Search results for: knowledge management best practice
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18304

Search results for: knowledge management best practice

1264 Pattern of Anisometropia, Management and Outcome of Anisometropic Amblyopia

Authors: Husain Rajib, T. H. Sheikh, D. G. Jewel

Abstract:

Background: Amblyopia is a frequent cause of monocular blindness in children. It can be unilateral or bilateral reduction of best corrected visual acuity associated with decrement in visual processing, accomodation, motility, spatial perception or spatial projection. Anisometropia is an important risk factor for amblyopia that develops when unequal refractive error causes the image to be blurred in the critical developmental period and central inhibition of the visual signal originating from the affected eye associated with significant visual problems including anisokonia, strabismus, and reduced stereopsis. Methods: It is a prospective hospital based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 50 anisometropic amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 3 to 13 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over month, then occlusion treatment was started. Occlusion was done daily for 6-8 hours (full time) together with vision therapy. The occlusion was carried out for 3 months. Results: In this study about 8% subjects had anisometropia from myopia, 18% from hyperopia, 74% from astigmatism. The initial mean visual acuity was 0.74 ± 0.39 Log MAR and after intervention of amblyopia therapy with active vision therapy mean visual acuity was 0.34 ± 0.26 Log MAR. About 94% of subjects were improving at least two lines. The depth of amblyopia associated with type of anisometropic refractive error and magnitude of Anisometropia (p<0.005). By doing this study 10% mild amblyopia, 64% moderate and 26% severe amblyopia were found. Binocular function also decreases with magnitude of Anisometropia. Conclusion: Anisometropic amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Occlusion therapy with at least one instructed hour of active visual activity practiced out of school hours was effective in anisometropic amblyopes who were diagnosed at the age of 8 years and older, and the patients complied well with the treatment.

Keywords: refractive error, anisometropia, amblyopia, strabismic amblyopia

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1263 Use of Information and Communication Technologies in Enhancing Health Care Delivery for Human Immunodeficiency Virus Patients in Bamenda Health District

Authors: Abanda Wilfred Chick

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Background: According to World Health Organization (WHO), the role of Information and Communication Technologies (ICT) in health sectors of developing nations has been demonstrated to have had a great improvement of fifty percent reduction in mortality and or twenty-five-fifty percent increase in productivity. The objective of this study was to assess the use of information and communication technologies in enhancing health care delivery for Human Immunodeficiency Virus (HIV) patients in Bamenda Health District. Methods: This was a descriptive-analytical cross-sectional study in which 388 participants were consecutively selected amongst health personnel and HIV patients from public and private health institutions involved in Human Immunodeficiency Virus management. Data on socio-demographic variables, the use of information and communication technologies tools, and associated challenges were collected using structured questionnaires. Descriptive statistics with a ninety-five percent confidence interval were used to summarize findings, while Cramer’s V test, logistic regression, and Chi-square test were used to measure the association between variables, Epi info version7.2, MS Excel, and SPSS version 25.0 were utilized for data entry and statistical analysis respectively. Results: Of the participants, one-quarter were health personnel, and three-quarters were HIV patients. For both groups of participants, there was a significant relationship between the use of ICT and demographic information such as level of education, marital status, and age (p<0.05). For the impediments to using ICT tools, a greater proportion identified the high cost of airtime or internet bundles, followed by an average proportion that indicated inadequate training on ICT tools; for health personnel, the majority said inadequate training on ICT tools/applications and half said unavailability of electricity. Conclusion: Not up to half of the HIV patients effectively make use of ICT tools/applications to receive health care. Of health personnel, three quarters use ICTs, and only one quarter effectively use mobile phones and one-third of computers, respectively, to render care to HIV patients.

Keywords: ICT tools, HIV patients, health personnel, health care delivery

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1262 Rethinking the Smartness for Sustainable Development Through the Relationship between Public and Private Actors

Authors: Selin Tosun

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The improvements in technology have started to transform the way we live, work, play, and commute in our cities. The emerging smart city understanding has been paving the way for more efficient, more useful, and more profitable cities. Smart sensors, smart lighting, smart waste, water and electricity management, smart transportation and communication systems are introduced to cities at a rapid pace. In today's world, innovation is often correlated with start-up companies and technological pioneers seeking broader economic objectives such as production and competitiveness. The government's position is primarily that of an enabler, with creativity mostly coming from the private sector. The paper argues that to achieve sustainable development, the ways in which smart and sustainable city approaches are being applied to cities need to be redefined. The research aims to address common discussions in the discourse of smart and sustainable cities criticizing the priority of lifestyle sterilization over human-centered sustainable interventions and social innovation strategies. The dichotomy between the fact that smart cities are mostly motivated by the competitive global market and the fact that the delocalization is, in fact, their biggest problem in the way of becoming authentic, sustainable cities is the main challenge that we face today. In other words, the key actors in smart cities have different and somewhat conflicting interests and demands. By reviewing the roles of the public and private actors in smart city making, the paper aspires to reconceptualize the understanding of “smartness” in achieving sustainable development in which the “smartness” is understood as a multi-layered complex phenomenon that can be channeled through different dynamics. The case cities around the world are explored and compared in terms of their technological innovations, governance and policy innovations, public-private stakeholder relationships, and the understanding of the public realm. The study aims to understand the current trends and general dynamics in the field, key issues that are being addressed, the scale that is preferred to reflect upon and the projects that are designed for the particular issues.

Keywords: smart city, sustainable development, technological innovation, social innovation

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1261 Beer Brand Commercials and Gender Representation in Nigeria: Contextualization's of Selected Television and YouTube Visuals of the 2010s and 2020s

Authors: Theresa Belema Chris-Biriowu

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The change in trends in relation to gender representation in beer brand commercials was the thrust of the study. The study investigated how beer brand commercials reflect societal realities in their portrayals of gender roles within the span of a decade. The major objective of the study was to find out how gender was contextualized in selected beer brand commercials that both air on Nigerian television and stream on YouTube. The study was anchored on the muted group theory. The population of the study was in two streams: the total number of beer beverages that are produced by the eleven breweries in Nigeria and the registered advertising agencies in Lagos, Nigeria. The sample size was also two-pronged: the purposive selection of beer brands that have their commercials on television and YouTube and the purposive selection of an ad agency that has produced running commercials for beer brands within the period between 2010s and 2020s. They adopted visual framing analysis and narrative analysis research techniques. The study qualitatively analyzed the contents of beer brand commercials and conducted an interview with the management of the ad agency for data collection. The data was presented in images and words. The findings showed that females are underrepresented and misrepresented in the beer brand commercials and that the beer brands are not producing commercials that adequately reflect the realities of present times. It was also found that very little has changed in the ad industry between the periods studied, and commercial screenplays are not written with a specific aim to either target the female demographics or give them equal opportunities to thrive in the beer economy. The study concluded that the gender gap in beer commercials subsists and translates to gender discrimination, especially since it is established that females are also stakeholders in the beer economy. The study recommends that beer brands should produce commercials that appeal to their audience irrespective of gender, reflect contemporary realities, and give all genders equal opportunities to thrive in the increasingly competitive industry.

