Search results for: emergency room
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2220

Search results for: emergency room

600 Analysis and Modeling of the Building’s Facades in Terms of Different Convection Coefficients

Authors: Enes Yasa, Guven Fidan

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Building Simulation tools need to better evaluate convective heat exchanges between external air and wall surfaces. Previous analysis demonstrated the significant effects of convective heat transfer coefficient values on the room energy balance. Some authors have pointed out that large discrepancies observed between widely used building thermal models can be attributed to the different correlations used to calculate or impose the value of the convective heat transfer coefficients. Moreover, numerous researchers have made sensitivity calculations and proved that the choice of Convective Heat Transfer Coefficient values can lead to differences from 20% to 40% of energy demands. The thermal losses to the ambient from a building surface or a roof mounted solar collector represent an important portion of the overall energy balance and depend heavily on the wind induced convection. In an effort to help designers make better use of the available correlations in the literature for the external convection coefficients due to the wind, a critical discussion and a suitable tabulation is presented, on the basis of algebraic form of the coefficients and their dependence upon characteristic length and wind direction, in addition to wind speed. Many research works have been conducted since early eighties focused on the convection heat transfer problems inside buildings. In this context, a Computational Fluid Dynamics (CFD) program has been used to predict external convective heat transfer coefficients at external building surfaces. For the building facades model, effects of wind speed and temperature differences between the surfaces and the external air have been analyzed, showing different heat transfer conditions and coefficients. In order to provide further information on external convective heat transfer coefficients, a numerical work is presented in this paper, using a Computational Fluid Dynamics (CFD) commercial package (CFX) to predict convective heat transfer coefficients at external building surface.

Keywords: CFD in buildings, external convective heat transfer coefficients, building facades, thermal modelling

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599 Self-Healing Composites of Silicone Rubber

Authors: Anna Strakowska, Marian Zaborski

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This abstract focuses an overview of the methods used to create self-healing silicone composites. It has been shown how incorporating of polyhedral oligomeric silsesquioxanes (POSS) molecules with acid and basic groups to silicone rubber affects the barrier properties, mechanical properties in room and reduced temperature or the influence on relaxation rates of the methylvinylsilicone rubber vulcanizates. Moreover, the presence of silsesquioxanes, their content and the way of composites preparing affect the amount of ionic bonds, as indicated by dynamic - mechanical thermal analysis (DMTA) as well as measurements of equilibrium swelling in toluene. The aim of this work was to study the influence of concentration and different functional groups types selected silsesquioxanes compounds on self-healing effect of silicone rubber and obtain elastomers with good barrier and mechanical properties. Composites based on the methylvinylsilicone rubber with fumed silica as the fillers were manufactured and studied. To obtain self-healing effect various silsesquioxanes with amino and acid groups were used. Every tested sample demonstrated the ability to the self-treatment. The most significant effect was observed for system containing amic-acid isobytyl POSS/ aminopropylisobutyl POSS. Composite with this silsesquioxanes was exhibited the best improvement of gas permeability after heal. Moreover, the addition of POSS with acid and basic groups clearly affects the mechanical properties of the vulcanizates. The most significant effect was observed for the composite material consisting of amic-acid isobytyl POSS / aminoethylaminopropylisobutyl POSS, which tensile strength was even greater than the reference vulcanizate with fumed silica. The development of autonomous self-healing materials could have an enormous influence on all industry branches from motorization to power industry. Self-repairing materials would have a massive impact on lengthening product lifetimes, increasing safety, and lowering product costs by reducing maintenance requirements.

Keywords: barrier properties, mechanical properties, POSS, self-healing composites

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598 Crystalline Particles Dispersed Cu-Based Metallic Glassy Composites Fabricated by Spark Plasma Sintering

Authors: Sandrine Cardinal, Jean-Marc Pelletier, Guang Xie, Florian Mercier, Florent Delmas

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Bulk metallic glasses exhibit several superior properties, compared to their corresponding crystalline counterpart, such as high strength, high elastic limit or good corrosion resistance. Therefore they can be considered as good candidates for structural applications in many sectors. However, they are generally brittle and do not exhibit plastic deformation at room temperature. These materials are mainly obtained by rapid cooling from a liquid state to prevent crystallization, which limits their size. To overcome these two drawbacks: fragility and limited dimensions, composite metallic glass matrix reinforced by a second phase whose role is to slow crack growth are developed. Concerning the limited size of the pieces, the proposed solution is to get the material from amorphous powders by densifying under load. In this study, Cu50Zr45Al5 bulk metallic glassy matrix composites (MGMCs) containing different volume fraction (Vf) of Zr crystalline particles were manufactured by spark plasma sintering (SPS). Microstructure, thermal stability and mechanical properties of the MGMCs were investigated. Matrix of the composites remains a fully amorphous phase after consolidation at 420°C under 600 MPa. A good dispersion of the particles in the glassy matrix is obtained. Results show that the compressive strength decreases with Vf : 1670 MPa (Vf=0%) to 1300MPa (Vf=30%), the elastic modulus decreases but only slighty respectively 97.3GPa and 94.5 GPa and plasticity is improved from 0 to 4%. Fractographic investigation indicates a good bonding between amorphous and crystalline particles. In conclusion, present study has demonstrated that SPS method is useful for the synthesis of the bulk glassy composites. Large controlled microstructure specimens with interesting ductility can be obtained compared with others methods.

