Search results for: patient safety incidents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6570

Search results for: patient safety incidents

4890 A Randomized Active Controlled Clinical Trial to Assess Clinical Efficacy and Safety of Tapentadol Nasal Spray in Moderate to Severe Post-Surgical Pain

Authors: Kamal Tolani, Sandeep Kumar, Rohit Luthra, Ankit Dadhania, Krishnaprasad K., Ram Gupta, Deepa Joshi

Abstract:

Background: Post-operative analgesia remains a clinical challenge, with central and peripheral sensitization playing a pivotal role in treatment-related complications and impaired quality of life. Centrally acting opioids offer poor risk benefit profile with increased intensity of gastrointestinal or central side effects and slow onset of clinical analgesia. The objective of this study was to assess the clinical feasibility of induction and maintenance therapy with Tapentadol Nasal Spray (NS) in moderate to severe acute post-operative pain. Methods: Phase III, randomized, active-controlled, non-inferiority clinical trial involving 294 cases who had undergone surgical procedures under general anesthesia or regional anesthesia. Post-surgery patients were randomized to receive either Tapentadol NS 45 mg or Tramadol 100mg IV as a bolus and subsequent 50 mg or 100 mg dose over 2-3 minutes. The frequency of administration of NS was at every 4-6 hours. At the end of 24 hrs, patients in the tramadol group who had a pain intensity score of ≥4 were switched to oral tramadol immediate release 100mg capsule until the pain intensity score reduced to <4. All patients who had achieved pain intensity ≤ 4 were shifted to a lower dose of either Tapentadol NS 22.5 mg or oral Tramadol immediate release 50mg capsule. The statistical analysis plan was envisaged as a non-inferiority trial involving comparison with Tramadol for Pain intensity difference at 60 minutes (PID60min), Sum of Pain intensity difference at 60 minutes (SPID60min), and Physician Global Assessment at 24 hrs (PGA24 hrs). Results: The per-protocol analyses involved 255 hospitalized cases undergoing surgical procedures. The median age of patients was 38.0 years. For the primary efficacy variables, Tapentadol NS was non-inferior to Inj/Oral Tramadol in relief of moderate to severe post-operative pain. On the basis of SPID60min, no clinically significant difference was observed between Tapentadol NS and Tramadol IV (1.73±2.24 vs. 1.64± 1.92, -0.09 [95% CI, -0.43, 0.60]). In the co-primary endpoint PGA24hrs, Tapentadol NS was non–inferior to Tramadol IV (2.12 ± 0.707 vs. 2.02 ±0.704, - 0.11[95% CI, -0.07, 0.28). However, on further assessment at 48hr, 72 hrs, and 120hrs, clinically superior pain relief was observed with the Tapentadol NS formulation that was statistically significant (p <0.05) at each of the time intervals. Secondary efficacy measures, including the onset of clinical analgesia and TOTPAR, showed non-inferiority to Tramadol. The safety profile and need for rescue medication were also similar in both the groups during the treatment period. The most common concomitant medications were anti-bacterial (98.3%). Conclusion: Tapentadol NS is a clinically feasible option for improved compliance as induction and maintenance therapy while offering a sustained and persistent patient response that is clinically meaningful in post-surgical settings.

Keywords: tapentadol nasal spray, acute pain, tramadol, post-operative pain

Procedia PDF Downloads 255
4889 Ultra-Sensitive Point-Of-Care Detection of PSA Using an Enzyme- and Equipment-Free Microfluidic Platform

Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

Abstract:

Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

Procedia PDF Downloads 115
4888 Building a Framework for Digital Emergency Response System for Aged, Long Term Care and Chronic Disease Patients in Asia Pacific Region

Authors: Nadeem Yousuf Khan

Abstract:

This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

Procedia PDF Downloads 124
4887 Stability in Slopes Related to Expansive Soils

Authors: Ivelise M. Strozberg, Lucas O. Vale, Maria V. V. Morais

Abstract:

Expansive soils are characterized by their significant volumetric variations, tending to suffer an increase of this volume when added water in their voids and a decrease of volume when this water is removed. The parameters of resistance (especially the angle of friction, cohesion and specific weight) of expansive or non-expansive soils of the same field present differences, as found in laboratory tests. What is expected is that, through this research, demonstrate that this variation directly affects the results of the calculation of factors of safety for slope stability. The expansibility due to specific clay minerals such as montmorillonites and vermiculites is the most common form of expansion of soils or rocks, causing expansion pressures. These pressures can become an aggravating problem in regions across the globe that, when not previously studied, may present high risks to the enterprise, such as cracks, fissures, movements in structures, breaking of retaining walls, drilling of wells, among others. The study provides results based on analyzes carried out in the Slide 2018 software belonging to the Rocsience group, where the software is a two-dimensional equilibrium slope stability program that calculates the factor of safety or probability of failure of certain surfaces composed of soils or rocks (or both, depending on the situation), - through the methods of: Bishop simplified, Fellenius and Janbu corrected. This research compares the factors of safety of a homogeneous earthfill dam geometry, analysed for operation and end-of-construction situations, having a height of approximately 35 meters, with a slope of 1.5: 1 in the slope downstream and 2: 1 on the upstream slope. As the water level is 32.73m high and the water table is drawn automatically by the Slide program using the finite element method for the operating situation, considering two hypotheses for the use of materials - the first with soils with characteristics of expansion and the second with soils without expansibility. For this purpose, soil samples were collected from the region of São Bento do Una - Pernambuco, Brazil and taken to the soil mechanics laboratory to characterize and determine the percentage of expansibility. There were found 2 types of soils in that area: 1 site of expansive soils (8%) and another with non- expansive ones. Based on the results found, the analysis of the values of factors of safety indicated, both upstream and downstream slopes, the highest values were obtained in the case where there is no presence of materials with expansibility resulting, for one of the situations, values of 1.353 (Fellenius), 1,295 (Janbu corrected) and 1,409 (Bishop simplified). There is a considerable drop in safety factors in cases where soils are potentially expansive, resulting in values for the same situation of 0.859 (Fellenius), 0.809 (Janbu corrected) and 0.842 (Bishop simplified), in the case of higher expansibility (8 %). This shows that the expansibility is a determinant factor in the fall of resistance of soil, determined by the factors of cohesion and angle of friction.