Keywords: beer brands, commercials, gender representation, visuals, television, YouTube

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1260 Pegylated Liposomes of Trans Resveratrol, an Anticancer Agent, for Enhancing Therapeutic Efficacy and Long Circulation

Authors: M. R. Vijayakumar, Sanjay Kumar Singh, Lakshmi, Hithesh Dewangan, Sanjay Singh

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Trans resveratrol (RES) is a natural molecule proved for cancer preventive and therapeutic activities devoid of any potential side effects. However, the therapeutic application of RES in disease management is limited because of its rapid elimination from blood circulation thereby low biological half life in mammals. Therefore, the main objective of this study is to enhance the circulation as well as therapeutic efficacy using PEGylated liposomes. D-α-tocopheryl polyethylene glycol 1000 succinate (vitamin E TPGS) is applied as steric surface decorating agent to prepare RES liposomes by thin film hydration method. The prepared nanoparticles were evaluated by various state of the art techniques such as dynamic light scattering (DLS) technique for particle size and zeta potential, TEM for shape, differential scanning calorimetry (DSC) for interaction analysis and XRD for crystalline changes of drug. Encapsulation efficiency and invitro drug release were determined by dialysis bag method. Cancer cell viability studies were performed by MTT assay, respectively. Pharmacokinetic studies were performed in sprague dawley rats. The prepared liposomes were found to be spherical in shape. Particle size and zeta potential of prepared formulations varied from 64.5±3.16 to 262.3±7.45 nm and -2.1 to 1.76 mV, respectively. DSC study revealed absence of potential interaction. XRD study revealed presence of amorphous form in liposomes. Entrapment efficiency was found to be 87.45±2.14 % and the drug release was found to be controlled up to 24 hours. Minimized MEC in MTT assay and tremendous enhancement in circulation time of RES PEGylated liposomes than its pristine form revealed that the stearic stabilized PEGylated liposomes can be an alternative tool to commercialize this molecule for chemopreventive and therapeutic applications in cancer.

Keywords: trans resveratrol, cancer nanotechnology, long circulating liposomes, bioavailability enhancement, liposomes for cancer therapy, PEGylated liposomes

Procedia PDF Downloads 589
1259 Improving the Supply Chain of Vietnamese Coffee in Buon Me Thuot City, Daklak Province, Vietnam to Achieve Sustainability

Authors: Giang Ngo Tinh Nguyen

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Agriculture plays an important role in the economy of Vietnam and coffee is one of most crucial agricultural commodities for exporting but the current farming methods and processing infrastructure could not keep up with the development of the sector. There are many catastrophic impacts on the environment such as deforestation; soil degradation that leads to a decrease in the quality of coffee beans. Therefore, improving supply chain to develop the cultivation of sustainable coffee is one of the most important strategies to boost the coffee industry and create a competitive advantage for Vietnamese coffee in the worldwide market. If all stakeholders in the supply chain network unite together; the sustainable production of coffee will be scaled up and the future of coffee industry will be firmly secured. Buon Ma Thuot city, Dak Lak province is the principal growing region for Vietnamese coffee which accounted for a third of total coffee area in Vietnam. It plays a strategically crucial role in the development of sustainable Vietnamese coffee. Thus, the research is to improve the supply chain of sustainable Vietnamese coffee production in Buon Ma Thuot city, Dak Lak province, Vietnam for the purpose of increasing the yields and export availability as well as helping coffee farmers to be more flexible in an ever-changing market situation. It will help to affirm Vietnamese coffee brand when entering international market; improve the livelihood of farmers and conserve the environment of this area. Besides, after analyzing the data, a logistic regression model is established to explain the relationship between the dependent variable and independent variables to help sustainable coffee organizations forecast the probability of farmer will be having a sustainable certificate with their current situation and help them choose promising candidates to develop sustainable programs. It investigates opinions of local farmers through quantitative surveys. Qualitative interviews are also used to interview local collectors and staff of Trung Nguyen manufacturing company to have an overview of the situation.

Keywords: supply chain management, sustainable agricultural development, sustainable coffee, Vietnamese coffee

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1258 Effects of Delphinidin on Lipid Metabolism in HepG2 Cells and Diet-Induced Obese Mice

Authors: Marcela Parra-Vargas, Ana Sandoval-Rodriguez, Roberto Rodriguez-Echevarria, Jose Dominguez-Rosales, Juan Armendariz-Borunda