Keywords: composite, mechanical properties, metallic glasses, spark plasma sintering

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597 An Efficient Robot Navigation Model in a Multi-Target Domain amidst Static and Dynamic Obstacles

Authors: Michael Ayomoh, Adriaan Roux, Oyindamola Omotuyi

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This paper presents an efficient robot navigation model in a multi-target domain amidst static and dynamic workspace obstacles. The problem is that of developing an optimal algorithm to minimize the total travel time of a robot as it visits all target points within its task domain amidst unknown workspace obstacles and finally return to its initial position. In solving this problem, a classical algorithm was first developed to compute the optimal number of paths to be travelled by the robot amidst the network of paths. The principle of shortest distance between robot and targets was used to compute the target point visitation order amidst workspace obstacles. Algorithm premised on the standard polar coordinate system was developed to determine the length of obstacles encountered by the robot hence giving room for a geometrical estimation of the total surface area occupied by the obstacle especially when classified as a relevant obstacle i.e. obstacle that lies in between a robot and its potential visitation point. A stochastic model was developed and used to estimate the likelihood of a dynamic obstacle bumping into the robot’s navigation path and finally, the navigation/obstacle avoidance algorithm was hinged on the hybrid virtual force field (HVFF) method. Significant modelling constraints herein include the choice of navigation path to selected target points, the possible presence of static obstacles along a desired navigation path and the likelihood of encountering a dynamic obstacle along the robot’s path and the chances of it remaining at this position as a static obstacle hence resulting in a case of re-routing after routing. The proposed algorithm demonstrated a high potential for optimal solution in terms of efficiency and effectiveness.

Keywords: multi-target, mobile robot, optimal path, static obstacles, dynamic obstacles

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596 The Design of Multiple Detection Parallel Combined Spread Spectrum Communication System

Authors: Lixin Tian, Wei Xue

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Many jobs in society go underground, such as mine mining, tunnel construction and subways, which are vital to the development of society. Once accidents occur in these places, the interruption of traditional wired communication is not conducive to the development of rescue work. In order to realize the positioning, early warning and command functions of underground personnel and improve rescue efficiency, it is necessary to develop and design an emergency ground communication system. It is easy to be subjected to narrowband interference when performing conventional underground communication. Spreading communication can be used for this problem. However, general spread spectrum methods such as direct spread communication are inefficient, so it is proposed to use parallel combined spread spectrum (PCSS) communication to improve efficiency. The PCSS communication not only has the anti-interference ability and the good concealment of the traditional spread spectrum system, but also has a relatively high frequency band utilization rate and a strong information transmission capability. So, this technology has been widely used in practice. This paper presents a PCSS communication model-multiple detection parallel combined spread spectrum (MDPCSS) communication system. In this paper, the principle of MDPCSS communication system is described, that is, the sequence at the transmitting end is processed in blocks and cyclically shifted to facilitate multiple detection at the receiving end. The block diagrams of the transmitter and receiver of the MDPCSS communication system are introduced. At the same time, the calculation formula of the system bit error rate (BER) is introduced, and the simulation and analysis of the BER of the system are completed. By comparing with the common parallel PCSS communication, we can draw a conclusion that it is indeed possible to reduce the BER and improve the system performance. Furthermore, the influence of different pseudo-code lengths selected on the system BER is simulated and analyzed, and the conclusion is that the larger the pseudo-code length is, the smaller the system error rate is.

Keywords: cyclic shift, multiple detection, parallel combined spread spectrum, PN code

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595 Muscle Neurotrophins Family Response to Resistance Exercise

Authors: Rasoul Eslami, Reza Gharakhanlou

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NT-4/5 and TrkB have been proposed to be involved in the coordinated adaptations of the neuromuscular system to elevated level of activity. Despite the persistence of this neurotrophin and its receptor expression in adult skeletal muscle, little attention has been paid to the functional significance of this complex in the mature neuromuscular system. Therefore, the purpose of this research was to study the effect of one session of resistance exercise on mRNA expression of NT4/5 and TrkB proteins in slow and fast muscles of Wistar Rats. Male Wistar rats (10 mo of age, preparation of Pasteur Institute) were housed under similar living conditions in cages (in groups of four) at room temperature under a controlled light/dark (12-h) cycle with ad libitum access to food and water. A number of sixteen rats were randomly divided to two groups (resistance exercise (T) and control (C); n=8 for each group). The resistance training protocol consisted of climbing a 1-meter–long ladder, with a weight attached to a tail sleeve. Twenty-four hours following the main training session, rats of T and C groups were anaesthetized and the right soleus and flexor hallucis longus (FHL) muscles were removed under sterile conditions via an incision on the dorsolateral aspect of the hind limb. For NT-4/5 and TrkB expression, quantitative real time RT-PCR was used. SPSS software and independent-samples t-test were used for data analysis. The level of significance was set at P < 0.05. Data indicate that resistance training significantly (P<0.05) decreased mRNA expression of NT4/5 in soleus muscle. However, no significant alteration was detected in FHL muscle (P>0.05). Our results also indicate that no significant alterations were detected for TrkB mRNA expression in soleus and FHL muscles (P>0.05). Decrease in mRNA expression of NT4/5 in soleus muscle may be as result of post-translation regulation following resistance training. Also, non-alteration in TrkB mRNA expression was indicated in probable roll of P75 receptor.

