at withstanding impacts and safer overall. Ultimately, this research will contribute to the broader field of lightweight composite materials and polymers, advancing more innovative and practical approaches to hydrogen storage. By refining how we design these tanks, we are moving toward more reliable and economically feasible hydrogen storage solutions, further emphasizing hydrogen's role in the landscape of sustainable energy carriers.Keywords: hydrogen storage, drop test, composite materials, type V tanks, finite element analysis
Procedia PDF Downloads 462245 Anticancer Activity of Milk Fat Rich in Conjugated Linoleic Acid Against Ehrlich Ascites Carcinoma Cells in Female Swiss Albino Mice
Authors: Diea Gamal Abo El-Hassan, Salwa Ahmed Aly, Abdelrahman Mahmoud Abdelgwad
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The major conjugated linoleic acid (CLA) isomers have anticancer effect, especially breast cancer cells, inhibits cell growth and induces cell death. Also, CLA has several health benefits in vivo, including antiatherogenesis, antiobesity, and modulation of immune function. The present study aimed to assess the safety and anticancer effects of milk fat CLA against in vivo Ehrlich ascites carcinoma (EAC) in female Swiss albino mice. This was based on acute toxicity study, detection of the tumor growth, life span of EAC bearing hosts, and simultaneous alterations in the hematological, biochemical, and histopathological profiles. Materials and Methods: One hundred and fifty adult female mice were equally divided into five groups. Groups (1-2) were normal controls, and Groups (3-5) were tumor transplanted mice (TTM) inoculated intraperitoneally with EAC cells (2×106 /0.2 mL). Group (3) was (TTM positive control). Group (4) TTM fed orally on balanced diet supplemented with milk fat CLA (40 mg CLA/kg body weight). Group (5) TTM fed orally on balanced diet supplemented with the same level of CLA 28 days before tumor cells inoculation. Blood samples and specimens from liver and kidney were collected from each group. The effect of milk fat CLA on the growth of tumor, life span of TTM, and simultaneous alterations in the hematological, biochemical, and histopathological profiles were examined. Results: For CLA treated TTM, significant decrease in tumor weight, ascetic volume, viable Ehrlich cells accompanied with increase in life span were observed. Hematological and biochemical profiles reverted to more or less normal levels and histopathology showed minimal effects. Conclusion: The present study proved the safety and anticancer efficiency of milk fat CLA and provides a scientific basis for its medicinal use as anticancer attributable to the additive or synergistic effects of its isomers.Keywords: anticancer activity, conjugated linoleic acid, Ehrlich ascites carcinoma, % increase in life span, mean survival time, tumor transplanted mice.
Procedia PDF Downloads 922244 Factors Determining the Vulnerability to Occupational Health Risk and Safety of Call Center Agents in the Philippines
Authors: Lito M. Amit, Venecio U. Ultra, Young-Woong Song
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The business process outsourcing (BPO) in the Philippines is expanding rapidly attracting more than 2% of total employment. Currently, the BPO industry is confronted with several issues pertaining to sustainable productivity such as meeting the staffing gap, high rate of employees’ turnover and workforce retention, and the occupational health and safety (OHS) of call center agents. We conducted a survey of OHS programs and health concerns among call center agents in the Philippines and determined the sociocultural factors that affect the vulnerability of call center agents to occupational health risks and hazards. The majority of the agents affirmed that OHS are implemented and OHS orientation and emergency procedures were conducted at employment initiations, perceived favorable and convenient working environment except for occasional noise disturbances and acoustic shock, visual, and voice fatigues. Male agents can easily adjust to the demands and changes in their work environment and flexible work schedules than female agents. Female agents have a higher tendency to be pressured and humiliated by low work performance, experience a higher incidence of emotional abuse, psychological abuse, and experience more physical stress than male agents. The majority of the call center agents had a night-shift schedule and regardless of other factors, night shift work brings higher stress to agents. While working in a call center, higher incidence of headaches and insomnia, burnout, suppressed anger, anxiety, and depressions were experienced by female, younger (21-25 years old) and those at night shift than their counterpart. Most common musculoskeletal disorders include body pain in the neck, shoulders and back; and hand and wrist disorders and these are commonly experienced by female and younger workers. About 30% experienced symptoms of cardiovascular and gastrointestinal disorders and weakened immune systems. Overall, these findings have shown the variable vulnerability by a different subpopulation of call center agents and are important in the occupational health risk prevention and management towards a sustainable human resource for BPO industry in the Philippines.Keywords: business process outsourcing industry, health risk of call center agents, socio-cultural determinants, Philippines