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Non-alcoholic fatty liver disease (NAFLD) is characterized by an excess of hepatic lipids, and it is to author’s best knowledge, the most prevalent chronic liver disorder. Anthocyanin-rich food consumption is linked to health benefits in metabolic disorders associated with obesity and NAFLD, although the precise functional role of anthocyanidin delphinidin (Dp) has yet to be established. The aim of this study was to investigate the effect of the Dp in NAFLD metabolic alterations by evaluating prevention or amelioration of hepatic lipid accumulation, as well as molecular mechanisms in two experimental obesity-related models of NALFD. In vitro: HepG2 cells were incubated with sodium palmitate (PA, 1 mM) to induce lipotoxic damage, and concomitantly treated with Dp (180 uM) for 24 h. Subsequently, total lipid accumulation was measured by colorimetric staining with Oil Red O, and total intrahepatic triglycerides were determined by an enzymatic assay. To assess molecular mechanisms, cells were pre-treated with PA for 24 h and then exposed to Dp for 1 h. In vivo: four-week-old male C57BL/6Nhsd mice were allocated in two main groups. Mice were fed with standard diet (control) or high-fat and high-carbohydrate diet (45% fat, HFD) for 16 wk to induce NAFLD. Then HFD was divided into subgroups: one treated orally with Dp (15 mg/kg bw, HFD-Dp) every day for 4 wk, while HFD group treated with vehicle (DMSO). Weight and fasting glucose were recorded weekly, while dietary ingestion was measured daily. Insulin tolerance test was performed at the end of treatment. Liver histology was evaluated with H&E and Masson’s trichrome stain. RT-PCR was used to evaluate gene expression and Western Blot to determine levels of protein in both experimental models. Parametric data were analyzed with one-way ANOVA and Tukey’s post-hoc test. Kruskal-Wallis and Mann-Whitney U test for non-parametric data, and P < 0.5 were considered significant. Dp prevented hepatic lipid accumulation by PA in HepG2 hepatocytes. Furthermore, Dp down-regulated gene expression of SREBP1c, FAS, and CPT1a without modifying AMPK phosphorylation levels. In vivo, Dp oral administration did not ameliorate lipid metabolic alterations raised by HFD. Adiposity, dietary ingestion, fasting glucose, and insulin sensitivity after Dp treatment remained similar to HFD group. Histological analysis showed hepatic damage in HFD groups and no differences between HFD and HFD-Dp groups were found. Hepatic gene expression of ACC and FAS were not altered by HFD. SREBP1c was similar in both HFD and HFD-Dp groups. No significant changes were observed in SREBP1c, ACC, and FAS adipose tissue gene expression by HFD or Dp treatment. Additionally, immunoblotting analysis revealed no changes in pathway SIRT1-LKB-AMPK and PPAR alpha by both HFD groups compared to control. In conclusion, the antioxidant Dp may provoke beneficial effects in the prevention of hepatic lipid accumulation. Nevertheless, the oral dose administrated in mice that simulated the total intake of anthocyanins consumed daily by humans has no effect as a treatment on hepatic lipid metabolic alterations and histological abnormalities associated with exposure to chronic HFD. A healthy lifestyle with regular intake of antioxidants such as anthocyanins may prevent metabolic alterations in NAFLD.

Keywords: anthocyanins, antioxidants, delphinidin, non-alcoholic fatty liver disease, obesity

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1257 Inhalable Lipid-Coated-Chitosan Nano-Embedded Microdroplets of an Antifungal Drug for Deep Lung Delivery

Authors: Ranjot Kaur, Om P. Katare, Anupama Sharma, Sarah R. Dennison, Kamalinder K. Singh, Bhupinder Singh

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Respiratory microbial infections being among the top leading cause of death worldwide are difficult to treat as the microbes reside deep inside the airways, where only a small fraction of drug can access after traditional oral or parenteral routes. As a result, high doses of drugs are required to maintain drug levels above minimum inhibitory concentrations (MIC) at the infection site, unfortunately leading to severe systemic side-effects. Therefore, delivering antimicrobials directly to the respiratory tract provides an attractive way out in such situations. In this context, current study embarks on the systematic development of lung lia pid-modified chitosan nanoparticles for inhalation of voriconazole. Following the principles of quality by design, the chitosan nanoparticles were prepared by ionic gelation method and further coated with major lung lipid by precipitation method. The factor screening studies were performed by fractional factorial design, followed by optimization of the nanoparticles by Box-Behnken Design. The optimized formulation has a particle size range of 170-180nm, PDI 0.3-0.4, zeta potential 14-17, entrapment efficiency 45-50% and drug loading of 3-5%. The presence of a lipid coating was confirmed by FESEM, FTIR, and X-RD. Furthermore, the nanoparticles were found to be safe upto 40µg/ml on A549 and Calu-3 cell lines. The quantitative and qualitative uptake studies also revealed the uptake of nanoparticles in lung epithelial cells. Moreover, the data from Spraytec and next-generation impactor studies confirmed the deposition of nanoparticles in lower airways. Also, the interaction of nanoparticles with DPPC monolayers signifies its biocompatibility with lungs. Overall, the study describes the methodology and potential of lipid-coated chitosan nanoparticles in futuristic inhalation nanomedicine for the management of pulmonary aspergillosis.

Keywords: dipalmitoylphosphatidylcholine, nebulization, DPPC monolayers, quality-by-design

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1256 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital

Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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1255 The Optimal Order Policy for the Newsvendor Model under Worker Learning

Authors: Sunantha Teyarachakul

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We consider the worker-learning Newsvendor Model, under the case of lost-sales for unmet demand, with the research objective of proposing the cost-minimization order policy and lot size, scheduled to arrive at the beginning of the selling-period. In general, the New Vendor Model is used to find the optimal order quantity for the perishable items such as fashionable products or those with seasonal demand or short-life cycles. Technically, it is used when the product demand is stochastic and available for the single selling-season, and when there is only a one time opportunity for the vendor to purchase, with possibly of long ordering lead-times. Our work differs from the classical Newsvendor Model in that we incorporate the human factor (specifically worker learning) and its influence over the costs of processing units into the model. We describe this by using the well-known Wright’s Learning Curve. Most of the assumptions of the classical New Vendor Model are still maintained in our work, such as the constant per-unit cost of leftover and shortage, the zero initial inventory, as well as the continuous time. Our problem is challenging in the way that the best order quantity in the classical model, which is balancing the over-stocking and under-stocking costs, is no longer optimal. Specifically, when adding the cost-saving from worker learning to such expected total cost, the convexity of the cost function will likely not be maintained. This has called for a new way in determining the optimal order policy. In response to such challenges, we found a number of characteristics related to the expected cost function and its derivatives, which we then used in formulating the optimal ordering policy. Examples of such characteristics are; the optimal order quantity exists and is unique if the demand follows a Uniform Distribution; if the demand follows the Beta Distribution with some specific properties of its parameters, the second derivative of the expected cost function has at most two roots; and there exists the specific level of lot size that satisfies the first order condition. Our research results could be helpful for analysis of supply chain coordination and of the periodic review system for similar problems.

Keywords: inventory management, Newsvendor model, order policy, worker learning

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1254 Spatiotemporal Variability of Snow Cover and Snow Water Equivalent over Eurasia

Authors: Yinsheng Zhang

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Changes in the extent and amount of snow cover in Eurasia are of great interest because of their vital impacts on the global climate system and regional water resource management. This study investigated the spatial and temporal variability of the snow cover extent (SCE) and snow water equivalent (SWE) of continental Eurasia using the Northern Hemisphere Equal-Area Scalable Earth Grid (EASE-Grid) Weekly SCE data for 1972–2006 and the Global Monthly EASE-Grid SWE data for 1979–2004. The results indicated that, in general, the spatial extent of snow cover significantly decreased during spring and summer, but varied little during autumn and winter over Eurasia in the study period. The date at which snow cover began to disappear in spring has significantly advanced, whereas the timing of snow cover onset in autumn did not vary significantly during 1972–2006. The snow cover persistence period declined significantly in the western Tibetan Plateau as well as the partial area of Central Asia and northwestern Russia but varied little in other parts of Eurasia. ‘Snow-free breaks’ (SFBs) with intermittent snow cover in the cold season were mainly observed in the Tibetan Plateau and Central Asia, causing a low sensitivity of snow cover persistence period to the timings of snow cover onset and disappearance over the areas with shallow snow. The averaged SFBs were 1–14 weeks in the Tibetan Plateau during 1972–2006 and the maximum intermittence could reach 25 weeks in some extreme years. At a seasonal scale, the SWE usually peaked in February or March but fell gradually since April across Eurasia. Both annual mean and annual maximum SWE decreased significantly during 1979–2004 in most parts of Eurasia except for eastern Siberia as well as northwestern and northeastern China.