Keywords: neurotrophin-4/5 (NT-4/5), TrkB receptor, resistance training, slow and fast muscles

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594 A Study of the Implications for the Health and Wellbeing of Energy-Efficient House Occupants: A UK-Based Investigation of Indoor Climate and Indoor Air Quality

Authors: Patricia Kermeci

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Policies related to the reduction of both carbon dioxide and energy consumption within the residential sector have contributed towards a growing number of energy-efficient houses being built in several countries. Many of these energy-efficient houses rely on the construction of very well insulated and highly airtight structures, ventilated mechanically. Although energy-efficient houses are indeed more energy efficient than conventional houses, concerns have been raised over the quality of their indoor air and, consequently, the possible adverse health and wellbeing effects for their occupants. Using a longitudinal study design over three different weather seasons (winter, spring and summer), this study has investigated the indoor climate and indoor air quality of different rooms (bedroom, living room and kitchen) in five energy-efficient houses and four conventional houses in the UK. Occupants have kept diaries of their activities during the studied periods and interviews have been conducted to investigate possible behavioural explanations for the findings. Data has been compared with reviews of epidemiological, toxicological and other health related published literature to reveals three main findings. First, it shows that the indoor environment quality of energy-efficient houses cannot be treated as a holistic entity as different rooms presented dissimilar indoor climate and indoor air quality. Thus, such differences might contribute to the health and wellbeing of occupants in different ways. Second, the results show that the indoor environment quality of energy-efficient houses can vary following changes in weather season, leaving occupants at a lower or higher risk of adverse health and wellbeing effects during different weather seasons. Third, one cannot assume that even identical energy-efficient houses provide a similar indoor environment quality. Fourth, the findings reveal that the practices and behaviours of the occupants of energy-efficient houses likely determine whether they enjoy a healthier indoor environment when compared with their control houses. In conclusion, it has been considered vital to understand occupants’ practices and behaviours in order to explain the ways they might contribute to the indoor climate and indoor air quality in energy-efficient houses.

Keywords: energy-efficient house, health and wellbeing, indoor environment, indoor air quality

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593 Generous Edge – Inviting the Spontaneous

Authors: Ofri Earon

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This article is about a growing focus in the city of Copenhagen – the edge zone between the private space inside the residential building and the public space out at the residential street. A slow transition between the private living room and the public urban space creates a mutual benefit. The urban space benefits from an insertion of a homey atmosphere by the extended performance of living rooms to the exterior. The dwelling benefits from belonging to a liveable neighborliness, which means an extension of the private home to a collective home (= the neighborhood). Grounded by this reciprocal value of the edge zone, through the article, it is argued that a wide generosity of the edge zones is of interest among both planners and residents. The article introduces the idea of the edge zone and its possible implications in the development of the liveable residential city. Three examples of ongoing projects at Arkitema Architects are bought to illustrate the challenges and potentials of a generous edge zone. Every example represents a specific dwelling typology in a particular urban context: (1) multi-family residential building in a previous industrial area in the city (2) new courtyard building in the city’s outskirt (3) low and dense residential area out in the suburbia. Throughout these examples, the article seeks to discuss the significance of the edge zone in forthcoming residential areas in Denmark. The analysis of the Danish examples raises the question of why a social behavior that happens spontaneously in the south of Europe has to be carefully implemented in the architecture of north of Europe. In this light, the article ends with a discussion on how to create edge zones that are not designed for a particular usage, but rather as an architectural invitation for varied social behaviors that spontaneously occur in different moments of time by different people. Finally, the article ends with a list of recommendations for the development of the generous edge zone as an open invitation for diverse usage over time.

Keywords: dwelling, edge zone, generosity, livability, urban space

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592 Multiscale Process Modeling Analysis for the Prediction of Composite Strength Allowables

Authors: Marianna Maiaru, Gregory M. Odegard

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During the processing of high-performance thermoset polymer matrix composites, chemical reactions occur during elevated pressure and temperature cycles, causing the constituent monomers to crosslink and form a molecular network that gradually can sustain stress. As the crosslinking process progresses, the material naturally experiences a gradual shrinkage due to the increase in covalent bonds in the network. Once the cured composite completes the cure cycle and is brought to room temperature, the thermal expansion mismatch of the fibers and matrix cause additional residual stresses to form. These compounded residual stresses can compromise the reliability of the composite material and affect the composite strength. Composite process modeling is greatly complicated by the multiscale nature of the composite architecture. At the molecular level, the degree of cure controls the local shrinkage and thermal-mechanical properties of the thermoset. At the microscopic level, the local fiber architecture and packing affect the magnitudes and locations of residual stress concentrations. At the macroscopic level, the layup sequence controls the nature of crack initiation and propagation due to residual stresses. The goal of this research is use molecular dynamics (MD) and finite element analysis (FEA) to predict the residual stresses in composite laminates and the corresponding effect on composite failure. MD is used to predict the polymer shrinkage and thermomechanical properties as a function of degree of cure. This information is used as input into FEA to predict the residual stresses on the microscopic level resulting from the complete cure process. Virtual testing is subsequently conducted to predict strength allowables. Experimental characterization is used to validate the modeling.

Keywords: molecular dynamics, finite element analysis, processing modeling, multiscale modeling

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591 Outcome at the Extreme of Viability: A Single-Centre Experience