Keywords: dam. slope. software. swelling soil

Procedia PDF Downloads 125
4886 Embodied Spirituality in Gestalt Therapy

Authors: Silvia Alaimo

Abstract:

This lecture brings to our attention the theme of spirituality within Gestalt therapy’s theoretical and clinical perspectives and which is closely connected to the fertile emptiness and creative indifference’ experiences. First of all, the premise that must be done is the overcoming traditional western culture’s philosophical and religious misunderstandings, such as the dicotomy between spirituality and pratical/material daily life, as well as the widespread secular perspective of classic psychology. Even fullness and emptiness have traditionally been associated with the concepts of being and not being. "There is only one way through which we can contact the deepest layers of our existence, rejuvenate our thinking and reach intuition (the harmony of thought and being): inner silence" (Perls) *. Therefore, "fertile void" doesn't mean empty in itself, but rather an useful condition of every creative and responsible act, making room for a deeper dimension close to spirituality. Spirituality concerns questions about the meaning of existence, which lays beyond the concrete and literal dimension, looking for the essence of things, and looking at the value of personal experience. Looking at fundamentals of Gestalt epistemology, phenomenology, aesthetics, and the relationship, we can reach the heart of a therapeutic work that takes spiritual contours and which are based on an embodied (incarnate size), through the relational aesthetic knowledge (Spagnuolo Lobb ), the deep contact with each other, the role of compassion and responsibility, as the patient's recognition criteria (Orange, 2013) rooted in the body. The aesthetic dimension, like the spiritual dimension to which it is often associated, is a subtle dimension: it is the dimension of the essence of things, of their "soul." In clinical practice, it implies that the relationship between therapist and patient is "in the absence of judgment," also called "zero point of creative indifference," expressed by ‘therapeutic mentality’. It consists in following with interest and authentic curiosity where the patient wants to go and support him in his intentionality of contact. It’s a condition of pure and simple awareness, of the full acceptance of "what is," a moment of detachment from one's own life in which one does not take oneself too seriously, a starting point for finding a center of balance and integration that brings to the creative act, to growth, and, as Perls would say, to the excitement and adventure of living.

Keywords: spirituality, bodily, embodied aesthetics, phenomenology, relationship

Procedia PDF Downloads 140
4885 Early Diagnosis of Alzheimer's Disease Using a Combination of Images Processing and Brain Signals

Authors: E. Irankhah, M. Zarif, E. Mazrooei Rad, K. Ghandehari

Abstract:

Alzheimer's prevalence is on the rise, and the disease comes with problems like cessation of treatment, high cost of treatment, and the lack of early detection methods. The pathology of this disease causes the formation of protein deposits in the brain of patients called plaque amyloid. Generally, the diagnosis of this disease is done by performing tests such as a cerebrospinal fluid, CT scan, MRI, and spinal cord fluid testing, or mental testing tests and eye tracing tests. In this paper, we tried to use the Medial Temporal Atrophy (MTA) method and the Leave One Out (LOO) cycle to extract the statistical properties of the three Fz, Pz, and Cz channels of ERP signals for early diagnosis of this disease. In the process of CT scan images, the accuracy of the results is 81% for the healthy person and 88% for the severe patient. After the process of ERP signaling, the accuracy of the results for a healthy person in the delta band in the Cz channel is 81% and in the alpha band the Pz channel is 90%. In the results obtained from the signal processing, the results of the severe patient in the delta band of the Cz channel were 89% and in the alpha band Pz channel 92%.

Keywords: Alzheimer's disease, image and signal processing, LOO cycle, medial temporal atrophy

Procedia PDF Downloads 200
4884 The Effectiveness of Scalp Cooling Therapy on Reducing Chemotherapy Induced Alopecia: A Critical Literature Review

Authors: M. Krishna

Abstract:

The study was intended to identify if scalp cooling therapy is effective on preventing chemotherapy-induced hair loss among cancer patients. Critical literature of non-randomized controlled trials was used to investigate whether scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. The review identified that scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. Most of the patients receiving chemotherapy experience alopecia. It is also perceived as the worst effect of chemotherapy. This may be severe and lead the patients to withdraw the chemo treatment. The image disturbance caused by alopecia will make the patient depressed and will lead to declined immunity. With the knowledge on effectiveness of scalp cooling therapy on preventing chemotherapy-induced alopecia, patient undergoing chemotherapy will not be hesitant to undergo the treatment. Patients are recommended to go through scalp cooling therapy every chemo cycle and the proper therapy duration is 30 minutes before, during chemo. The suggested duration of the scalp cooling therapy is 45-90 minutes for an effective and positive outcome. This finding is excluding other factors of alopecia such as menopause, therapeutic drugs, poor hair density, liver function problems, and drug regimes.

Keywords: alopecia, cancer, chemotherapy, scalp cooling therapy

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4883 Hyperspectral Imaging and Nonlinear Fukunaga-Koontz Transform Based Food Inspection

Authors: Hamidullah Binol, Abdullah Bal

Abstract:

Nowadays, food safety is a great public concern; therefore, robust and effective techniques are required for detecting the safety situation of goods. Hyperspectral Imaging (HSI) is an attractive material for researchers to inspect food quality and safety estimation such as meat quality assessment, automated poultry carcass inspection, quality evaluation of fish, bruise detection of apples, quality analysis and grading of citrus fruits, bruise detection of strawberry, visualization of sugar distribution of melons, measuring ripening of tomatoes, defect detection of pickling cucumber, and classification of wheat kernels. HSI can be used to concurrently collect large amounts of spatial and spectral data on the objects being observed. This technique yields with exceptional detection skills, which otherwise cannot be achieved with either imaging or spectroscopy alone. This paper presents a nonlinear technique based on kernel Fukunaga-Koontz transform (KFKT) for detection of fat content in ground meat using HSI. The KFKT which is the nonlinear version of FKT is one of the most effective techniques for solving problems involving two-pattern nature. The conventional FKT method has been improved with kernel machines for increasing the nonlinear discrimination ability and capturing higher order of statistics of data. The proposed approach in this paper aims to segment the fat content of the ground meat by regarding the fat as target class which is tried to be separated from the remaining classes (as clutter). We have applied the KFKT on visible and nearinfrared (VNIR) hyperspectral images of ground meat to determine fat percentage. The experimental studies indicate that the proposed technique produces high detection performance for fat ratio in ground meat.

Keywords: food (ground meat) inspection, Fukunaga-Koontz transform, hyperspectral imaging, kernel methods

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4882 Advanced Eales’ Disease with Neovascular Glaucoma at First Presentation: Case Report

Authors: Mohammed A. Alfayyadh, Halla A. AlAbdulhadi, Mahdi H. Almubarak

Abstract:

Purpose: Eales’ disease is an idiopathic vasculitis that affects the peripheral retina. It is characterized by recurrent vitreous hemorrhage as a complication of retinal neovascularization. It is more prevalent in India and affects young males. Here we present a patient with neovascular glaucoma as a rare first presentation of Eales’ disease. Observations: This is a 24-year-old Indian gentleman, who complained of a sudden decrease in vision in the left eye over less than 24 hours, along with frontal headache and eye pain for the last three weeks. Ocular examination revealed peripheral retinal ischemia in the right eye, very high intraocular pressure, rubeosis iridis, vitreous hemorrhage and extensive retinal ischemia in the left eye, vascular sheathing and neovascularization in both eyes. Purified protein derivative skin test was positive. The patient was managed with anti-glaucoma, intravitreal anti-vascular endothelial growth factor and laser photocoagulation. Systemic steroids and anti-tuberculous therapy were also initiated. Conclusions: Neovascular glaucoma is an infrequent complication of Eales’ disease. However, the lack of early detection of the disease in the early stages might lead to such serious complication.