Procedia PDF Downloads 4942243 Process Modeling in an Aeronautics Context
Authors: Sophie Lemoussu, Jean-Charles Chaudemar, Robertus A. Vingerhoeds
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Many innovative projects exist in the field of aeronautics, each addressing specific areas so to reduce weight, increase autonomy, reduction of CO2, etc. In many cases, such innovative developments are being carried out by very small enterprises (VSE’s) or small and medium sized-enterprises (SME’s). A good example concerns airships that are being studied as a real alternative to passenger and cargo transportation. Today, no international regulations propose a precise and sufficiently detailed framework for the development and certification of airships. The absence of such a regulatory framework requires a very close contact with regulatory instances. However, VSE’s/SME’s do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses an additional challenge for those VSE’s/SME’s, in particular those that have system integration responsibilities and that must provide all the necessary evidence to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The main objective of this research is to provide a methodological framework enabling VSE’s/SME’s with limited resources to organize the development of airships while taking into account the constraints of safety, cost, time and performance. This paper proposes to provide a contribution to this problematic by proposing a Model-Based Systems Engineering approach. Through a comprehensive process modeling approach applied to the development processes, the regulatory constraints, existing best practices, etc., a good image can be obtained as to the process landscape that may influence the development of airships. To this effect, not only the necessary regulatory information is taken on board, also other international standards and norms on systems engineering and project management are being modeled and taken into account. In a next step, the model can be used for analysis of the specific situation for given developments, derive critical paths for the development, identify eventual conflicting aspects between the norms, standards, and regulatory expectations, or also identify those areas where not enough information is available. Once critical paths are known, optimization approaches can be used and decision support techniques can be applied so to better support VSE’s/SME’s in their innovative developments. This paper reports on the adopted modeling approach, the retained modeling languages, and how they all fit together.Keywords: aeronautics, certification, process modeling, project management, regulation, SME, systems engineering, VSE
Procedia PDF Downloads 1612242 Case of an Engineering Design Class in Architectural Engineering
Authors: Myunghoun Jang
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Most engineering colleges in South Korea have engineering design classes in order to develop and enhance a student's creativity and problem-solving ability. Many cases about engineering design class are shown in journals and magazines, but a case lasting many years is few. The engineering design class in the Department of Architectural Engineering, Jeju National University was open in 2009 and continues to this year. 3-5 teams in every year set up their problems found their solutions and produced good results. Three of the results obtained patents. The class also provides students with opportunities to improve communication skill because they have many discussions in solving their problems.Keywords: engineering design, architectural engineering, team-based learning, construction safety
Procedia PDF Downloads 2362241 Design and Development of High Strength Aluminium Alloy from Recycled 7xxx-Series Material Using Bayesian Optimisation
Authors: Alireza Vahid, Santu Rana, Sunil Gupta, Pratibha Vellanki, Svetha Venkatesh, Thomas Dorin