Authors: Antonia Harold-Barry, Eugene Dempsey

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Background: The objective is to examine the survival and outcome of infants born under 26 weeks gestation in an Irish tertiary maternity hospital from 2007-2016 and to describe the survival and neurodevelopmental outcomes of these extremely preterm infants. Method: The population is 132 infants born at 23, 24, and 25 weeks in Cork University Maternity Hospital from 2007 to 2016. Ethical approval was granted by the Cork Clinical Research Ethics Committee. Patient details were obtained from the Vermont Oxford and Badger Networks. Survival rates and Bayley scores were calculated to assess neurodevelopmental outcomes. Statistical analysis with SPSS included frequencies, distributions, and comparisons between data from 2007-2011 and 2012-2016. Results: Overall survival rate was 63%. Of the surviving babies, 61% had Bayley scores calculated. Survival stood at 39% for delivery at 23 weeks, 50% at 24 weeks, and 83% at 25 weeks. The 2012 to 2016 cohort has shown further increases in survival, with 50% of babies at 23 weeks, 58% at 24 weeks, and 89% at 25 weeks. Corresponding figures for 2007-2011 are 20%, 39%, and 75%. Gestational age and incidence of periventricular leukomalacia were statistically significant, with a p-value of 0.022. Gestational age and delivery room deaths had a p-value of 0.025, as did gestational age and birth weight. A comparison of the two cohorts (2007-2011 and 2012-2016) with the administration of antenatal steroids showed a statistically significant p-value of 0.044. Conclusion: There is less morbidity and mortality in infants born at 25 than at 23 or 24 weeks. Survival of extremely premature infants has increased significantly over the past ten years. Survival rates with normal neurodevelopmental outcomes are comparable with international standards and reflect positive changes in attitude and practices in neonatal intensive care. This study will inform parents about the potential outcomes of extreme prematurity and policy regarding the management of extreme prematurity.

Keywords: extreme of viability, neurodevelopmental outcome, periventricular leukomalacia, prematurity

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590 Ethanol in Carbon Monoxide Intoxication: Focus on Delayed Neuropsychological Sequelae

Authors: Hyuk-Hoon Kim, Young Gi Min

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Background: In carbon monoxide (CO) intoxication, the pathophysiology of delayed neurological sequelae (DNS) is very complex and remains poorly understood. And predicting whether patients who exhibit resolved acute symptoms have escaped or will experience DNS represents a very important clinical issue. Brain magnetic resonance (MR) imaging has been conducted to assess the severity of brain damage as an objective method to predict prognosis. And co-ingestion of a second poison in patients with intentional CO poisoning occurs in almost one-half of patients. Among patients with co-ingestions, 66% ingested ethanol. We assessed the effects of ethanol on neurologic sequelae prevalence in acute CO intoxication by means of abnormal lesion in brain MR. Method: This study was conducted retrospectively by collecting data for patients who visited an emergency medical center during a period of 5 years. The enrollment criteria were diagnosis of acute CO poisoning and the measurement of the serum ethanol level and history of taking a brain MR during admission period. Official readout data by radiologist are used to decide whether abnormal lesion is existed or not. The enrolled patients were divided into two groups: patients with abnormal lesion and without abnormal lesion in Brain MR. A standardized extraction using medical record was performed; Mann Whitney U test and logistic regression analysis were performed. Result: A total of 112 patients were enrolled, and 68 patients presented abnormal brain lesion on MR. The abnormal brain lesion group had lower serum ethanol level (mean, 20.14 vs 46.71 mg/dL) (p-value<0.001). In addition, univariate logistic regression analysis showed the serum ethanol level (OR, 0.99; 95% CI, 0.98 -1.00) was independently associated with the development of abnormal lesion in brain MR. Conclusion: Ethanol could have neuroprotective effect in acute CO intoxication by sedative effect in stressful situation and mitigative effect in neuro-inflammatory reaction.

Keywords: carbon monoxide, delayed neuropsychological sequelae, ethanol, intoxication, magnetic resonance

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589 Magnetic Chloromethylated Polymer Nanocomposite for Selective Pollutant Removal

Authors: Fabio T. Costa, Sergio E. Moya, Marcelo H. Sousa

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Nanocomposites designed by embedding magnetic nanoparticles into a polymeric matrix stand out as ideal magnetic-hybrid and magneto-responsive materials as sorbents for removal of pollutants in environmental applications. Covalent coupling is often desired for the immobilization of species on these nanocomposites, in order to keep them permanently bounded, not desorbing or leaching over time. Moreover, unwanted adsorbates can be separated by successive washes/magnetic separations, and it is also possible to recover the adsorbate covalently bound to the nanocomposite surface through detaching/cleavage protocols. Thus, in this work, we describe the preparation and characterization of highly-magnetizable chloromethylated polystyrene-based nanocomposite beads for selective covalent coupling in environmental applications. For synthesis optimization, acid resistant core-shelled maghemite (γ-Fe₂O₃) nanoparticles were coated with oleate molecules and directly incorporated into the organic medium during a suspension polymerization process. Moreover, the cross-linking agent ethylene glycol dimethacrylate (EGDMA) was utilized for co-polymerization with the 4-vinyl benzyl chloride (VBC) to increase the resistance of microbeads against leaching. After characterizing samples with XRD, ICP-OES, TGA, optical, SEM and TEM microscopes, a magnetic composite consisting of ~500 nm-sized cross-linked polymeric microspheres embedding ~8 nm γ-Fe₂O₃ nanoparticles was verified. This nanocomposite showed large room temperature magnetization (~24 emu/g) due to the high content in maghemite (~45 wt%) and resistance against leaching even in acidic media. Moreover, the presence of superficial chloromethyl groups, probed by FTIR and XPS spectroscopies and confirmed by an amination test can selectively adsorb molecules through the covalent coupling and be used in molecular separations as shown for the selective removal of 4-aminobenzoic acid from a mixture with benzoic acid.