Keywords: case report, Eales’ disease, mycobacterium tuberculosis, neovascular glaucoma

Procedia PDF Downloads 132
4881 Traditional Medicine and Islamic Holistic Approach in Palliative Care Management of Terminal Illpatient of Cancer

Authors: Mohammed Khalil Ur Rahman, Mohammed Alsharon, Arshad Muktar, Zahid Shaik

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Any ailment can go into terminal stages, cancer being one such disease which is many times detected in latent stages. Cancer is often characterized by constitutional symptoms which are agonizing in nature which disturbs patients and their family as well. In order to relieve such intolerable symptoms treatment modality employed is known to be ‘Palliative Care’. The goal of palliative care is to enhance patient’s quality of life by relieving or rather reducing the distressing symptoms of patients such as pain, nausea/ vomiting, anorexia/loss of appetite, excessive salivation, mouth ulcers, weight loss, constipation, oral thrush, emaciation etc. which are due to the effect of disease or due to the undergoing treatment such as chemotherapy, radiation etc. Ayurveda and Unani as well as other traditional medicines is getting more and more international attention in recent years and Ayurveda and Unani holistic perspective of the disease, it seems that there are many herbs and herbomineral preparation which can be employed in the treatment of malignancy and also in palliative care. Though many of them have yet to be scientifically proved as anti-cancerous but there is definitely a positive lead that some of these medications relieve the agonising symptoms thereby making life of the patient easy. Health is viewed in Islam in a holistic way. One of the names of the Quran is al-shifa' meaning ‘that which heals’ or ‘the restorer of health’ to refer to spiritual, intellectual, psychological, and physical health. The general aim of medical science, according to Islam, is to secure and adopt suitable measures which, with Allah’s permission, help to preserve or restore the health of the human body. Islam motivates the Physician to view the patient as one organism. The patient has physical, social, psychological, and spiritual dimensions that must be considered in synthesis with an integrated, holistic approach. Aims & Objectives: - To suggest herbs which are mentioned in Ayurveda Unani with potential palliative activity in case of Cancer patients. - Most of tibb nabawi [Prophetic Medicine] is preventive medicine and must have been divinely inspired. - Spiritual Aspects of Healing: Prayer, dua, recitation of the Quran - Remembrance of Allah play a central role.Materials & Method: Literary review of the herbs supported with experiential evidence will be discussed. Discussion: On the basis of collected data subject will be discussed in length. Conclusion: Will be presented in paper.

Keywords: palliative care, holistic, Ayurvedic and Unani traditional system of medicine, Quran, hadith

Procedia PDF Downloads 344
4880 Application of 2D Electrical Resistivity Tomographic Imaging Technique to Study Climate Induced Landslide and Slope Stability through the Analysis of Factor of Safety: A Case Study in Ooty Area, Tamil Nadu, India

Authors: S. Maniruzzaman, N. Ramanujam, Qazi Akhter Rasool, Swapan Kumar Biswas, P. Prasad, Chandrakanta Ojha

Abstract:

Landslide is one of the major natural disasters in South Asian countries. Applying 2D Electrical Resistivity Tomographic Imaging estimation of geometry, thickness, and depth of failure zone of the landslide can be made. Landslide is a pertinent problem in Nilgris plateau next to Himalaya. Nilgris range consists of hard Archean metamorphic rocks. Intense weathering prevailed during the Pre-Cambrian time had deformed the rocks up to 45m depth. The landslides are dominant in the southern and eastern part of plateau of is comparatively smaller than the northern drainage basins, as it has low density of drainage; coarse texture permitted the more of infiltration of rainwater, whereas in the northern part of the plateau entombed with high density of drainage pattern and fine texture with less infiltration than run off, and low to the susceptible to landslide. To get comprehensive information about the landslide zone 2D Electrical Resistivity Tomographic imaging study with CRM 500 Resistivity meter are used in Coonoor– Mettupalyam sector of Nilgiris plateau. To calculate Factor of Safety the infinite slope model of Brunsden and Prior is used. Factor of Safety can be expressed (FS) as the ratio of resisting forces to disturbing forces. If FS < 1 disturbing forces are larger than resisting forces and failure may occur. The geotechnical parameters of soil samples are calculated on the basis upon the apparent resistivity values for litho units of measured from 2D ERT image of the landslide zone. Relationship between friction angles for various soil properties is established by simple regression analysis from apparent resistivity data. Increase of water content in slide zone reduces the effectiveness of the shearing resistance and increase the sliding movement. Time-lapse resistivity changes to slope failure is determined through geophysical Factor of Safety which depends on resistivity and site topography. This ERT technique infers soil property at variable depths in wider areas. This approach to retrieve the soil property and overcomes the limit of the point of information provided by rain gauges and porous probes. Monitoring of slope stability without altering soil structure through the ERT technique is non-invasive with low cost. In landslide prone area an automated Electrical Resistivity Tomographic Imaging system should be installed permanently with electrode networks to monitor the hydraulic precursors to monitor landslide movement.

Keywords: 2D ERT, landslide, safety factor, slope stability

Procedia PDF Downloads 323
4879 An Accidental Forecasting Modelling for Various Median Roads

Authors: Pruethipong Xinghatiraj, Rajwanlop Kumpoopong

Abstract:

Considering the current situation of road safety, Thailand has the world’s second-highest road fatality rate. Therefore, decreasing the road accidents in Thailand is a prime policy of the Thai government seeking to accomplish. One of the approaches to reduce the accident rate is to improve road environments to fit with the local behavior of the road users. The Department of Highways ensures that choosing the road median types right to the road characteristics, e.g. roadside characteristics, traffic volume, truck traffic percentage, etc., can decrease the possibility of accident occurrence. Presently, raised median, depressed median, painted median and median barriers are typically used in Thailand Highways. In this study, factors affecting road accident for each median type will be discovered through the analysis of the collecting of accident data, death numbers on sample of 600 Kilometers length across the country together with its roadside characteristics, traffic volume, heavy vehicles percentage, and other key factors. The benefits of this study can assist the Highway designers to select type of road medians that can match local environments and then cause less accident prone.