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Aluminum is the preferred material for lightweight applications and its alloys are constantly improving. The high strength 7xxx alloys have been extensively used for structural components in aerospace and automobile industries for the past 50 years. In the next decade, a great number of airplanes will be retired, providing an obvious source of valuable used metals and great demand for cost-effective methods to re-use these alloys. The design of proper aerospace alloys is primarily based on optimizing strength and ductility, both of which can be improved by controlling the additional alloying elements as well as heat treatment conditions. In this project, we explore the design of high-performance alloys with 7xxx as a base material. These designed alloys have to be optimized and improved to compare with modern 7xxx-series alloys and to remain competitive for aircraft manufacturing. Aerospace alloys are extremely complex with multiple alloying elements and numerous processing steps making optimization often intensive and costly. In the present study, we used Bayesian optimization algorithm, a well-known adaptive design strategy, to optimize this multi-variable system. An Al alloy was proposed and the relevant heat treatment schedules were optimized, using the tensile yield strength as the output to maximize. The designed alloy has a maximum yield strength and ultimate tensile strength of more than 730 and 760 MPa, respectively, and is thus comparable to the modern high strength 7xxx-series alloys. The microstructure of this alloy is characterized by electron microscopy, indicating that the increased strength of the alloy is due to the presence of a high number density of refined precipitates.Keywords: aluminum alloys, Bayesian optimization, heat treatment, tensile properties
Procedia PDF Downloads 1192240 A Discrete Event Simulation Model For Airport Runway Operations Optimization (Case Study)
Authors: Awad Khireldin, Colin Law
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Runways are the major infrastructure of airports around the world. Efficient operations of runways are key to ensure that airports are running smoothly with minimal delays. There are many factors that affect the efficiency of runway operations, such as the aircraft wake separation, runways system configuration, the fleet mix, and the runways separation distance. This paper aims to address how to maximize runway operations using a Discrete Event Simulation model. A case study of Cairo International Airport (CIA) is developed to maximize the utilizing of three parallel runways using a simulation model. Different scenarios have been designed where every runway could be assigned for arrival, departure, or mixed operations. A benchmarking study was also included to compare the actual to the proposed results to spot the potential improvements. The simulation model shows that there is a significant difference in utilization and delays between the actual and the proposed ones, there are several recommendations that can be provided to airport management, in the short and long term, to increase the efficiency and to reduce the delays. By including the recommendation with different operations scenarios, such as upgrading the airport slot Coordination from Level 1 to Level 2 in the short term. In the long run, discuss the possibilities to increase the International Air Transport association (IATA) slot coordination to Level 3 as more flights are expected to be handled by the airport. Technological advancements such as radar in the approach full airside simulation model could improve the airport performance where the airport is recommended to review the standard operations procedures with the appropriate authorities. Also, the airport can adopt a future operational plan to accommodate the forecasted additional traffic density in case of adding a fourth terminal building to increase the airport capacity.Keywords: airport performance, runway, discrete event simulation, capacity, airside
Procedia PDF Downloads 1312239 All at Sea: Why OT / IT Infrastructure Is So Complex and the Challenges of Securing These on a Cruise Ship
Authors: Ken Munro
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Cruise ships are possibly the most complex collection of systems it is possible to find in one physical, moving location. Propulsion, navigation, power generation and more, combined with a hotel, restaurant, casino, theatre etc, with safety and fire control systems to boot. That complexity creates huge challenges with keeping OT and IT systems apart. Ships engines are often remotely managed, network segregation is often defeated through troubleshooting when at sea. This session will refer to multiple entertaining and informative tales of taking control of ships, including accessing a ships Azipods via a game simulator for passengers. Fortunately, genuine attacks against vessels are very rare, but the effects and impacts to world trade are becoming increasingly obvious.Keywords: maritime security, cybersecurity, OT, IT, networks
Procedia PDF Downloads 332238 The Safe Introduction of Tocilizumab for the Treatment of SARS-CoV-2 Pneumonia at an East London District General Hospital
Authors: Andrew Read, Alice Parry, Kate Woods
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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoingKeywords: education, patient safety , SARS-CoV-2, Tocilizumab
Procedia PDF Downloads 1752237 Using a Mobile App to Foster Children Active Travel to School in Spain
Authors: P. Pérez-Martín, G. Pedrós, P. Martínez-Jiménez, M. Varo-Martínez