Keywords: Eurasia, snow cover extent, snow cover persistence period, snow-free breaks, onset and disappearance timings, snow water equivalent

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1253 The Impact of the Fitness Center Ownership Structure on the Service Quality Perception in the Fitness in Serbia

Authors: Dragan Zivotic, Mirjana Ilic, Aleksandra Perovic, Predrag Gavrilovic

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As with the provision of other services, the service quality perception is one of the key factors that the modern manager must pay attention to. Countries in which the state regulation is in transition also have specific features in providing fitness services. Identification of the dimensions in which the most significant different service quality perception between different types of fitness centers, enables managers to profile the offer according to the wishes and expectations of users. The aim of the paper was the comparison of the quality of services perception in the field of fitness in Serbia between three categories of fitness centers: the privately owned centers, the publicly owned centers, and the Public-private partnership centers. For this research 350 respondents of both genders (174 men and 176 women) were interviewed, aged between 18 and 68 years, being beneficiaries of fitness services for at least 1 year. Administered questionnaire with 100 items provided information about the 15 basic areas in which they expressed the service quality perception in the gym. The core sample was composed of 212 service users in private fitness centers, 69 service users in public fitness centers and 69 service users in the public-private partnership. Sub-samples were equal in representation of women and men, as well as by age and length of use of fitness services. The obtained results were subject of univariate analysis with the Kruskal-Wallis non-parametric analysis of variance. Significant differences between the analyzed sub-samples were not found solely in the areas of rapid response and quality outcomes. In the multivariate model, the results were processed by backward stepwise discriminant analysis that extracted 3 areas that maximize the differences between sub-samples: material and technical basis, secondary facilities and coaches. By applying the classification function 93.87% of private centers services users, 62.32% of public centers services users and 85.51% of the public-private partnership centers users of services were correctly classified (total 86.00%). These results allow optimizing the allocation of the necessary resources in profiling offers of a fitness center in order to optimally adjust it to the user’s needs and expectations.

Keywords: fitness, quality perception, management, public ownership, private ownership, public-private partnership, discriminative analysis

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1252 Ratings of Hand Activity and Force Levels in Identical Hand-Intensive Work Tasks in Women and Men

Authors: Gunilla Dahlgren, Per Liv, Fredrik Öhberg, Lisbeth Slunga Järvholm, Mikael Forsman, Börje Rehn

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Background: Accuracy of risk assessment tools in hand-repetitive work is important. This can support precision in the risk management process and for a sustainable working life for women and men equally. Musculoskeletal disorders, MSDs, from the hand, wrist, and forearm, are common in the working population. Women report a higher prevalence of MSDs in these regions. Objective: The objective of this study was to compare if women and men who performed the identical hand-intensive work task were rated equally using the Hand Activity Threshold Limit Value® (HA-TLV) when self-rated and observer-rated. Method: Fifty-six workers from eight companies participated, with various intensities in hand-repetitive work tasks. In total, 18 unique identical hand-intensive work tasks were executed in 28 pairs of a woman and a man. Hand activity and force levels were assessed. Each worker executed the work task for 15 minutes, which was also video recorded. Data was collected on workers who self-rated directly after the execution of the work task. Also, experienced observers performed ratings from videos of the same work tasks. For comparing means between women and men, paired samples t-tests were used. Results: The main results showed that there was no difference in self-ratings of hand activity level and force by women and men who executed the same work task. Further, there was no difference between observer ratings of hand activity level. However, the observer force ratings of women and men differed significantly (p=0.01). Conclusion: Hand activity and force levels are rated equally in women and men when self-rated, also by observers for hand activity. However, it is an observandum that observer force rating is rated higher for women and lower for men. This indicates the need of comparing force ratings with technical measures.

Keywords: gender, equity, sex differences, repetitive strain injury, cumulative trauma disorders, upper extremity, exposure assessment, workload, health risk assessment, observation, psychophysics

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1251 'Pacta Sunt Servanda': Which Form of Contract to Use in the Construction Industry

Authors: Ahmed Stifi, Sascha Gentes

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The contract in its simplest definition is an agreement involving parties with a number of documents which may be as little as a marriage contract involving two parties or as big as a contract of construction and operation of a nuclear power plant involving companies and stakeholders with hundreds or even thousands of documents. All parties in the construction industry, not only the contract experts, agree that the success of a project is linked primarily to the form of contract regulating the relationship between stakeholders of the project. Therefore it is essential for the construction industry to study, analyze and improve its contracts forms continuously. However, it should be mentioned that different contract forms are developed to suit the construction evolution in term of its machinery, materials and construction process. There exist some similarities in some clauses and variations in many of these forms depending upon the type of project, the kind of clients and more importantly the laws and regulations governing the transaction in the country where the project is carried out. This paper will discuss the most important forms of construction contracts starting from national level, intended to the contract form in Germany and moving on to the international level introducing FIDIC contracts and its different forms, some newly developed contracts forms namely the integrated form of agreement, the new engineering contract and the project alliance agreement. The result of the study shows that many of the contract’s paragraphs are similar and the main difference comes in the approach of the relationship between the parties. Is it based on co-operation and mutual trust, or in some cases a load of responsibility for a particular party which increases the problems and disputes that affects the success of the project negatively. Thus we can say that the form of the contract, that plays an essential role in the approach of the project management, which is ultimately the key factor for the success of the project. So we advise to use a form of contract, which enhance the mutual trust between the project parties, contribute to support the cooperation between them, distribute responsibility and risks on an equitable basis and build on the principle “win-win". In additional to the conventional role of the contract it should integrate all parties into one team to achieve the target value of the project.

