Search results for: emergency department (ED)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2374

Search results for: emergency department (ED)

664 Rare Diagnosis in Emergency Room: Moyamoya Disease

Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

Abstract:

Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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663 Characterization, Classification and Fertility Capability Classification of Three Rice Zones of Ebonyi State, Southeastern Nigeria

Authors: Sunday Nathaniel Obasi, Chiamak Chinasa Obasi

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Soil characterization and classification provide the basic information necessary to create a functional evaluation and soil classification schemes. Fertility capability classification (FCC) on the other hand is a technical system that groups the soils according to kinds of problems they present for management of soil physical and chemical properties. This research was carried out in Ebonyi state, southeastern Nigeria, which is an agrarian state and a leading rice producing part of southeastern Nigeria. In order to maximize the soil and enhance the productivity of rice in Ebonyi soils, soil classification, and fertility classification information need to be supplied. The state was grouped into three locations according to their agricultural zones namely; Ebonyi north, Ebonyi central and Ebonyi south representing Abakaliki, Ikwo and Ivo locations respectively. Major rice growing areas of the soils were located and two profile pits were sunk in each of the studied zones from which soils were characterized, classified and fertility capability classification (FCC) developed. Soil classification was done using United State Department of Agriculture (USDA) Soil Taxonomy and correlated with World Reference Base for soil resources. Results obtained classified Abakaliki 1 and Abakaliki 2 as Typic Fluvaquents (Ochric Fluvisols). Ikwo 1 was classified as Vertic Eutrudepts (Eutric Vertisols) while Ikwo 2 was classified as Typic Eutrudepts (Eutric Cambisols). Ivo 1 and Ivo 2 were both classified as Aquic Eutrudepts (Gleyic Leptosols). Fertility capability classification (FCC) revealed that all studied soils had mostly loamy topsoils and subsoils except Ikwo 1 with clayey topsoil. Limitations encountered in the studied soils include; dryness (d), low ECEC (e), low nutrient capital reserve (k) and water logging/ anaerobic condition (gley). Thus, FCC classifications were Ldek for Abakaliki 1 and 2, Ckv for Ikwo 1, LCk for Ikwo 2 while Ivo 1 and 2 were Legk and Lgk respectively.

Keywords: soil classification, soil fertility, limitations, modifiers, Southeastern Nigeria

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662 Hands on Tools to Improve Knowlege, Confidence and Skill of Clinical Disaster Providers

Authors: Lancer Scott

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Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

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661 Role of Intralesional Tranexamic Acid in Comparison of Oral Tranexamic Acid in the Treatment of Melasma

Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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660 Training Student Teachers to Work in Partnership with Parents of Students with Special Needs

Authors: Alicia Greenbank, Efrat Bengio

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The aim of this research was to examine the efficacy of the first course in Israel, whose objective is to train student teachers in the special education department to work cooperatively with parents of children with special needs. Studies often highlight the importance of cooperation between teachers and parents of students with special needs. Israel’s Special Education Law defines parents as complete partners, and the Ministry of Education encourages and even requires that partnership be present. Yet this partnership is difficult to achieve many kindergarten teachers, and teachers have a lot of difficulties establishing and managing a pattern of cooperation with their students’ parents. Often we see different perspectives on the child's development and needs, distrust, lack of appreciation, and communication difficulties on both sides – parents & teachers. The course describes a method of instilling the need for cooperation at an early stage of teacher training-in the teacher training program. 22 students in the special education program for early childhood education in the fourth year of learning took part in the course. The fourth-year is the experiential training year and the first time that students have worked in a school. The course consisted of 14 sessions. Seven parents of students with different disabilities participated at 6 of the sessions. The changes in the students' attitudes towards partnership and their ability to manage this partnership were carried out by examining the reports written by the students before the meetings with the parents and the reflections they wrote after each meeting with the parents and at the end of the course. Three themes emerged from the narrative analysis, corresponding to the three preconditions for joint activities with parents — Approach, Attitude, Appropriate Atmosphere, according to the Four A’s Model. The findings showed that a course combining meetings with parents of children with special needs offers many benefits for teacher training. The course raised student awareness of the question partnership, changed students’ approaches and attitudes towards the parents, stressed the importance of partnership, and provided students with tools for working with parents through the school. Based on the findings of this study, courses in this format can be applied in order to cooperate between teachers and parents, for example, parents of gifted children with special needs.

Keywords: Partnership with parents in special education, parents of children with disabilities, parents of children with special needs, parents’ involvement in special education

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659 Health Risk Assessment of Exposing to Benzene in Office Building around a Chemical Industry Based on Numerical Simulation