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In recent decades, family habits related to children’s displacements to school have changed, increasing motorized travels against active modes. This entails a major negative impact on the urban environment, road safety in cities and the physical and psychological development of children. One of the more common actions used to reverse this trend is Walking School Bus (WSB), which consists of a predefined adult-scorted pedestrian route to school with several stops along the path where schoolchildren are collected. At Tirso de Molina School in Cordoba (Spain), a new ICT-based methodology to deploy WSB has been tested. A mobile app that allows the geoposition of the group, the notification of the arrival and real-time communication between the WSB participants have been presented to the families in order to organize and register the daily participation. After an initial survey to know the travel mode and the spatial distribution of the interested families, three WSB routes have been established and the families have been trained in the app usage. During nine weeks, 33 children have joined the WSB and their parents have accompanied the groups in turns. A high recurrence in the attendance has been registered. Through a final survey, participants have valued highly the tool and the methodology designed, emphasizing as most useful features of the mobile app: notifications system, chat and real-time monitoring. It has also been found that the tool has had a major impact on the degree of confidence of parents regarding the autonomous on foot displacement of their children to school. Moreover, 37,9% of the participant families have reported a total or partial modal shift from car to walking, and the benefits more reported are an increment of the parents available time and less problems in the travel to school daily organization. As a consequence, It has been proved the effectiveness of this user-centric innovative ICT-based methodology to reduce the levels of private car drop offs, minimize barriers of time constraints, volunteer recruitment, and parents’ safety concerns, while, at the same time, increase convenience and time savings for families. This pilot study can offer guidance for community coordinated actions and local authority interventions to support sustainable school travel outcomes.Keywords: active travel, mobile app, sustainable mobility, urban transportation planning, walking school bus
Procedia PDF Downloads 3362236 The Dismantling of the Santa Ana Riverbed Homeless Encampment: A Case Study
Authors: Shasta Bula
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This research provides the first case study of the Santa Ana riverbed homeless encampment. It contributes valuable information about the little-studied factors contributing to the formation and dismantling of transient homeless encampments. According to the author’s best knowledge, this is the discussion of three reoccurring characteristics of homeless camps: camps form a self-governing system, camps are viewed by the community as unsavory places, and the campers are viewed as being unable or unwilling to participate in normal society. Three theories are proposed as explanations for these characteristics: the social capital theory as a reason for homeless campers to develop a system of self-government, the aesthetics theory as rationale for camps being viewed as unsavory places, and the theory of vulnerable and inevitable inequality as a reason why campers are seen as being unable or unwilling to participate in normal society. Three hypotheses are introduced to assess these theories: The encampment was created because it provided inhabitants a sense of safety and autonomy. It was dismantled due to its highly visible location and lack of adherence to the Orange County consumption and leisure aesthetic. Most homeless people from this encampment relocated approximately thirty miles east to Riverside County to avoid harassment by police. An extensive review of interviews with camp inhabitants revealed that fifty-one percent resided in the camp because it gave them a sense of safety and autonomy. An examination of Anaheim city council meeting meetings showed that thirty-eight percent of complaints were related to aesthetic concerns. Analysis of population reports from the U.S. Department of Housing and Urban Development indicated that there was a notable increase in homelessness in Orange County the year after the camp was dismantled. These results reflect that the social capital theory is an applicable explanation for the homeless being drawn to set up camp as a collective. The aesthetics theory can be used to explain why a third of residents complained about the encampment. Camp residents did not move East to Riverside after the camp was dismantled. Further investigation into the enforcement of anti-camping ordinances needs to be conducted to evaluate if policing contributed to the vulnerability of the homeless.Keywords: poverty, social relations, transformation of urban settlements, urban anthropology