Keywords: contract, FIDIC, integrated form of agreement, new engineering contract, project alliance agreemen

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1250 Tangible Losses, Intangible Traumas: Re-envisioning Recovery Following the Lytton Creek Fire 2021 through Place Attachment Lens

Authors: Tugba Altin

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In an era marked by pronounced climate change consequences, communities are observed to confront traumatic events that yield both tangible and intangible repercussions. Such events not only cause discernible damage to the landscape but also deeply affect the intangible aspects, including emotional distress and disruptions to cultural landscapes. The Lytton Creek Fire of 2021 serves as a case in point. Beyond the visible destruction, the less overt but profoundly impactful disturbance to place attachment (PA) is scrutinized. PA, representing the emotional and cognitive bonds individuals establish with their environments, is crucial for understanding how such events impact cultural identity and connection to the land. The study underscores the significance of addressing both tangible and intangible traumas for holistic community recovery. As communities renegotiate their affiliations with altered environments, the cultural landscape emerges as instrumental in shaping place-based identities. This renewed understanding is pivotal for reshaping adaptation planning. The research advocates for adaptation strategies rooted in the lived experiences and testimonies of the affected populations. By incorporating both the tangible and intangible facets of trauma, planning efforts are suggested to be more culturally attuned and emotionally insightful, fostering true resonance with the affected communities. Through such a comprehensive lens, this study contributes enriching the climate change discourse, emphasizing the intertwined nature of tangible recovery and the imperative of emotional and cultural healing after environmental disasters. Following the pronounced aftermath of the Lytton Creek Fire in 2021, research aims to deeply understand its impact on place attachment (PA), encompassing the emotional and cognitive bonds individuals form with their environments. The interpretive phenomenological approach, enriched by a hermeneutic framework, is adopted, emphasizing the experiences of the Lytton community and co-researchers. Phenomenology informed the understanding of 'place' as the focal point of attachment, providing insights into its formation and evolution after traumatic events. Data collection departs from conventional methods. Instead of traditional interviews, walking audio sessions and photo elicitation methods are utilized. These allow co-researchers to immerse themselves in the environment, re-experience, and articulate memories and feelings in real-time. Walking audio facilitates reflections on spatial narratives post-trauma, while photo voices captured intangible emotions, enabling the visualization of place-based experiences. The analysis is collaborative, ensuring the co-researchers' experiences and interpretations are central. Emphasizing their agency in knowledge production, the process is rigorous, facilitated by the harmonious blend of interpretive phenomenology and hermeneutic insights. The findings underscore the need for adaptation and recovery efforts to address emotional traumas alongside tangible damages. By exploring PA post-disaster, the research not only fills a significant gap but advocates for an inclusive approach to community recovery. Furthermore, the participatory methodologies employed challenge traditional research paradigms, heralding potential shifts in qualitative research norms.

Keywords: wildfire recovery, place attachment, trauma recovery, cultural landscape, visual methodologies

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1249 The Influence of Apple Pomace on Colour and Chemical Composition of Extruded Corn Snack Product

Authors: Jovana Petrovic, Biljana Pajin, Ivana Loncarevic, Aleksandar Fistes, Antun Jozinivic, Durdica Ackar, Drago Subaric

Abstract:

Recovery of food wastes and their conversion to economically viable products will play a vital role for the management strategies in the years to come. Apple pomace may be considered as wastes, but they contain considerable amounts of high value reusable materials. Apple pomace, the by-product of apple juice and cider production, is a good source of fibre, particularly insoluble one. The remaining apple pulp contains 12% dry residue, which is half dietary fibre. Another remarkable aspect is its richness in polyphenols, components with antioxidant activity. Apple pomace could be an interesting alternative source for fibre and polyphenols in extruded corn meals. The extruded corn meals with the addition of finely ground apple pomace were prepared (the ratio of corn meal: apple pomace was 85:15 and 70:30). Characterization of the extrudates in terms of determining the chemical composition and colour was performed. The color of samples was measured by MINOLTA Chroma Meter CR-400 (Minolta Co., Ltd., Osaka, Japan) using D 65 lighting, a 2º standard observer angle and an 8-mm aperture in the measuring head. The following CIELab color coordinates were determined: L* – lightness, a* – redness to greenness and b* – yellowness to blueness. Protein content decreased significantly from 7.91% to 5.19% with increase in pomace from 0% to 30%, while total fibre content increase from 3.39% to 16.62%. The apple pomace addition produced extrudates with a significantly lower L* value and significantly higher a* value. This study has been fully supported by the Provincial Secretariat for High Education and Scientific Research of the Government of Autonomous Province of Vojvodina, Republic of Serbia, project 142-451-2483/2017 and the Ministry of Science and Technological Development of the Republic of Serbia (Project no. 31014).

Keywords: apple pomace, chemical composition, colour, extruded corn snack products, food waste recovery

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1248 Provision of Afterschool Programs: Understanding the Educational Needs and Outcomes of Newcomer and Refugee Students in Canada

Authors: Edward Shizha, Edward Makwarimba

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Newcomer and refugee youth feel excluded in the education system in Canada, and the formal education environment does not fully cater for their learning needs. The objective of this study was to build knowledge and understanding of the educational needs and experiences of these youth in Canada and how available afterschool programs can most effectively support their learning needs and academic outcomes. The Employment and Social Development Canada (ESDC), which funded this research, enables and empowers students to advance their educational experience through targeted investments in services that are delivered by youth-serving organizations outside the formal education system through afterschool initiatives. A literature review and a provincial/territorial internet scan were conducted to determine the availability of services and programs that serve the educational needs and academic outcomes of newcomer youth in 10 provinces and 3 territories in Canada. The goal was to identify intersectional factors (e.g., gender, sexuality, culture, social class, race, etc.) that influence educational outcomes of newcomer/refugee students and to recommend ways the ESDC could complement settlement services to enhance students’ educational success. First, data was collected through a literature search of various databases, including PubMed, Web of Science, Scopus, Google docs, ACADEMIA, and grey literature, including government documents, to inform our analysis. Second, a provincial/territorial internet scan was conducted using a template that was created by ESDC staff with the input of the researchers. The objective of the web-search scan was to identify afterschool programs, projects, and initiatives offered to newcomer/refugee youth by service provider organizations. The method for the scan included both qualitative and quantitative data gathering. Both the literature review and the provincial/territorial scan revealed that there are gender disparities in educational outcomes of newcomer and refugee youth. High school completion rates by gender show that boys are at higher risk of not graduating than girls and that girls are more likely than boys to have at least a high school diploma and more likely to proceed to postsecondary education. Findings from literature reveal that afterschool programs are required for refugee youth who experience mental health challenges and miss out on significant periods of schooling, which affect attendance, participation, and graduation from high school. However, some refugee youth use their resilience and ambition to succeed in their educational outcomes. Another finding showed that some immigrant/refugee students, through ethnic organizations and familial affiliation, maintain aspects of their cultural values, parental expectations and ambitious expectations for their own careers to succeed in both high school and postsecondary education. The study found a significant combination of afterschool programs that include academic support, scholarships, bursaries, homework support, career readiness, internships, mentorship, tutoring, non-clinical counselling, mental health and social well-being support, language skills, volunteering opportunities, community connections, peer networking, culturally relevant services etc. These programs assist newcomer youth to develop self-confidence and prepare for academic success and future career development. The study concluded that advantages of afterschool programs are greatest for youth at risk for poor educational outcomes, such as Latino and Black youth, including 2SLGBTQI+ immigrant youth.