Keywords: highways, road safety, road median, forecasting model

Procedia PDF Downloads 271
4878 Experimental Stress Analysis on Pipeline in Condition of Frost Heave and Thaw Settlement

Authors: Zhiqiang Cheng, Qingliang He, Lu Li, Jie Ren

Abstract:

The safety of pipelines in the condition of frost heave or thaw settlement is necessarily evaluated. A full-scale experiment pipe with the typical structure configuration in station pipeline is constructed, the residual stress is tested with X-ray residual stress device, and the residual stress field of pipe is analyzed. The evolution of pipe strain with pressure in the scope of maximum allowable operation pressure (MAOP) is investigated by both strain gauge and X-ray methods. Load caused by frost heave or thaw settlement is simulated by two ways of lifting jack. The relation of maximum stress of pipe and clearances between supporter and pipe is studied in case of frost heave. The relation of maximum stress of pipe and maximum deformation of pipe on the ground is studied in case of thaw settlement. The study methods and results are valuable for safety assessment of station pipeline according to clearances or deformation in the condition of frost heave or thaw settlement.

Keywords: frost heave, pipeline, stress analysis, thaw settlement

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4877 Research on Reducing Food Losses by Extending the Date of Minimum Durability on the Example of Cereal Products

Authors: Monika Trzaskowska, Dorota Zielinska, Anna Lepecka, Katarzyna Neffe-Skocinska, Beata Bilska, Marzena Tomaszewska, Danuta Kolozyn-Krajewska

Abstract:

Microbiological quality and food safety are important food characteristics. Regulation (EU) No 1169/2011 of the European Parliament and of the Council on the provision of food information to consumers introduces the obligation to provide information on the 'use-by' date or the date of minimum durability (DMD). The second term is the date until which the properly stored or transported foodstuff retains its physical, chemical, microbiological and organoleptic properties. The date should be preceded by 'best before'. It is used for durable products, e.g., pasta. In relation to reducing food losses, the question may be asked whether products with the date of minimum durability currently declared retain quality and safety beyond this. The aim of the study was to assess the sensory quality and microbiological safety of selected cereal products, i.e., pasta and millet after DMD. The scope of the study was to determine the markers of microbiological quality, i.e., the total viable count (TVC), the number of bacteria from the Enterobacteriaceae family and the number of yeast and mold (TYMC) on the last day of DMD and after 1 and 3 months of storage. In addition, the presence of Salmonella and Listeria monocytogenes was examined on the last day of DMD. The sensory quality of products was assessed by quantitative descriptive analysis (QDA), the intensity of 14 differentiators and overall quality were defined and determined. In the tested samples of millet and pasta, no pathogenic bacteria Salmonella and Listeria monocytogenes were found. The value of the distinguishing features of selected quality and microbiological safety indicators on the last DMD day was in the range of about 3-1 log cfu/g. This demonstrates the good microbiological quality of the tested food. Comparing the products, a higher number of microorganisms was found in the samples of millet. After 3 months of storage, TVC decreased in millet, while in pasta, it was found to increase in value. In both products, the number of bacteria from the Enterobacretiaceae family decreased. In contrast, the number of TYMCs increased in samples of millet, and in pasta decreased. The intensity of sensory characteristic in the studied period varied. It remained at a similar level or increased. Millet was found to increase the intensity and flavor of 'cooked porridge' 3 months after DMD. Similarly, in the pasta, the smell and taste of 'cooked pasta' was more intense. To sum up, the researched products on the last day of the minimum durability date were characterized by very good microbiological and sensory quality, which was maintained for 3 months after this date. Based on these results, the date of minimum durability of tested products could be extended. The publication was financed on the basis of an agreement with the National Center for Research and Development No. Gospostrateg 1/385753/1/NCBR/2018 for the implementation and financing of the project under the strategic research and development program 'social and economic development of Poland in the conditions of globalizing markets – GOSPOSTRATEG - acronym PROM'.

Keywords: date of minimum durability, food losses, food quality and safety, millet, pasta

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4876 Proposals for the Practical Implementation of the Biological Monitoring of Occupational Exposure for Antineoplastic Drugs

Authors: Mireille Canal-Raffin, Nadege Lepage, Antoine Villa

Abstract:

Context: Most antineoplastic drugs (AD) have a potential carcinogenic, mutagenic and/or reprotoxic effect and are classified as 'hazardous to handle' by National Institute for Occupational Safety and Health Their handling increases with the increase of cancer incidence. AD contamination from workers who handle AD and/or care for treated patients is, therefore, a major concern for occupational physicians. As part of the process of evaluation and prevention of chemical risks for professionals exposed to AD, Biological Monitoring of Occupational Exposure (BMOE) is the tool of choice. BMOE allows identification of at-risk groups, monitoring of exposures, assessment of poorly controlled exposures and the effectiveness and/or wearing of protective equipment, and documenting occupational exposure incidents to AD. This work aims to make proposals for the practical implementation of the BMOE for AD. The proposed strategy is based on the French good practice recommendations for BMOE, issued in 2016 by 3 French learned societies. These recommendations have been adapted to occupational exposure to AD. Results: AD contamination of professionals is a sensitive topic, and the BMOE requires the establishment of a working group and information meetings within the concerned health establishment to explain the approach, objectives, and purpose of monitoring. Occupational exposure to AD is often discontinuous and 2 steps are essential upstream: a study of the nature and frequency of AD used to select the Biological Exposure Indice(s) (BEI) most representative of the activity; a study of AD path in the institution to target exposed professionals and to adapt medico-professional information sheet (MPIS). The MPIS is essential to gather the necessary elements for results interpretation. Currently, 28 urinary specific BEIs of AD exposure have been identified, and corresponding analytical methods have been published: 11 BEIs were AD metabolites, and 17 were AD. Results interpretation is performed by groups of homogeneous exposure (GHE). There is no threshold biological limit value of interpretation. Contamination is established when an AD is detected in trace concentration or in a urine concentration equal or greater than the limit of quantification (LOQ) of the analytical method. Results can only be compared to LOQs of these methods, which must be as low as possible. For 8 of the 17 AD BEIs, the LOQ is very low with values between 0.01 to 0.05µg/l. For the other BEIs, the LOQ values were higher between 0.1 to 30µg/l. Results restitution by occupational physicians to workers should be individual and collective. Faced with AD dangerousness, in cases of workers contamination, it is necessary to put in place corrective measures. In addition, the implementation of prevention and awareness measures for those exposed to this risk is a priority. Conclusion: This work is a help for occupational physicians engaging in a process of prevention of occupational risks related to AD exposure. With the current analytical tools, effective and available, the (BMOE) to the AD should now be possible to develop in routine occupational physician practice. The BMOE may be complemented by surface sampling to determine workers' contamination modalities.