Keywords: nanocomposite, magnetic nanoparticle, covalent separation, pollutant removal

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588 Mechanical Properties of Waste Clay Brick Based Geopolymer Cured at Various Temperature

Authors: Shihab Ibrahim

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Geopolymer binders as an alternative binder system to ordinary Portland cement are the focus of the past 2 decades of researches. In order to eliminate CO2 emission by cement manufacturing and utilizing construction waste as a source material, clean waste clay bricks which are the waste from Levent Brick factory was activated with a mixture of sodium hydroxide and sodium silicate solution. 12 molarity of sodium hydroxide solution was used and the ratio of sodium silicate to sodium hydroxide was 2.5. Alkaline solution to clay brick powder ratio of 0.35, 0.4, 0.45, and 0.5 was studied. Alkaline solution to powder ratio of 0.4 was found to be optimum ratio to have the same workability as ordinary Portland cement paste. Compressive strength of the clay brick based geopolymer paste samples was evaluated under different curing temperatures and curing durations. One day compressive strength of 57.3 MPa after curing at 85C for 24 hours was obtained which was higher than 7 days compressive strength of ordinary Portland cement paste. The highest compressive strength 71.4 MPa was achieved at seventh day age for the geopolymer paste samples cured at 85C for 24 hours. It was found that 8 hour curing at elevated temperature 85C, is sufficient to get 96% of total strength. 37.4 MPa strength at seventh day of clay brick based geopolymer sample cured at room temperature was achieved. Water absorption around 10% was found for clay brick based geopolymer samples cured at different temperatures with compare to 9.14% water absorption of ordinary Portland cement paste. The clay brick based geopolymer binder can have the potentiality to be used as an alternative binder to Portland cement in a case that the heat treatment provided. Further studies are needed in order to produce the binder in a way that can harden and gain strength without any elevated curing.

Keywords: construction and demolition waste, geopolymer, clay brick, compressive strength.

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587 Eco-Fashion Dyeing of Denim and Knitwear with Particle-Dyes

Authors: Adriana Duarte, Sandra Sampaio, Catia Ferreira, Jaime I. N. R. Gomes

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With the fashion of faded worn garments the textile industry has moved from indigo and pigments to dyes that are fixed by cationization, with products that can be toxic, and that can show this effect after washing down the dye with friction and/or treating with enzymes in a subsequent operation. Increasingly they are treated with bleaches, such as hypochlorite and permanganate, both toxic substances. An alternative process is presented in this work for both garment and jet dyeing processes, without the use of pre-cationization and the alternative use of “particle-dyes”. These are hybrid products, made up by an inorganic particle and an organic dye. With standard soluble dyes, it is not possible to avoid diffusion into the inside of the fiber unless using previous cationization. Only in this way can diffusion be avoided keeping the centre of the fibres undyed so as to produce the faded effect by removing the surface dye and showing the white fiber beneath. With “particle-dyes”, previous cationization is avoided. By applying low temperatures, the dye does not diffuse completely into the inside of the fiber, since it is a particle and not a soluble dye, being then able to give the faded effect. Even though bleaching can be used it can also be avoided, by the use of friction and enzymes they can be used just as for other dyes. This fashion brought about new ways of applying reactive dyes by the use of previous cationization of cotton, lowering the salt, and temperatures that reactive dyes usually need for reacting and as a side effect the application of a more environmental process. However, cationization is a process that can be problematic in applying it outside garment dyeing, such as jet dyeing, being difficult to obtain level dyeings. It also should be applied by a pad-fix or Pad-batch process due to the low affinity of the pre-cationization products making it a more expensive process, and the risk of unlevelness in processes such as jet dyeing. Wit particle-dyes, since no pre-cationizartion is necessary, they can be applied in jet dyeing. The excess dye is fixed by a fixing agent, fixing the insoluble dye onto the surface of the fibers. By applying the fixing agent only one to 1-3 rinses in water at room temperature are necessary, saving water and improving the washfastness.

Keywords: denim, garment dyeing, worn look, eco-fashion

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586 Community Involvement in Reducing Maternal and Perinatal Mortality in Cross River State, Nigeria: 'The Saving Mother Giving Life' Strategic Approach in Cross River State

Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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585 Digi-Buddy: A Smart Cane with Artificial Intelligence and Real-Time Assistance

Authors: Amaladhithyan Krishnamoorthy, Ruvaitha Banu

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Vision is considered as the most important sense in humans, without which leading a normal can be often difficult. There are many existing smart canes for visually impaired with obstacle detection using ultrasonic transducer to help them navigate. Though the basic smart cane increases the safety of the users, it does not help in filling the void of visual loss. This paper introduces the concept of Digi-Buddy which is an evolved smart cane for visually impaired. The cane consists for several modules, apart from the basic obstacle detection features; the Digi-Buddy assists the user by capturing video/images and streams them to the server using a wide-angled camera, which then detects the objects using Deep Convolutional Neural Network. In addition to determining what the particular image/object is, the distance of the object is assessed by the ultrasonic transducer. The sound generation application, modelled with the help of Natural Language Processing is used to convert the processed images/object into audio. The object detected is signified by its name which is transmitted to the user with the help of Bluetooth hear phones. The object detection is extended to facial recognition which maps the faces of the person the user meets in the database of face images and alerts the user about the person. One of other crucial function consists of an automatic-intimation-alarm which is triggered when the user is in an emergency. If the user recovers within a set time, a button is provisioned in the cane to stop the alarm. Else an automatic intimation is sent to friends and family about the whereabouts of the user using GPS. In addition to safety and security by the existing smart canes, the proposed concept devices to be implemented as a prototype helping visually-impaired visualize their surroundings through audio more in an amicable way.