Keywords: afterschool programs, educational outcomes, newcomer youth, refugee youth, youth-serving organizations

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1247 Prevalence, Associated Risk Factors, and Bacterial Pathogens in Dairy Camels: A Review

Authors: Djeddi Khaled, Houssou Hind, Miloudi Abdelatif, Rabah Siham

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Camels play a vital role as multipurpose animals, providing milk meat and serving as a means of transportation. They serve as a financial reserve for pastoralists and hold significant cultural and social value. Camel milk, known for its exceptional nutritional properties, is considered a valuable substitute for human milk. However, udder infections, particularly mastitis, pose significant challenges to camel farming. Clinical and subclinical mastitis can lead to substantial economic losses. Mastitis, especially the subclinical form, is a persistent and prevalent condition affecting milk hygiene and quality in dairy camels. This review offers insights into the prevalence and risk factors associated with subclinical mastitis in camels. The prevalence of subclinical mastitis in dairy camels was found to range from 9.28% to 87.78%. Major pathogens responsible for camel mastitis include Staphylococcus aureus, Coagulase-negative Staphylococcus, Streptococcus agalactiae, Streptococcus dysgalactiae, Escherichia coli, Micrococcus spp, Pasteurella haemolytica and Corynebacterium spp. The study outlines key risk factors contributing to camel mastitis, emphasizing factors such as severe tick infestation, age, stage of lactation, parity, body condition score, skin lesion on the teats or udders, anti-suckling devices, previous history of the udder, conformation of the udder, breed, unhygienic milking practices, production system, amongst others have been reported to be important in the prevalence of subclinical mastitis. This comprehensive overview provides valuable insights into the multifaceted aspects of camel mastitis, encompassing prevalent bacterial pathogens and diverse risk factors. The findings underscore the importance of holistic management practices, emphasizing hygiene, health monitoring, and targeted interventions to ensure the well-being and productivity of camels in various agro-pastoral contexts.

Keywords: bacterial pathogens, camel, mastitis, risk factors

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1246 The Role of Middle Managers SBU's in Context of Change: Sense-Making Approach

Authors: Hala Alioua, Alberic Tellier

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This paper is designed to spotlight the research on corporate strategic planning, by emphasizing the role of middle manager of SBU’s and related issues such as the context of vision change. Previous research on strategic vision has been focused principally at the SME, with relatively limited consideration given to the role of middle managers SBU’s in the context of change. This project of research has been done by using a single case study. We formulated through our immersion for 2.5 years on the ground and by a qualitative method and abduction approach. This entity that we analyze is a subsidiary of multinational companies headquartered in Germany, specialized in manufacturing automotive equipment. The "Delta Company" is a French manufacturing plant that has undergone numerous changes over the past three years. The two major strategic changes that have a significant impact on the Delta plant are the strengths of its core business through « lead plant strategy» in 2011 and the implementation of a new strategic vision in 2014. These consecutive changes impact the purpose of the mission of the middle managers. The plant managers ask the following questions: How the middle managers make sense of the corporate strategic planning imposed by the parent company? How they appropriate the new vision and decline it into actions on the ground? We chose the individual interview technique through open-ended questions as the source of data collection. We first of all carried out an exploratory approach by interviewing 8 members of the Management committee’s decision and 19 heads of services. The first findings and results show that exist a divergence of opinion and interpretations of the corporate strategic planning among organization members and there are difficulties to make sense and interpretations of the signals of the environment. The lead plant strategy enables new projects which insure the workload of Delta Company. Nevertheless, it creates a tension and stress among the middle managers because its provoke lack of resources to the detriment of their main jobs as manufacturer plant. The middle managers does not have a clear vision and they are wondering if the new strategic vision means more autonomy and less support from the group.

Keywords: change, middle managers, vision, sensemaking

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1245 Development, Evaluation and Scale-Up of a Mental Health Care Plan (MHCP) in Nepal

Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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1244 Identification and Classification of Medicinal Plants of Indian Himalayan Region Using Hyperspectral Remote Sensing and Machine Learning Techniques

Authors: Kishor Chandra Kandpal, Amit Kumar

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The Indian Himalaya region harbours approximately 1748 plants of medicinal importance, and as per International Union for Conservation of Nature (IUCN), the 112 plant species among these are threatened and endangered. To ease the pressure on these plants, the government of India is encouraging its in-situ cultivation. The Saussurea costus, Valeriana jatamansi, and Picrorhiza kurroa have also been prioritized for large scale cultivation owing to their market demand, conservation value and medicinal properties. These species are found from 1000 m to 4000 m elevation ranges in the Indian Himalaya. Identification of these plants in the field requires taxonomic skills, which is one of the major bottleneck in the conservation and management of these plants. In recent years, Hyperspectral remote sensing techniques have been precisely used for the discrimination of plant species with the help of their unique spectral signatures. In this background, a spectral library of the above 03 medicinal plants was prepared by collecting the spectral data using a handheld spectroradiometer (325 to 1075 nm) from farmer’s fields of Himachal Pradesh and Uttarakhand states of Indian Himalaya. The Random forest (RF) model was implied on the spectral data for the classification of the medicinal plants. The 80:20 standard split ratio was followed for training and validation of the RF model, which resulted in training accuracy of 84.39 % (kappa coefficient = 0.72) and testing accuracy of 85.29 % (kappa coefficient = 0.77). This RF classifier has identified green (555 to 598 nm), red (605 nm), and near-infrared (725 to 840 nm) wavelength regions suitable for the discrimination of these species. The findings of this study have provided a technique for rapid and onsite identification of the above medicinal plants in the field. This will also be a key input for the classification of hyperspectral remote sensing images for mapping of these species in farmer’s field on a regional scale. This is a pioneer study in the Indian Himalaya region for medicinal plants in which the applicability of hyperspectral remote sensing has been explored.