Keywords: antineoplastic drugs, urine, occupational exposure, biological monitoring of occupational exposure, biological exposure indice

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4875 Human Identification and Detection of Suspicious Incidents Based on Outfit Colors: Image Processing Approach in CCTV Videos

Authors: Thilini M. Yatanwala

Abstract:

CCTV (Closed-Circuit-Television) Surveillance System is being used in public places over decades and a large variety of data is being produced every moment. However, most of the CCTV data is stored in isolation without having integrity. As a result, identification of the behavior of suspicious people along with their location has become strenuous. This research was conducted to acquire more accurate and reliable timely information from the CCTV video records. The implemented system can identify human objects in public places based on outfit colors. Inter-process communication technologies were used to implement the CCTV camera network to track people in the premises. The research was conducted in three stages and in the first stage human objects were filtered from other movable objects available in public places. In the second stage people were uniquely identified based on their outfit colors and in the third stage an individual was continuously tracked in the CCTV network. A face detection algorithm was implemented using cascade classifier based on the training model to detect human objects. HAAR feature based two-dimensional convolution operator was introduced to identify features of the human face such as region of eyes, region of nose and bridge of the nose based on darkness and lightness of facial area. In the second stage outfit colors of human objects were analyzed by dividing the area into upper left, upper right, lower left, lower right of the body. Mean color, mod color and standard deviation of each area were extracted as crucial factors to uniquely identify human object using histogram based approach. Color based measurements were written in to XML files and separate directories were maintained to store XML files related to each camera according to time stamp. As the third stage of the approach, inter-process communication techniques were used to implement an acknowledgement based CCTV camera network to continuously track individuals in a network of cameras. Real time analysis of XML files generated in each camera can determine the path of individual to monitor full activity sequence. Higher efficiency was achieved by sending and receiving acknowledgments only among adjacent cameras. Suspicious incidents such as a person staying in a sensitive area for a longer period or a person disappeared from the camera coverage can be detected in this approach. The system was tested for 150 people with the accuracy level of 82%. However, this approach was unable to produce expected results in the presence of group of people wearing similar type of outfits. This approach can be applied to any existing camera network without changing the physical arrangement of CCTV cameras. The study of human identification and suspicious incident detection using outfit color analysis can achieve higher level of accuracy and the project will be continued by integrating motion and gait feature analysis techniques to derive more information from CCTV videos.

Keywords: CCTV surveillance, human detection and identification, image processing, inter-process communication, security, suspicious detection

Procedia PDF Downloads 185
4874 Assessing the Indicators Influencing Port Resilience: A Comprehensive Literature Review

Authors: Guo Rui, Cao Xinhu

Abstract:

In recent decades, the world has endured severe challenges in light of climate change, epidemics, geopolitics, terrorism, economic uncertainties, as well as regional conflicts and rivalries. The appropriate use of critical infrastructures (Cis) is confronted. Ports, as typical Cis cover more than 80% of the global freight movement. Within this context, even the minimal disruption of port operations could cause malfunction of the holistic supply chain network and substantial economic losses. Hence, it is crucial to evaluate port performance from the perspective of resilience. Research on resilience and risk/safety management has been increasing, however, it needs more attention, as it could prevent potential socio-economic losses and inspire decision-makers to make resilience-based decisions to answer the challenges, such as COVID-19. To facilitate better moves from decision-makers, ports need to identify proper factors influencing port resilience. Inappropriately influenced factor selection could have a cascading effect on undesirable port performances. Thus, a systematic evaluation of factors is essential to stimulate the improvement process of port resilience investigation. This study zooms into container ports considering their critical role in international trade and global supply chains. 440 articles are selected after relevance ranking, and consequently, 62 articles are scrutinized after the title and abstract screening. Forty-one articles are included for bibliographic analysis in the end. It is found that there is no standardized index system to measure port resilience. And most studies evaluate port resilience merely in the recovery phase. Only two articles cover absorption, adaption and recovery state. However, no literature involves the prevention state. Hence, a uniform resilience index system is expected with a clear resilience definition. And port safety and security should also be considered while evaluating port resilience.

Keywords: port resilience, port safety and security, literature review, index system, port performance

Procedia PDF Downloads 128
4873 Pakis and Whites: A Critical View of Nadeem Aslam’s Treatment of Racism in “Maps for Lost Lovers”

Authors: Humaira Tariq

Abstract:

An issue faced by a majority of immigrants, especially coming from the third world countries, is that of racism. The natives find it very hard to accept people of another race, origin and background amongst them. History is replete with incidents where immigrants have paid a heavy price for being the odd ones out. Being an integral part of the immigrant experience, this issue of racism, is an important theme in most of diaspora related fiction. The present paper will endeavor to expose and explore Nadeem Aslam’s handling of this theme in his novel, 'Maps for Lost Lovers'. The researcher has found Aslam to take an objective stance on this issue, as he shows that where the West is unwilling to accept the immigrants in their midst, there, majority of the immigrants, are also responsible for alienating themselves in the new environment. He shows a kind of persecution mania haunting the immigrants from the third world countries where they feel the condition for being much worse than it actually is. The paper presents a critical view of the handling of racism in Aslam’s novel where he is found to criticize not only the English for their mistreatment of Pakistani immigrants, but is also disapproving of the judgmental attitude of the immigrants.

Keywords: english, immigrants, natives, pakistani, racism

Procedia PDF Downloads 411
4872 Challenges to Press Freedom in Pakistan

Authors: Awais Ahmad

Abstract:

People of Khyber Pakhtunkhwa (KP) and Federally Administered Tribal Areas (FATA) remains underrepresented in Pakistan’s mainstream media and their miseries and concerns are unheard and unnoticed. Rising the incidents of human rights violation in KP province of Pakistan, and its absence in the mainstream media has raised many questions on the clause of press freedom known as 19/A in the constitution of Pakistan, that has claimed freedom of speech to all Pakistani citizens. Using a ‘think a loud’ research technique, senior most journalists of KP have been interviewed to get to know reasons of why and how Pashtun’s voices have been silenced in a democratic country where individual’s opinion is considered more powerful, and they can exercise freedom to protest and speak-up for their rights. The information collected from the journalists has been used to evaluate press freedom in KP and FATA by applying the institutional theory. The paper evaluates different recent cases where Pashtun journalists, media outlets and social activists were being punished for criticizing authorities and military establishment. This study also explores that the perception of local journalists regarding press freedom and what are the factors they consider it restrictions while they perform their duties.