Procedia PDF Downloads 942235 Used MATLAB Code to Study the Vehicle Bridge Coupling Vibration Based On the Method of Newmark-β
Authors: Saidi Abdelkrim, Hamouine Abdelmadjid, Abdellatif Megnounif
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The study of interaction between vehicles and bridge structures has become extremely important. Large deflections and vibration induced by heavy and high-speed vehicles affect significantly the safety and efficiency of bridge. The vibration of a bridge caused by passage of vehicles is one of the most imperative considerations in the design of a bridge as a common sort of transportation structure. A major goal of this study is to create a simplified model of a vehicle bridge system in MATLAB. The model will then be used to study the influence of parameters to vehicle-bridge vibrations.Keywords: vehicle-bridge interaction, Newmark-β, MATLAB code
Procedia PDF Downloads 6182234 Analysis of Brake System for Vehicle Off-Road
Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale, José Ubiragi de Lima Mendes
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In elapsing of the years it elaborates automobile it is developing automobiles more and more modern that, every year, the vehicles recently of the assembly lines, practically they push for the past produced models there is very little time. Those innovations didn't also pass unperceived in 0respect the safety of the vehicles. It is in this development apprenticeship the brakes systems equipped more and more with resources sophisticated. In that way, before of that context, this research tried to project a brake system for a vehicle off-road and to analyze your acting as the brakes efficiency: distances traveled and time, concluding with possible improvements in the system.Keywords: brakes system, off-road, vehicle acting, automotive and mechanical engineering
Procedia PDF Downloads 4842233 Development of Generally Applicable Intravenous to Oral Antibiotic Switch Therapy Criteria
Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon
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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy
Procedia PDF Downloads 3562232 Using HABIT to Establish the Chemicals Analysis Methodology for Maanshan Nuclear Power Plant
Authors: J. R. Wang, S. W. Chen, Y. Chiang, W. S. Hsu, J. H. Yang, Y. S. Tseng, C. Shih
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In this research, the HABIT analysis methodology was established for Maanshan nuclear power plant (NPP). The Final Safety Analysis Report (FSAR), reports, and other data were used in this study. To evaluate the control room habitability under the CO2 storage burst, the HABIT methodology was used to perform this analysis. The HABIT result was below the R.G. 1.78 failure criteria. This indicates that Maanshan NPP habitability can be maintained. Additionally, the sensitivity study of the parameters (wind speed, atmospheric stability classification, air temperature, and control room intake flow rate) was also performed in this research.Keywords: PWR, HABIT, Habitability, Maanshan
Procedia PDF Downloads 4452231 Using HABIT to Estimate the Concentration of CO2 and H2SO4 for Kuosheng Nuclear Power Plant
Authors: Y. Chiang, W. Y. Li, J. R. Wang, S. W. Chen, W. S. Hsu, J. H. Yang, Y. S. Tseng, C. Shih
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In this research, the HABIT code was used to estimate the concentration under the CO2 and H2SO4 storage burst conditions for Kuosheng nuclear power plant (NPP). The Final Safety Analysis Report (FSAR) and reports were used in this research. In addition, to evaluate the control room habitability for these cases, the HABIT analysis results were compared with the R.G. 1.78 failure criteria. The comparison results show that the HABIT results are below the criteria. Additionally, some sensitivity studies (stability classification, wind speed and control room intake rate) were performed in this study.Keywords: BWR, HABIT, habitability, Kuosheng
Procedia PDF Downloads 4892230 The Effect of Artificial Intelligence on Electric Machines and Welding
Authors: Mina Malak Zakaria Henin
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The finite detail evaluation of magnetic fields in electromagnetic devices shows that the machine cores revel in extraordinary flux patterns consisting of alternating and rotating fields. The rotating fields are generated in different configurations variety, among circular and elliptical, with distinctive ratios between the fundamental and minor axes of the flux locus. Experimental measurements on electrical metal uncovered one-of-a-kind flux patterns that divulge distinctive magnetic losses in the samples below the test. Therefore, electric machines require unique interest throughout the core loss calculation technique to bear in mind the flux styles. In this look, a circular rotational unmarried sheet tester is employed to measure the middle losses in the electric-powered metallic pattern of M36G29. The sample becomes exposed to alternating fields, circular