Keywords: artificial intelligence, facial recognition, natural language processing, internet of things

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584 Τhe Importance of Previous Examination Results, in Futural Differential Diagnostic Procedures and Especially in the Era of Covid-19

Authors: Angelis P. Barlampas

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Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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583 Corruption, Institutional Quality and Economic Growth in Nigeria

Authors: Ogunlana Olarewaju Fatai, Kelani Fatai Adeshina

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The interplay of corruption and institutional quality determines how effective and efficient an economy progresses. An efficient institutional quality is a key requirement for economic stability. Institutional quality in most cases has been used interchangeably with Governance and these have given room for proxies that legitimized Governance as measures for institutional quality. A poorly-tailored institutional quality has a penalizing effect on corruption and economic growth, while defective institutional quality breeds corruption. Corruption is a hydra-headed phenomenon as it manifests in different forms. The most celebrated definition of corruption is given as “the use or abuse of public office for private benefits or gains”. It also denotes an arrangement between two mutual parties in the determination and allocation of state resources for pecuniary benefits to circumvent state efficiency. This study employed Barro (1990) type augmented model to analyze the nexus among corruption, institutional quality and economic growth in Nigeria using annual time series data, which spanned the period 1996-2019. Within the analytical framework of Johansen Cointegration technique, Error Correction Mechanism (ECM) and Granger Causality tests, findings revealed a long-run relationship between economic growth, corruption and selected measures of institutional quality. The long run results suggested that all the measures of institutional quality except voice & accountability and regulatory quality are positively disposed to economic growth. Moreover, the short-run estimation indicated a reconciliation of the divergent views on corruption which pointed at “sand the wheel” and “grease the wheel” of growth. In addition, regulatory quality and the rule of law indicated a negative influence on economic growth in Nigeria. Government effectiveness and voice & accountability, however, indicated a positive influence on economic growth. The Granger causality test results suggested a one-way causality between GDP and Corruption and also between corruption and institutional quality. Policy implications from this study pointed at checking corruption and streamlining institutional quality framework for better and sustained economic development.

Keywords: institutional quality, corruption, economic growth, public policy

Procedia PDF Downloads 139
582 Stability of Pump Station Cavern in Chagrin Shale with Time

Authors: Mohammad Moridzadeh, Mohammad Djavid, Barry Doyle

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An assessment of the long-term stability of a cavern in Chagrin shale excavated by the sequential excavation method was performed during and after construction. During the excavation of the cavern, deformations of rock mass were measured at the surface of excavation and within the rock mass by surface and deep measurement instruments. Rock deformations were measured during construction which appeared to result from the as-built excavation sequence that had potentially disturbed the rock and its behavior. Also some additional time dependent rock deformations were observed during and post excavation. Several opinions have been expressed to explain this time dependent deformation including stress changes induced by excavation, strain softening (or creep) in the beddings with and without clay and creep of the shaley rock under compressive stresses. In order to analyze and replicate rock behavior observed during excavation, including current and post excavation elastic, plastic, and time dependent deformation, Finite Element Analysis (FEA) was performed. The analysis was also intended to estimate long term deformation of the rock mass around the excavation. Rock mass behavior including time dependent deformation was measured by means of rock surface convergence points, MPBXs, extended creep testing on the long anchors, and load history data from load cells attached to several long anchors. Direct creep testing of Chagrin Shale was performed on core samples from the wall of the Pump Room. Results of these measurements were used to calibrate the FEA of the excavation. These analyses incorporate time dependent constitutive modeling for the rock to evaluate the potential long term movement in the roof, walls, and invert of the cavern. The modeling was performed due to the concerns regarding the unanticipated behavior of the rock mass as well as the forecast of long term deformation and stability of rock around the excavation.

Keywords: Cavern, Chagrin shale, creep, finite element.

Procedia PDF Downloads 332
581 Battling against the Great Disruption to Surgical Care in a Pandemic: Experience of Eleven South and Southeast Asian Countries

Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

Procedia PDF Downloads 65
580 Analyzing the Sociolinguistic Profile of the Algerian Community in the UK in terms of French Language Use: The Case of Émigré Ph.D. Students

Authors: Hadjer Chellia

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the present study reports on second language use among Algerian international students in the UK. In Algeria, French has an important status among the Algerian verbal repertoires due to colonial reasons. This has triggered many language conflicts and many debates among policy makers in Algeria. In higher education, Algerian English students’ sociolinguistic profile is characterised by the use of French as a sign of prestige. What may leave room for debate is the effect of crossing borders towards the UK as a result of international mobility programmes, a transition which could add more complexity since French, is not so significant as a language in the UK context. In this respect, the micro-objective is to explore the fate of French use among Ph.D. students in the UK as a newly established group vis-à-vis English. To fulfill the purpose of the present inquiry, the research employs multiple approaches in which semi-structured interview is a primary source of data to know participants’ attitudes about French use, targeting both their pre-migratory experience and current one. Web-based questionnaires are set up to access larger population. Focus group sessions are further procedures of scrutiny in this piece of work to explore the actual linguistic behaviours. Preliminary findings from both interviews and questionnaires reveal that students’ current experience, particularly living in the UK, affects their pre-migratory attitudes towards French language and its use. The overall findings are expected to bring manifold contributions to the field of research among which is setting factors that influence language use among newly established émigrés communities. The research is also relevant to international students’ experience of study abroad in terms of language use in the guise of internationalization of higher education, mobility and exchange programmes. It could contribute to the sociolinguistics of the Algerian diaspora: the dispersed residence of non-native communities - not to mention its significance on the Algerian research field abroad.