Keywords: press freedom, federally administered tribal areas (fata), khyber pakhtunkhwa (kp), military establishment

Procedia PDF Downloads 70
4871 Pharmacokinetics and Safety of Pacritinib in Patients with Hepatic Impairment and Healthy Volunteers

Authors: Suliman Al-Fayoumi, Sherri Amberg, Huafeng Zhou, Jack W. Singer, James P. Dean

Abstract:

Pacritinib is an oral kinase inhibitor with specificity for JAK2, FLT3, IRAK1, and CSF1R. In clinical studies, pacritinib was well tolerated with clinical activity in patients with myelofibrosis. The most frequent adverse events (AEs) observed with pacritinib are gastrointestinal (diarrhea, nausea, and vomiting; mostly grade 1-2 in severity) and typically resolve within 2 weeks. A human ADME mass balance study demonstrated that pacritinib is predominantly cleared via hepatic metabolism and biliary excretion (>85% of administered dose). The major hepatic metabolite identified, M1, is not thought to materially contribute to the pharmacological activity of pacritinib. Hepatic diseases are known to impair hepatic blood flow, drug-metabolizing enzymes, and biliary transport systems and may affect drug absorption, disposition, efficacy, and toxicity. This phase 1 study evaluated the pharmacokinetics (PK) and safety of pacritinib and the M1 metabolite in study subjects with mild, moderate, or severe hepatic impairment (HI) and matched healthy subjects with normal liver function to determine if pacritinib dosage adjustments are necessary for patients with varying degrees of hepatic insufficiency. Study participants (aged 18-85 y) were enrolled into 4 groups based on their degree of HI as defined by Child-Pugh Clinical Assessment Score: mild (n=8), moderate (n=8), severe (n=4), and healthy volunteers (n=8) matched for age, BMI, and sex. Individuals with concomitant renal dysfunction or progressive liver disease were excluded. A single 400 mg dose of pacritinib was administered to all participants. Blood samples were obtained for PK evaluation predose and at multiple time points postdose through 168 h. Key PK parameters evaluated included maximum plasma concentration (Cmax), time to Cmax (Tmax), area under the plasma concentration time curve (AUC) from hour zero to last measurable concentration (AUC0-t), AUC extrapolated to infinity (AUC0-∞), and apparent terminal elimination half-life (t1/2). Following treatment, pacritinib was quantifiable for all study participants at 1 h through 168 h postdose. Systemic pacritinib exposure was similar between healthy volunteers and individuals with mild HI. However, there was a significant difference between those with moderate and severe HI and healthy volunteers with respect to peak concentration (Cmax) and plasma exposure (AUC0-t, AUC0-∞). Mean Cmax decreased by 47% and 57% respectively in participants with moderate and severe HI vs matched healthy volunteers. Similarly, mean AUC0-t decreased by 36% and 45% and mean AUC0-∞ decreased by 46% and 48%, respectively in individuals with moderate and severe HI vs healthy volunteers. Mean t1/2 ranged from 51.5 to 74.9 h across all groups. The variability on exposure ranged from 17.8% to 51.8% across all groups. Systemic exposure of M1 was also significantly decreased in study participants with moderate or severe HI vs. healthy participants and individuals with mild HI. These changes were not significantly dissimilar from the inter-patient variability in these parameters observed in healthy volunteers. All AEs were grade 1-2 in severity. Diarrhea and headache were the only AEs reported in >1 participant (n=4 each). Based on these observations, it is unlikely that dosage adjustments would be warranted in patients with mild, moderate, or severe HI treated with pacritinib.

Keywords: pacritinib, myelofibrosis, hepatic impairment, pharmacokinetics

Procedia PDF Downloads 300
4870 A Prospective Study of a Clinically Significant Anatomical Change in Head and Neck Intensity-Modulated Radiation Therapy Using Transit Electronic Portal Imaging Device Images

Authors: Wilai Masanga, Chirapha Tannanonta, Sangutid Thongsawad, Sasikarn Chamchod, Todsaporn Fuangrod

Abstract:

The major factors of radiotherapy for head and neck (HN) cancers include patient’s anatomical changes and tumour shrinkage. These changes can significantly affect the planned dose distribution that causes the treatment plan deterioration. A measured transit EPID images compared to a predicted EPID images using gamma analysis has been clinically implemented to verify the dose accuracy as part of adaptive radiotherapy protocol. However, a global gamma analysis dose not sensitive to some critical organ changes as the entire treatment field is compared. The objective of this feasibility study is to evaluate the dosimetric response to patient anatomical changes during the treatment course in HN IMRT (Head and Neck Intensity-Modulated Radiation Therapy) using a novel comparison method; organ-of-interest gamma analysis. This method provides more sensitive to specific organ change detection. Random replanned 5 HN IMRT patients with causes of tumour shrinkage and patient weight loss that critically affect to the parotid size changes were selected and evaluated its transit dosimetry. A comprehensive physics-based model was used to generate a series of predicted transit EPID images for each gantry angle from original computed tomography (CT) and replan CT datasets. The patient structures; including left and right parotid, spinal cord, and planning target volume (PTV56) were projected to EPID level. The agreement between the transit images generated from original CT and replanned CT was quantified using gamma analysis with 3%, 3mm criteria. Moreover, only gamma pass-rate is calculated within each projected structure. The gamma pass-rate in right parotid and PTV56 between predicted transit of original CT and replan CT were 42.8%( ± 17.2%) and 54.7%( ± 21.5%). The gamma pass-rate for other projected organs were greater than 80%. Additionally, the results of organ-of-interest gamma analysis were compared with 3-dimensional cone-beam computed tomography (3D-CBCT) and the rational of replan by radiation oncologists. It showed that using only registration of 3D-CBCT to original CT does not provide the dosimetric impact of anatomical changes. Using transit EPID images with organ-of-interest gamma analysis can provide additional information for treatment plan suitability assessment.

Keywords: re-plan, anatomical change, transit electronic portal imaging device, EPID, head, and neck

Procedia PDF Downloads 220
4869 School Accidents in Educational Establishment in Tunisia: A Five Years Retrospective Survey in the Governorate of Mahdia

Authors: Lamia Bouzgarrou, Amira Omrane, Leila Mrabet, Taoufik Khalfallah

Abstract:

Background and aims: School accidents are one of the leading causes of morbidity and mortality among pupils and students. Indeed, they may induce an elevated number of lost school days, heavy emotional and physical disabilities, and financial costs on the victims and their families. This study aims to evaluate the annual incidence of school accidents in the central Tunisian governorate of Mahdia and to identify the epidemiological profile of victims and risk factors of these accidents. Methods: A retrospective study was conducted over the period of 5 school years, focusing on school accidents that occurred in public educational institutions (primary, basic, secondary and university) in the governorate of Mahdia (area = 2 966 km² and number of inhabitants in 2014 = 410 812). All accidents declared near the only official insurance of this type of injuries (MASU: Mutual School and University Accidents), and initially taken in charge at the University Hospital of Mahdia were included. Data was collected from the MASU reporting forms and the medical records of emergency and other specialized hospital departments. Results: With 3248 identified victims, the annual incidence of school accidents was equal to 0.69 per 100 pupils and students per year. The average age of victims was 14.51 ± 0.059 years and the sex ratio was 1.58. Pupils aged between 12 and 15 years, were concerned by 46.7% of the identified accidents. The practice of sports was the most relevant circumstances of these accidents (76.2 %). In 56.58 % of cases, falls were the leading mechanism. Bruises and fractures were the most frequent lesions (32.43 % and 30.51 %). Serious school accidents were noted in 28% of cases with hospitalization in 2.27 % of them. The average lost school days, was 12.23±1.73 days. Accidents occurring during sports or leisure activities were significantly more serious (p= 0.021). Furthermore, the frequency of hospitalization was significantly higher among boys (2.81% vs. 1.43%; p= 0.035), students ≤11 years (p= 0.008), and following crush trauma (p= 0.000). In addition, the surgical interventions were statistically more frequent among male victims (p=0.00), accidents occurring during physical education sessions (p=0.000); those associated to falls (p=0.000) and to crushes mechanisms (p=0.002), and injuries affecting lower limbs (p=0.000). Following this Multi-varied analysis concluded that the severity of school accident is correlated to the activity practiced during the trauma and the geographical location of the school. Conclusion: Children and adolescents are one of the most vulnerable groups against incidents with the risk of permanent disability, mainly related to the perturbation of the growth process and physiological limitations. Our five-year study, objectified a real elevate incidence of school accident among children and adolescents, with a considerable rate of severe injuries. In any community, the promotion of adolescents and children’s health is an important indicator of the public health level. Thus, it’s important to develop a multidisciplinary prevention strategy of school accident, based on safety and security rules and adapted to the specificity of our context.