areas, and elliptical fields with axis ratios of zero.2, zero. Four, 0.6 and 0.8. The measured statistics changed into applied on 6-4 switched reluctance motors at 3 distinctive frequencies of interest to the industry 60 Hz, 400 Hz, and 1 kHz. The effects reveal an excessive margin of error, which can arise at some point in the loss calculations if the flux pattern difficulty is overlooked. The mistake in exceptional components of the gadget associated with considering the flux styles may be around 50%, 10%, and a couple of at 60Hz, 400Hz, and 1 kHz, respectively. The future paintings will focus on the optimization of gadget geometrical shape, which has a primary effect on the flux sample on the way to decrease the magnetic losses in system cores.Keywords: converters, electric machines, MEA (more electric aircraft), PES (power electronics systems) synchronous machine, vector control Multi-machine/ Multi-inverter, matrix inverter, Railway tractionalternating core losses, finite element analysis, rotational core losses
Procedia PDF Downloads 282229 An AHP Study on The Migrant and Refugee Employees Occupational Health and Safety Issues in Turkey
Authors: Cengiz Akyildiz, Ismail Ekmekci
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In the past 15 years, many people have sought refuge and emigrated to developed countries due to the civil war in Syria, terrorism and turmoil in Iraq, Iran and Afghanistan, hunger problems in Africa and the purpose of work. Many of these people came to Turkey. By the end of the 2019, in Turkey, regular and irregular migrants, asylum seekers and foreigners under international protection are about 6 million people. The majority of these people are Syrians. Approximately 2 800 000 immigrants and refugees are in the workforce. Migrant workers in our country constitute the largest proportion among all countries in the world according to the local labor force. 2.5 million of these employees, with a high rate of about 90%, work informally and do not have legal records and valid employment contracts as a workforce; They cannot benefit from Occupational Health and Safety (OHS) services. Migrant workers generally receive less wages than local workers, working longer hours and worse conditions; they are often subjected to human rights violations, harassment, human trafficking and violence. Migrant workers face problems such as OHS practices, environmental and occupational exposures, language / cultural barriers, access to health services, and lack of documentation. Therefore, the OHS problems of these employees are becoming an increasingly problematic area. However, there is not enough research, analysis and academic studies in this field. The order of importance should be known for the radical solution of the problems, because of the problems with high severity are also at high risk. In this study, for the first time, a Search Conference was held with the participation of 45 stakeholders to reveal the OHS problems of regular and irregular migrant workers in our country. The problems arising from this workshop were compared with the problems in the literature and the problems in this field were determined and weighted for our country. Later, to determine the significance levels of these problems, AHP study, which is a Multi Criteria Decision Making Method in which 15 experts participated, was conducted and the significance levels of these problems were determined. When the data obtained are evaluated, it has been seen that the OSH risks of migrant workers arise from 58% laws and government policies, 29% from employers, 13% from personal faults of employees. An academic study has been carried out for the first time in this field regarding the OHS problems of migrant workers, and an academic study has been created to guide which of the problems should be prioritized.Keywords: environmental conditions, migrant workers, OHS issues, workplace conditions
Procedia PDF Downloads 1512228 Effects of Using a Recurrent Adverse Drug Reaction Prevention Program on Safe Use of Medicine among Patients Receiving Services at the Accident and Emergency Department of Songkhla Hospital Thailand
Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn
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Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.Keywords: recurrent drug, adverse reaction, safety, use of medicine
Procedia PDF Downloads 4562227 Central Line Stock and Use Audit in Adult Patients: A Quality Improvement Project on Central Venous Catheter Standardisation Across Hospital Departments
Authors: Gregor Moncrieff, Ursula Bahlmann
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A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.Keywords: central venous catheter, medical equipment, medical safety, quality improvement
Procedia PDF Downloads 1172226 Vibration Analysis of FGM Sandwich Panel with Cut-Outs Using Refined Higher-Order Shear Deformation Theory (HSDT) Based on Isogeometric Analysis
Authors: Lokanath Barik, Abinash Kumar Swain