Keywords: Algerian diaspora, French language, language maintenance, language shift, mobility

Procedia PDF Downloads 313
579 Improving Fingerprinting-Based Localization System Using Generative Artificial Intelligence

Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a novel semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 39 cm, and more than 90% of the errors are less than 82 cm. That is, numerical results proved that, in comparison to traditional methods, the proposed SRCLoc method can significantly improve positioning performance and reduce radio map construction costs.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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578 Improving Lane Detection for Autonomous Vehicles Using Deep Transfer Learning

Authors: Richard O’Riordan, Saritha Unnikrishnan

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Autonomous Vehicles (AVs) are incorporating an increasing number of ADAS features, including automated lane-keeping systems. In recent years, many research papers into lane detection algorithms have been published, varying from computer vision techniques to deep learning methods. The transition from lower levels of autonomy defined in the SAE framework and the progression to higher autonomy levels requires increasingly complex models and algorithms that must be highly reliable in their operation and functionality capacities. Furthermore, these algorithms have no room for error when operating at high levels of autonomy. Although the current research details existing computer vision and deep learning algorithms and their methodologies and individual results, the research also details challenges faced by the algorithms and the resources needed to operate, along with shortcomings experienced during their detection of lanes in certain weather and lighting conditions. This paper will explore these shortcomings and attempt to implement a lane detection algorithm that could be used to achieve improvements in AV lane detection systems. This paper uses a pre-trained LaneNet model to detect lane or non-lane pixels using binary segmentation as the base detection method using an existing dataset BDD100k followed by a custom dataset generated locally. The selected roads will be modern well-laid roads with up-to-date infrastructure and lane markings, while the second road network will be an older road with infrastructure and lane markings reflecting the road network's age. The performance of the proposed method will be evaluated on the custom dataset to compare its performance to the BDD100k dataset. In summary, this paper will use Transfer Learning to provide a fast and robust lane detection algorithm that can handle various road conditions and provide accurate lane detection.

Keywords: ADAS, autonomous vehicles, deep learning, LaneNet, lane detection

Procedia PDF Downloads 80
577 Capacity Oversizing for Infrastructure Sharing Synergies: A Game Theoretic Analysis

Authors: Robin Molinier

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Industrial symbiosis (I.S) rely on two basic modes of cooperation between organizations that are infrastructure/service sharing and resource substitution (the use of waste materials, fatal energy and recirculated utilities for production). The former consists in the intensification of use of an asset and thus requires to compare the incremental investment cost to be incurred and the stand-alone cost faced by each potential participant to satisfy its own requirements. In order to investigate the way such a cooperation mode can be implemented we formulate a game theoretic model integrating the grassroot investment decision and the ex-post access pricing problem. In the first period two actors set cooperatively (resp. non-cooperatively) a level of common (resp. individual) infrastructure capacity oversizing to attract ex-post a potential entrant with a plug-and-play offer (available capacity, tariff). The entrant’s requirement is randomly distributed and known only after investments took place. Capacity cost exhibits sub-additive property so that there is room for profitable overcapacity setting in the first period under some conditions that we derive. The entrant willingness-to-pay for the access to the infrastructure is driven by both her standalone cost and the complement cost to be incurred in case she chooses to access an infrastructure whose the available capacity is lower than her requirement level. The expected complement cost function is thus derived, and we show that it is decreasing, convex and shaped by the entrant’s requirements distribution function. For both uniform and triangular distributions optimal capacity level is obtained in the cooperative setting and equilibrium levels are determined in the non-cooperative case. Regarding the latter, we show that competition is deterred by the first period investor with the highest requirement level. Using the non-cooperative game outcomes which gives lower bounds for the profit sharing problem in the cooperative one we solve the whole game and describe situations supporting sharing agreements.

Keywords: capacity, cooperation, industrial symbiosis, pricing

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576 Reallocation of Bed Capacity in a Hospital Combining Discrete Event Simulation and Integer Linear Programming

Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

Procedia PDF Downloads 126
575 Sensory and Microbiological Sustainability of Smoked Meat Products–Smoked Ham in Order to Determine the Shelf-Life under the Changed Conditions at +15°C

Authors: Radovan Čobanović, Milica Rankov Šicar

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The meat is in the group of perishable food which can be spoiled very rapidly if stored at room temperature. Salting in combination with smoke is intended to extend shelf life, and also to form the specific taste, odor and color. The smoke do not affect only on taste and flavor of the product, it has a bactericidal and oxidative effect and that is the reason because smoked products are less susceptible to oxidation and decay processes. According to mentioned the goal of this study was to evaluate shelf life of smoked ham, which is stored in conditions of high temperature (+15 °C). For the purposes of this study analyzes were conducted on eight samples of smoked ham every 7th day from the day of reception until 21st day. During this period, smoked ham is subjected to sensory analysis (appearance, odor, taste, color, aroma) and bacteriological analyzes (Listeria monocytogenes, Salmonella spp. and yeasts and molds) according to Serbian state regulation. All analyses were tested according to ISO methodology: sensory analysis ISO 6658, Listeria monocytogenes ISO 11 290-1, Salmonella spp ISO 6579 and yeasts and molds ISO 21527-2. Results of sensory analysis of smoked ham indicating that the samples after the first seven days of storage showed visual changes at the surface in the form of allocations of salt, most likely due to the process of drying out the internal parts of the product. The sample, after fifteen days of storage had intensive exterior changes, but the taste was still acceptable. Between the fifteenth and twenty-first day of storage, there is an unacceptable change on the surface and inside of the product and the occurrence of molds and yeasts but neither one analyzed pathogen was found. Based on the obtained results it can be concluded that this type of product cannot be stored for more than seven days at an elevated temperature of +15°C because there are a visual changes that would certainly have influence on decision of customers when purchase of this product is concerned.