Keywords: children and adolescents, children health, injuries and disability, school accident

Procedia PDF Downloads 120
4868 Safety Evaluation of Intramuscular Administration of Zuprevo® Compared to Draxxin® in the Treatment of Swine Respiratory Disease at Weaning Age

Authors: Josine Beek, S. Agten, R. Del Pozo, B. Balis

Abstract:

The objective of the present study was to compare the safety of intramuscular administration of Zuprevo® (tildipirosin, 40 mg/mL) with Draxxin® (tulathromycin, 100 mg/mL) in the treatment of swine respiratory disease at weaning age. The trial was carried out in two farrow-to-finish farms with 300 sows (farm A) and 500 sows (farm B) in a batch-production system. Farm A had no history of respiratory problems, whereas farm B had a history of respiratory outbreaks with increased mortality ( > 2%) in the nursery. Both farms were positive to Pasteurella multocida, Bordetella bronchiseptica, Actinobacillus pleuropneumoniae and Haemophilus parasuis. From each farm, one batch of piglets was included (farm A: 644 piglets; farm B: 963 piglets). One day before weaning (day 0; 18-21 days of age), piglets were identified by an individual ear tag and randomly assigned to a treatment group. At day 0, Group 1 was treated with a single intramuscular injection with Zuprevo® (tildipirosin, 40 mg/mL; 1 mL/10 kg) and group 2 with Draxxin® (tulathromycin, 100 mg/mL; 1 mL/40 kg). For practical reasons, dosage of the product was adjusted according to three weight categories: < 4 kg, 4-6 kg and > 6 kg. Within each farm, piglets of both groups were comingled at weaning and subsequently managed and located in the same facilities and with identical environmental conditions. Our study involved the period from day 0 until 10 weeks of age. Safety of treatment was evaluated by 1) visual examination for signs of discomfort directly after treatment and after 15 min, 1 h and 24 h and 2) mortality rate within 24 h after treatment. Efficacy of treatment was evaluated based on mortality rate from day 0 until 10 weeks of age. Each piglet that died during the study period was necropsied by the herd veterinarian to determine the probable cause of death. Data were analyzed using binary logistic regression and differences were considered significant if p < 0.05. The pig was the experimental unit. In total, 848 piglets were treated with tildipirosin and 759 piglets with tulathromycin. In farm A, one piglet with retarded growth ( < 1 kg at 18 days of age) showed an adverse reaction after injection of tildipirosin: lateral recumbence and dullness for ± 30 sec. The piglet recovered after 1-2 min. This adverse reaction was probably due to overdosing (12 mg/kg). No adverse effect of treatment was observed in any other piglet. There was no mortality within 24 h after treatment. No significant difference was found in mortality rate between both groups from day 0 until 10 weeks of age. In farm A, overall mortality rate was 0.3% (2/644). In farm B, mortality rate was 0.2% (1/502) in group 1 (tildipirosin) and 0.9% (4/461) in group 2 (tulathromycin)(p=0.60). The necropsy of piglets that died during the study period revealed no macroscopic lesions of the respiratory tract. In conclusion, Zuprevo® (tildipirosin, 40 mg/mL) was shown to be a safe and efficacious alternative to Draxxin® (tulathromycin, 100 mg/mL) for the early treatment of swine respiratory disease at weaning age.

Keywords: antibiotic treatment, safety, swine respiratory disease, tildipirosin

Procedia PDF Downloads 400
4867 Euthanasia with Reference to Defective Newborns: An Analysis

Authors: Nibedita Priyadarsini

Abstract:

It is said that Ethics has a wide range of application which mainly deals with human life and human behavior. All ethical decisions are ultimately concerned with life and death. Both life and death must be considered dignified. Medical ethics with its different topics mostly deals with life and death concepts among which euthanasia is one. Various types of debates continue over Euthanasia long since. The question of putting an end to someone’s life has aroused controversial in legal sphere as well as in moral sphere. To permit or not to permit has remained an enigma the world over. Modern medicine is in the stage of transcending limits that cannot be set aside. The morality of allowing people to die without treatment has become more important as methods of treatment have become more sophisticated. Allowing someone to die states an essential recognition that there is some point in any terminal illness when further curative treatment has no purpose and the patient in such situation should allow dying a natural death in comfort, peace, and dignity, without any interference from medical science and technology. But taking a human life is in general sense is illogical in itself. It can be said that when we kill someone, we cause the death; whereas if we merely let someone die, then we will not be responsible for anyone’s death. This point is often made in connection with the euthanasia cases and which is often debatable. Euthanasia in the pediatric age group involves some important issues that are different from those of adult issues. The main distinction that occurs is that the infants and newborns and young children are not able to decide about their future as the adult does. In certain cases, where the child born with some serious deformities with no hope of recovery, in that cases doctor decide not to perform surgery in order to remove the blockage, and let the baby die. Our aim in this paper is to examine, whether it is ethically justified to withhold or to apply euthanasia on the part of the defective infant. What to do with severely defective infants from earliest time if got to know that they are not going to survive at all? Here, it will deal mostly with the ethics in deciding the relevant ethical concerns in the practice of euthanasia with the defective newborns issues. Some cases in relation to disabled infants and newborn baby will be taken in order to show what to do in a critical condition, that the patient and family members undergoes and under which condition those could be eradicated, if not all but some. The final choice must be with the benefit of the patient.