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This paper presents vibration analysis of FGM sandwich structure with a complex profile governed by refined higher-order shear deformation theory (RHSDT) using isogeometric analysis (IGA). Functionally graded sandwich plates provide a wide range of applications in aerospace, defence, and aircraft industries due to their ability to distribute material functions to influence the thermo-mechanical properties as desired. In practical applications, these structures generally have intrinsic profiles, and their response to loads is significantly affected due to cut-outs. IGA is primarily a NURBS-based technique that is effective in solving higher-order differential equations due to its inherent C1 continuity imposition in solution space for a single patch. Complex structures generally require multiple patches to accurately represent the geometry, and hence, there is a loss of continuity at adjoining patch junctions. Therefore, patch coupling is desired to maintain continuity requirements throughout the domain. In this work, a novel strong coupling approach is provided that generates a well-defined NURBS-based model while achieving continuity. The methodology is validated by free vibration analysis of sandwich plates with present literature. The results are in good agreement with the analytical solution for different plate configurations and power law indexes. Numerical examples of rectangular and annular plates are discussed with variable boundary conditions. Additionally, parametric studies are provided by varying the aspect ratio, porosity ratio and their influence on the natural frequency of the plate.Keywords: vibration analysis, FGM sandwich structure, multipatch geometry, patch coupling, IGA
Procedia PDF Downloads 822225 Cyber Bullying, Online Risks and Parental Mediation: A Comparison between Adolescent Reports and Parent Perceptions in South Africa
Authors: Masa Popovac, Philip Fine
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Information and Communication Technologies (ICTs) have altered our social environments, and young people in particular have immersed themselves in the digital age. Despite countless benefits, younger ICT users are being exposed to various online risks such as contact with strangers, viewing of risky content, sending or receiving sexually themed images or comments (i.e. ‘sexting’) as well as cyber bullying. Parents may not be fully aware of the online spaces their children inhabit and often struggle to implement effective mediation strategies. This quantitative study explored (i) three types of online risks (contact risks, content risks and conduct risks), (ii) cyber bullying victimization and perpetration, and (iii) parental mediation among a sample of 689 South African adolescents aged between 12-17 years. Survey data was also collected for 227 of their parents relating to their perceptions of their child’s online experiences. A comparison between adolescent behaviors and parental perceptions was examined on the three variables in the study. Findings reveal various online risk taking behaviors. In terms of contact risks, 56% of adolescents reported having contact with at least one online stranger, with many meeting these strangers in person. Content risks included exposure to harmful information such as websites promoting extreme diets or self-harm as well as inappropriate content: 84% of adolescents had seen violent content and 75% had seen sexual content online. Almost 60% of adolescents engaged in conduct risks such as sexting. Eight online victimization behaviors were examined in the study and 79% of adolescents had at least one of these negative experiences, with a third (34%) defining this experience as cyber bullying. A strong connection between victimization and perpetration was found, with 63% of adolescents being both a victim and perpetrator. Very little parental mediation of ICT use was reported. Inferential statistics revealed that parents consistently underestimated their child’s online risk taking behaviors as well as their cyber bullying victimization and perpetration. Parents also overestimated mediation strategies in the home. The generational gap in the knowledge and use of ICTs is a barrier to effective parental mediation and online safety, since many negative online experiences by adolescents go undetected and can continue for extended periods of time thereby exacerbating the potential psychological and emotional distress. The study highlights the importance of including parents in online safety efforts.Keywords: cyber bullying, online risk behaviors, parental mediation, South Africa
Procedia PDF Downloads 4832224 Review of the Safety of Discharge on the First Postoperative Day Following Carotid Surgery: A Retrospective Analysis
Authors: John Yahng, Hansraj Riteesh Bookun
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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.Keywords: carotid, complication, discharge, surgery
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