Keywords: himalaya, hyperspectral remote sensing, machine learning; medicinal plants, random forests

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1243 Dynamic Modelling and Assessment for Urban Growth and Transport in Riyadh City, Saudi Arabia

Authors: Majid Aldalbahi

Abstract:

In 2009, over 3.4 billion people in the world resided in urban areas as a result of rapid urban growth. This figure is estimated to increase to 6.5 billion by 2050. This urban growth phenomenon has raised challenges for many countries in both the developing and developed worlds. Urban growth is a complicated process involving the spatiotemporal changes of all socio-economic and physical components at different scales. The socio-economic components of urban growth are related to urban population growth and economic growth, while physical components of urban growth and economic growth are related to spatial expansion, land cover change and land use change which are the focus of this research. The interactions between these components are complex and no-linear. Several factors and forces cause these complex interactions including transportation and communication, internal and international migrations, public policies, high natural growth rates of urban populations and public policies. Urban growth has positive and negative consequences. The positive effects relates to planned and orderly urban growth, while negative effects relate to unplanned and scattered growth, which is called sprawl. Although urban growth is considered as necessary for sustainable urbanization, uncontrolled and rapid growth cause various problems including consumption of precious rural land resources at urban fringe, landscape alteration, traffic congestion, infrastructure pressure, and neighborhood conflicts. Traditional urban planning approaches in fast growing cities cannot accommodate the negative consequences of rapid urban growth. Microsimulation programme, and modelling techniques are effective means to provide new urban development, management and planning methods and approaches. This paper aims to use these techniques to understand and analyse the complex interactions for the case study of Riyadh city, a fast growing city in Saudi Arabia.

Keywords: policy implications, urban planning, traffic congestion, urban growth, Suadi Arabia, Riyadh

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1242 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome

Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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1241 NanoSat MO Framework: Simulating a Constellation of Satellites with Docker Containers

Authors: César Coelho, Nikolai Wiegand

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The advancement of nanosatellite technology has opened new avenues for cost-effective and faster space missions. The NanoSat MO Framework (NMF) from the European Space Agency (ESA) provides a modular and simpler approach to the development of flight software and operations of small satellites. This paper presents a methodology using the NMF together with Docker for simulating constellations of satellites. By leveraging Docker containers, the software environment of individual satellites can be easily replicated within a simulated constellation. This containerized approach allows for rapid deployment, isolation, and management of satellite instances, facilitating comprehensive testing and development in a controlled setting. By integrating the NMF lightweight simulator in the container, a comprehensive simulation environment was achieved. A significant advantage of using Docker containers is their inherent scalability, enabling the simulation of hundreds or even thousands of satellites with minimal overhead. Docker's lightweight nature ensures efficient resource utilization, allowing for deployment on a single host or across a cluster of hosts. This capability is crucial for large-scale simulations, such as in the case of mega-constellations, where multiple traditional virtual machines would be impractical due to their higher resource demands. This ability for easy horizontal scaling based on the number of simulated satellites provides tremendous flexibility to different mission scenarios. Our results demonstrate that leveraging Docker containers with the NanoSat MO Framework provides a highly efficient and scalable solution for simulating satellite constellations, offering not only significant benefits in terms of resource utilization and operational flexibility but also enabling testing and validation of ground software for constellations. The findings underscore the importance of taking advantage of already existing technologies in computer science to create new solutions for future satellite constellations in space.

Keywords: containerization, docker containers, NanoSat MO framework, satellite constellation simulation, scalability, small satellites

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1240 Evaluation of Teaching Performance in Higher Education: From the Students' Responsibility to Their Evaluative Competence

Authors: Natacha Jesus-Silva, Carla S. Pereira, Natercia Durao, Maria Das Dores Formosinho, Cristina Costa-Lobo

Abstract:

Any assessment process, by its very nature, raises a wide range of doubts, uncertainties, and insecurities of all kinds. The evaluation process should be ethically irreproachable, treating each and every one of the evaluated according to a conduct that ensures that the process is fair, contributing to all recognize and feel well with the processes and results of the evaluation. This is a very important starting point and implies that positive and constructive conceptions and attitudes are developed regarding the evaluation of teaching performance, where students' responsibility is desired. It is not uncommon to find teachers feeling threatened at various levels, in particular as regards their autonomy and their professional dignity. Evaluation must be useful in that it should enable decisions to be taken to improve teacher performance, the quality of teaching or the learning climate of the school. This study is part of a research project whose main objective is to identify, select, evaluate and synthesize the available evidence on Quality Indicators in Higher Education. In this work, the 01 parameters resulting from pedagogical surveys in a Portuguese higher education institution in the north of the country will be presented, surveys for the 2015/2016 school year, presented to 1751 students, in a total of 11 degrees and 18 master's degrees. It has analyzed the evaluation made by students with respect to the performance of a group of 68 teachers working full time. This paper presents the lessons learned in the last three academic years, allowing for the identification of the effects on the following areas: teaching strategies and methodologies, capacity of systematization, learning climate, creation of conditions for active student participation. This paper describes the procedures resulting from the descriptive analysis (frequency analysis, descriptive measures and association measures) and inferential analysis (ANOVA one-way, MANOVA one-way, MANOVA two-way and correlation analysis).

Keywords: teaching performance, higher education, students responsibility, indicators of teaching management

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1239 Early and Mid-Term Results of Anesthetic Management of Minimal Invasive Coronary Artery Bypass Grafting Using One Lung Ventilation

Authors: Devendra Gupta, S. P. Ambesh, P. K Singh

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Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.

Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube

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1238 A Future Urban Street Design in Baltimore, Maryland Based on a Hierarchy of Functional Needs and the Context of Autonomous Vehicles, Green Infrastructure, and Evolving Street Typologies

Authors: Samuel Quick

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The purpose of this paper is to examine future urban street design in the context of developing technologies, evolving street typologies, and projected transportation trends. The goal was to envision a future urban street in the year 2060 that addresses the advent and implementation of autonomous vehicles, the promotion of new street typologies, and the projection of current transportation trends. Using a hierarchy of functional needs for urban streets, the future street was designed and evaluated based on the functions the street provides to the surrounding community. The site chosen for the future street design is an eight-block section of West North Avenue in the city of Baltimore, Maryland. Three different conceptual designs were initially completed and evaluated leading to a master plan for West North Avenue as well as street designs for connecting streets that represent different existing street types. Final designs were compared with the existing street design and evaluated with the adapted ‘Hierarchy of Needs’ theory. The review of the literature and the results from this paper indicate that urban streets will have to become increasingly multi-functional to meet the competing needs of the environment and community. Future streets will have to accommodate multimodal transit which will include mass transit, walking, and biking. Furthermore, a comprehensive implementation of green infrastructure within the urban street will provide access to nature for urban communities and essential stormwater management. With these developments, the future of an urban street will move closer to a greenway typology. Findings from this study indicate that urban street design will have to be policy-driven to promote and implement autonomous bus-rapid-transit in order to conserve street space for other functions. With this conservation of space, urban streets can then provide more functions to the surrounding community, taking a holistic approach to urban street design.

Keywords: autonomous vehicle, greenway, green infrastructure, multi-modality, street typology

Procedia PDF Downloads 183
1237 Real Time Detection of Application Layer DDos Attack Using Log Based Collaborative Intrusion Detection System

Authors: Farheen Tabassum, Shoab Ahmed Khan

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The brutality of attacks on networks and decisive infrastructures are on the climb over recent years and appears to continue to do so. Distributed Denial of service attack is the most prevalent and easy attack on the availability of a service due to the easy availability of large botnet computers at cheap price and the general lack of protection against these attacks. Application layer DDoS attack is DDoS attack that is targeted on wed server, application server or database server. These types of attacks are much more sophisticated and challenging as they get around most conventional network security devices because attack traffic often impersonate normal traffic and cannot be recognized by network layer anomalies. Conventional techniques of single-hosted security systems are becoming gradually less effective in the face of such complicated and synchronized multi-front attacks. In order to protect from such attacks and intrusion, corporation among all network devices is essential. To overcome this issue, a collaborative intrusion detection system (CIDS) is proposed in which multiple network devices share valuable information to identify attacks, as a single device might not be capable to sense any malevolent action on its own. So it helps us to take decision after analyzing the information collected from different sources. This novel attack detection technique helps to detect seemingly benign packets that target the availability of the critical infrastructure, and the proposed solution methodology shall enable the incident response teams to detect and react to DDoS attacks at the earliest stage to ensure that the uptime of the service remain unaffected. Experimental evaluation shows that the proposed collaborative detection approach is much more effective and efficient than the previous approaches.

Keywords: Distributed Denial-of-Service (DDoS), Collaborative Intrusion Detection System (CIDS), Slowloris, OSSIM (Open Source Security Information Management tool), OSSEC HIDS

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1236 Clustering and Modelling Electricity Conductors from 3D Point Clouds in Complex Real-World Environments

Authors: Rahul Paul, Peter Mctaggart, Luke Skinner

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Maintaining public safety and network reliability are the core objectives of all electricity distributors globally. For many electricity distributors, managing vegetation clearances from their above ground assets (poles and conductors) is the most important and costly risk mitigation control employed to meet these objectives. Light Detection And Ranging (LiDAR) is widely used by utilities as a cost-effective method to inspect their spatially-distributed assets at scale, often captured using high powered LiDAR scanners attached to fixed wing or rotary aircraft. The resulting 3D point cloud model is used by these utilities to perform engineering grade measurements that guide the prioritisation of vegetation cutting programs. Advances in computer vision and machine-learning approaches are increasingly applied to increase automation and reduce inspection costs and time; however, real-world LiDAR capture variables (e.g., aircraft speed and height) create complexity, noise, and missing data, reducing the effectiveness of these approaches. This paper proposes a method for identifying each conductor from LiDAR data via clustering methods that can precisely reconstruct conductors in complex real-world configurations in the presence of high levels of noise. It proposes 3D catenary models for individual clusters fitted to the captured LiDAR data points using a least square method. An iterative learning process is used to identify potential conductor models between pole pairs. The proposed method identifies the optimum parameters of the catenary function and then fits the LiDAR points to reconstruct the conductors.

Keywords: point cloud, LİDAR data, machine learning, computer vision, catenary curve, vegetation management, utility industry

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1235 Outcome of Unilateral Retinoblastoma: A Ten Years Experience of Children's Cancer, Hospital Egypt

Authors: Ahmed Elhussein, Hossam El-Zomor, Adel Alieldin, Mahmoud A. Afifi, Abdullah Elhusseiny, Hala Taha, Amal Refaat, Soha Ahmed, Mohamed S. Zagloul

Abstract:

Background: A majority of children with retinoblastoma (60%) have a disease in one eye only (unilateral disease). This is a retrospective study to evaluate two different treatment modalities in those patients for saving their lives and vision. Methods: Four hundred and four patients were diagnosed with unilateral intraocular retinoblastoma at Children’s Cancer, Hospital Egypt (CCHE) through the period of July/2007 until December/2017. Management strategies included primary enucleation versus ocular salvage treatment. Results: Patients presented with mean age 24.5 months with range (1.2-154.3 months). According to the international retinoblastoma classification, Group D (n=172, 42%) was the most common, followed by group E (n=142, 35%), group C (n=63, 16%), and group B (n=27, 7%). All patients were alive at the end of the study except four patients who died, with 5-years overall survival 98.3% [CI, (96.5-100%)]. Patients presented with advanced disease and poor visual prognosis (n=241, 59.6%) underwent primary enucleation with 6 cycles adjuvant chemotherapy if they had high-risk features in the enucleated eye; only four patients out of 241 ended-up either with extraocular metastasis (n=3) or death (n=1). While systemic chemotherapy and focal therapy were the primary treatment for those who presented with favorable disease status and good visual prognosis (n=163, 40.4%); seventy-seven patients of them (47%) ended up with a pre-defined event (enucleation, EBRT, off protocol chemotherapy or 2ry malignancy). Ocular survival for patients received primary chemotherapy + focal therapy was [50.9% (CI, 43.5-59.6%)] at 3 years and [46.9% (CI,39.3-56%)] at 5 years. Comparison between upfront enucleation and primary chemotherapy for occurrence of extraocular metastasis revealed that there was no statistical difference between them except in group D (p value). While for occurrence of death, no statistical difference in all classification groups. Conclusion: In retinoblastoma, primary chemotherapy is a reasonable option and has a good probability for ocular salvage without increasing the risk of metastasis in comparison to upfront enucleation except in group D.

Keywords: CCHE, chemotherapy, enucleation, retinoblastoma

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