Keywords: ethics, medical ethics, euthanasia, defective newborns

Procedia PDF Downloads 205
4866 Challenges to Ensure Food Safety through Sanitation and Hygiene Coverage in Bangladesh

Authors: Moshiur Rahman, Tahmida Jakia

Abstract:

Bangladesh, a densely populated South Asian country is home to more than 160 million people. In two decades ago, the people of this developing nation drank heavily contaminated surface water. Over the past thirty years, the country, and its development partners, has undertaken extensive efforts to provide microbiologically safe groundwater based drinking water through the use of tube-wells. About 85% of the people now drink tube-well water from about 11 million tube-wells/hand pumps. However, diarrhoeal and other water-related diseases are still reported among the major causes of morbidity and mortality among Bangladeshi children. This implies that the mode of transmission of pathogens through water and/or other modes continue. In addition, massive scale arsenic contamination has been recently reported in the ground water. Thirty five million people may be at risk of consuming arsenic contaminated water exceeding 0.05 mg/l in Bangladesh. Drinking of arsenic contaminated water has been linked with skin problems, cancer, cardiovascular diseases, neurological diseases, eye problems, cancer of the internal organs, and other diseases. In the study area, Narail district, recent investigations about existing water quality situations indicated presence of low to high levels of arsenic, salinity, iron, manganese and bacteriological contamination risks. As challenges for safe water exist; it is likely that sanitation and food hygiene practices are poor which lead threat to ensure food security.The main attempt of this study is to find out the challenges to ensure food security andprovide probable solutions to ensure food safety towards 0.7 million of people in study area. A survey has been conducted at Lohagara and Kalia sub district of Narail district with a pretested questionnaire. Primary data are collected through a questionnaire, while secondary data are collected from pertinent offices as well as academic journals. FGD has also been done to know the knowledge regarding water, sanitation as well as food preparation and consumption practice of community people in study area. The major focus of this study is to assess the state of sanitation and food hygiene condition of rural people. It is found that most of the villagers have lack of knowledge about food safety. Open defecation rate is high which lead threat to ensure food security.

Keywords: food safety, challenges, hygiene, Bangladesh

Procedia PDF Downloads 337
4865 Personnel Training of Automotive Manufacturers in Virtual Reality

Authors: Mirza Ahsan Baig, Paul Evans

Abstract:

Due to the high demand for automobiles, manufacturers have to run their production lines non-stop for long periods. At such a scale, unplanned downtime could cost up to $50 billion annually. Improper training of new hires could lead to safety issues causing unplanned downtimes. The project developed a virtual reality simulation that could train personnel for key operations on an automobile manufacturing floor, reducing the risk of unplanned downtime while eliminating any disruption (due to training) on the assembly line. An automation firm sponsored it to explore the possibilities the likes of Jaguar and BMW are yet to achieve! The project was inspired by Bentley, the only company that succeeded in simulation training scenarios within virtual space. The project aims to inspire other significant firms to do the same. It was increasing employee safety, eliminating downtimes, and improving efficiency. The developed prototype uncovered various limitations within existing simulation providers and was able to simulate state-of-the-art training scenarios. It also explored the possibility of a multiuser interface and resolved complex issues such as lack of movement space within the training area.

Keywords: virtual reality, scenario training, limited movement, multiuser

Procedia PDF Downloads 90
4864 Comprehensive Care and the Right to Autonomy of Children and Adolescents with Cancer

Authors: Sandra Soca Lozano, Teresa Isabel Lozano Pérez, Germain Weber

Abstract:

Cancer is a chronic disease of high prevalence in children and adolescents. Medical care in Cuba is carried out by a multidisciplinary team and family is the mediator between this team and the patient. Around this disease, there are interwoven many stereotypes and taboos by its relation to death. In this research report, we describe the work paradigm of psychological care to patients suffering from these diseases in the University Pediatric Hospital Juan Manuel Márquez of Havana, Cuba. We present the psychosocial factors that must be taken into account to provide comprehensive care and ensuring the quality of life of patients and their families. We also present the factors related to the health team and the management of information done with the patient. This is a descriptive proposal from the working experience accumulated in the named institution and in the review of the literature. As a result of this report we make a proposal of teamwork and the aspects in which psychological intervention should be continue performing in terms of increasing the quality of the care made by the health team. We conclude that it is necessary to continue improving the information management of children and adolescents with theses health problems and took into account their right to autonomy.

Keywords: comprehensive care, management of information, psychosocial factors, right to autonomy

Procedia PDF Downloads 337
4863 The Orthodontic Management of Multiple Tooth Agenesis with Macroglossia in Adult Patient: Case Report

Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning

Abstract:

Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.

Keywords: general diastema, macroglossia, space closure, tooth agenesis

Procedia PDF Downloads 180
4862 Safety of Ports, Harbours, Marine Terminals: Application of Quantitative Risk Assessment

Authors: Dipak Sonawane, Sudarshan Daga, Somesh Gupta

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Quantitative risk assessment (QRA) is a very precise and consistent approach to defining the likelihood, consequence and severity of a major incident/accident. A variety of hazardous cargoes in bulk, such as hydrocarbons and flammable/toxic chemicals, are handled at various ports. It is well known that most of the operations are hazardous, having the potential of damaging property, causing injury/loss of life and, in some cases, the threat of environmental damage. In order to ensure adequate safety towards life, environment and property, the application of scientific methods such as QRA is inevitable. By means of these methods, comprehensive hazard identification, risk assessment and appropriate implementation of Risk Control measures can be carried out. In this paper, the authors, based on their extensive experience in Risk Analysis for ports and harbors, have exhibited how QRA can be used in practice to minimize and contain risk to tolerable levels. A specific case involving the operation for unloading of hydrocarbon at a port is presented. The exercise provides confidence that the method of QRA, as proposed by the authors, can be used appropriately for the identification of hazards and risk assessment of Ports and Terminals.

Keywords: quantitative risk assessment, hazard assessment, consequence analysis, individual risk, societal risk

Procedia PDF Downloads 84
4861 To Determine the Effects of Regulatory Food Safety Inspections on the Grades of Different Categories of Retail Food Establishments across the Dubai Region

Authors: Shugufta Mohammad Zubair

Abstract:

This study explores the Effect of the new food System Inspection system also called the new inspection color card scheme on reduction of critical & major food safety violations in Dubai. Data was collected from all retail food service establishments located in two zones in the city. Each establishment was visited twice, once before the launch of the new system and one after the launch of the system. In each visit, the Inspection checklist was used as the evaluation tool for observation of the critical and major violations. The old format of the inspection checklist was concerned with scores based on the violations; but the new format of the checklist for the new inspection color card scheme is divided into administrative, general major and critical which gives a better classification for the inspectors to identify the critical and major violations of concerned. The study found that there has been a better and clear marking of violations after the launch of new inspection system wherein the inspectors are able to mark and categories the violations effectively. There had been a 10% decrease in the number of food establishment that was previously given A grade. The B & C grading were also considerably dropped by 5%.

Keywords: food inspection, risk assessment, color card scheme, violations

Procedia PDF Downloads 325