Keywords: sustainability, smoked meat products, food engineering, agricultural process engineering

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574 Screening and Optimization of Conditions for Pectinase Production by Aspergillus Flavus

Authors: Rumaisa Shahid, Saad Aziz Durrani, Shameel Pervez, Ibatsam Khokhar

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Food waste is a prevalent issue in Pakistan, with over 40 percent of food discarded annually. Despite their decay, rotting fruits retain residual nutritional value consumed by microorganisms, notably fungi and bacteria. Fungi, preferred for their extracellular enzyme release, are gaining prominence, particularly for pectinase production. This enzyme offers several advantages, including clarifying juices by breaking down pectic compounds. In this study, three Aspergillus flavus isolates derived from decomposed fruits and manure were selected for pectinase production. The primary aim was to isolate fungi from diverse waste sources, identify the isolates and assess their capacity for pectinase production. The identification was done through morphological characteristics with the help of Light microscopy and Scanning Electron Microscopy (SEM). Pectinolytic potential was screened using pectin minimal salt agar (PMSA) medium, comparing clear zone diameters among isolates. Identification relied on morphological characteristics. Optimizing substrate (lemon and orange peel powder) concentrations, pH, temperature, and incubation period aimed to enhance pectinase yield. Spectrophotometry enabled quantitative analysis. The temperature was set at room temperature (28 ºC). The optimal conditions for Aspergillus flavus strain AF1(isolated from mango) included a pH of 5, an incubation period of 120 hours, and substrate concentrations of 3.3% for orange peels and 6.6% for lemon peels. For AF2 and AF3 (both isolated from soil), the ideal pH and incubation period were the same as AF1 i.e. pH 5 and 120 hours. However, their optimized substrate concentrations varied, with AF2 showing maximum activity at 3.3% for orange peels and 6.6% for lemon peels, while AF3 exhibited its peak activity at 6.6% for orange peels and 8.3% for lemon peels. Among the isolates, AF1 demonstrated superior performance under these conditions, comparatively.

Keywords: pectinase, lemon peel, orange peel, aspergillus flavus

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573 Application of Electrochromic Glazing for Reducing Peak Cooling Loads

Authors: Ranojoy Dutta

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HVAC equipment capacity has a direct impact on occupant comfort and energy consumption of a building. Glazing gains, especially in buildings with high window area, can be a significant contributor to the total peak load on the HVAC system, leading to over-sized systems that mostly operate at poor part load efficiency. In addition, radiant temperature, which largely drives occupant comfort in glazed perimeter zones, is often not effectively controlled despite the HVAC being designed to meet the air temperature set-point. This is due to short wave solar radiation transmitted through windows, that is not sensed by the thermostat until much later when the thermal mass in the room releases the absorbed solar heat to the indoor air. The implication of this phenomenon is increased cooling energy despite poor occupant comfort. EC glazing can significantly eliminate direct solar transmission through windows, reducing both the space cooling loads for the building and improving comfort for occupants near glazing. This paper will review the exact mechanism of how EC glazing would reduce the peak load under design day conditions, leading to reduced cooling capacity vs regular high-performance glazing. Since glazing heat transfer only affects the sensible load, system sizing will be evaluated both with and without the availability of a DOAS to isolate the downsizing potential of the primary cooling equipment when outdoor air is conditioned separately. Given the dynamic nature of glazing gains due to the sun’s movement, effective peak load mitigation with EC requires an automated control system that can predict solar movement and radiation levels so that the right tint state with the appropriate SHGC is utilized at any given time for a given façade orientation. Such an automated EC product will be evaluated for a prototype commercial office model situated in four distinct climate zones.

Keywords: electrochromic glazing, peak sizing, thermal comfort, glazing load

Procedia PDF Downloads 111
572 The Views of Health Care Professionals outside of the General Practice Setting on the Provision of Oral Contraception in Comparison to Long-Acting Reversible Contraception

Authors: Carri Welsby, Jessie Gunson, Pen Roe

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Currently, there is limited research examining health care professionals (HCPs) views on long-acting reversible contraception (LARC) advice and prescription, particularly outside of the general practice (GP) setting. The aim of this study is to systematically review existing evidence around the barriers and enablers of oral contraception (OC) in comparison to LARC, as perceived by HCPs in non-GP settings. Five electronic databases were searched in April 2018 using terms related to LARC, OC, HCPs, and views, but not terms related to GPs. Studies were excluded if they concerned emergency oral contraception, male contraceptives, contraceptive use in conjunction with a health condition(s), developing countries, GPs and GP settings, were non-English or was not published before 2013. A total of six studies were included for systematic reviewing. Five key areas emerged, under which themes were categorised, including (1) understanding HCP attitudes and counselling practices towards contraceptive methods; (2) assessment of HCP attitudes and beliefs about contraceptive methods; (3) misconceptions and concerns towards contraceptive methods; and (4) influences on views, attitudes, and beliefs of contraceptive methods. Limited education and training of HCPs exists around LARC provision, particularly compared to OC. The most common misconception inhibiting HCPs contraceptive information delivery to women was the belief that LARC was inappropriate for nulliparous women. In turn, by not providing the correct information on a variety of contraceptive methods, HCP counselling practices were disempowering for women and restricted them from accessing reproductive justice. Educating HCPs to be able to provide accurate and factual information to women on all contraception is vital to encourage a woman-centered approach during contraceptive counselling and promote informed choices by women.

Keywords: advice, contraceptives, health care professionals, long acting reversible contraception, oral contraception, reproductive justice

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571 Regional Anesthesia: A Vantage Point for Management of Normal Pressure Hydrocephalus

Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

Procedia PDF Downloads 55