Authors: Majid Bayatian, Mohammadreza Ashouri

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Releasing hazardous chemicals is one of the major problems for office buildings in the chemical industry and, therefore, environmental risks are inherent to these environments. The adverse health effects of the airborne concentration of benzene have been a matter of significant concern, especially in oil refineries. The chronic and acute adverse health effects caused by benzene exposure have attracted wide attention. Acute exposure to benzene through inhalation could cause headaches, dizziness, drowsiness, and irritation of the skin. Chronic exposures have reported causing aplastic anemia and leukemia at the occupational settings. Association between chronic occupational exposure to benzene and the development of aplastic anemia and leukemia were documented by several epidemiological studies. Numerous research works have investigated benzene emissions and determined benzene concentration at different locations of the refinery plant and stated considerable health risks. The high cost of industrial control measures requires justification through lifetime health risk assessment of exposed workers and the public. In the present study, a Computational Fluid Dynamics (CFD) model has been proposed to assess the exposure risk of office building around a refinery due to its release of benzene. For simulation, GAMBIT, FLUENT, and CFD Post software were used as pre-processor, processor, and post-processor, and the model was validated based on comparison with experimental results of benzene concentration and wind speed. Model validation results showed that the model is highly validated, and this model can be used for health risk assessment. The simulation and risk assessment results showed that benzene could be dispersion to an office building nearby, and the exposure risk has been unacceptable. According to the results of this study, a validated CFD model, could be very useful for decision-makers for control measures and possibly support them for emergency planning of probable accidents. Also, this model can be used to assess exposure to various types of accidents as well as other pollutants such as toluene, xylene, and ethylbenzene in different atmospheric conditions.

Keywords: health risk assessment, office building, Benzene, numerical simulation, CFD

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658 Effects of Anti-FGL2 Monoclonal Antibody SPF89 on Vascular Inflammation

Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang

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Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).

Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells

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657 Learning from Flood: A Case Study of a Frequently Flooded Village in Hubei, China

Authors: Da Kuang

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Resilience is a hotly debated topic in many research fields (e.g., engineering, ecology, society, psychology). In flood management studies, we are experiencing the paradigm shift from flood resistance to flood resilience. Flood resilience refers to tolerate flooding through adaptation or transformation. It is increasingly argued that our city as a social-ecological system holds the ability to learn from experience and adapt to flood rather than simply resist it. This research aims to investigate what kinds of adaptation knowledge the frequently flooded village learned from past experience and its advantages and limitations in coping with floods. The study area – Xinnongcun village, located in the west of Wuhan city, is a linear village and continuously suffered from both flash flood and drainage flood during the past 30 years. We have a field trip to the site in June 2017 and conducted semi-structured interviews with local residents. Our research summarizes two types of adaptation knowledge that people learned from the past floods. Firstly, at the village scale, it has formed a collective urban form which could help people live during both flood and dry season. All houses and front yards were elevated about 2m higher than the road. All the front yards in the village are linked and there is no barrier. During flooding time, people walk to neighbors through houses yards and boat to outside village on the lower road. Secondly, at individual scale, local people learned tacit knowledge of preparedness and emergency response to flood. Regarding the advantages and limitations, the adaptation knowledge could effectively help people to live with flood and reduce the chances of getting injuries. However, it cannot reduce local farmers’ losses on their agricultural land. After flood, it is impossible for local people to recover to the pre-disaster state as flood emerges during June and July will result in no harvest. Therefore, we argue that learning from past flood experience could increase people’s adaptive capacity. However, once the adaptive capacity cannot reduce people’s losses, it requires a transformation to a better regime.

Keywords: adaptation, flood resilience, tacit knowledge, transformation

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656 Clinical Audit of Selected Nephrology Nursing Procedures Performed in Nephrology Unit of AIIMS with a View to Develop Nephrology Nursing Procedure Protocol

Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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655 Development of a Model for Predicting Radiological Risks in Interventional Cardiology

Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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654 Effect of Probiotic (RE3) Supplement on Growth Performance, Diarrhea Incidence and Blood Parameters of N'dama Calves

Authors: Y. Abdul Aziz, E. L. K. Osafo, S. O. Apori, A. Osman

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A sixteen week trial was conducted at the Research Farm (Technology Village) of the Department of Animal Science, School of Agriculture, University of Cape Coast, Cape Coast, Ghana. This study sought to investigate the effects of Probiotic (RE3) on growth performance, diarrhea incidence and blood parameters of N’dama calves. Sixteen N’dama calves aged 3 months of an average initial weight of 44.2 kg were randomly assigned to one of four dietary treatments according to their body weight, age, and sex. Treatment 1 (T1) serve as a control animal (No RE3 supplementation). Treatment 2 (T2) receives 0.03 ml RE3 per kg body weight. Treatment 3 (T3) receives 0.06 ml RE3 per kg body weight, and Treatment 4 (T4) also receives 0.09 ml RE3 per kg body weight in a Completely Randomize Design (CRD). There were 4 replicates per treatment. The calves were allowed access to feed and water ad libitum. The body weight of the calves was recorded at the start of the experiment and thereafter regularly at two weeks interval. Weighing was done early morning before the calves are allowed to access feed and water and were also observed in their pens for occurrence of diarrhea and faecal scores recorded. Blood samples were obtained from each calf at the end of the study through jugular vein puncture. Supplementation of RE3 to calves had showed a beneficial effect by reducing the incidence of diarrhea. The highest faecal score was recorded in T1 and the least faecal score was recorded in T3. There was significant difference (P < 0.05) in the faecal score between the treatment group and the control after two weeks of the experiment. There was no significant difference (P > 0.05) in the average daily gain of the animals. Hematological and biochemical indices of calves were all within the normal range except in treatments (1, 3 and 4) which recorded high White Blood Cell (WBC) count with no significant difference (P > 0.05).

Keywords: probiotics (RE3), diarrhea incidence, blood parameters, N’dama calves

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653 Exploring Academic Writing Challenges of First Year English as an Additional Language Students at an ODeL Institution in South Africa

Authors: Tumelo Jaquiline Ntsopi

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This study explored the academic writing challenges of first-year students who use English as an Additional Language (EAL) registered in the EAW101 module at an ODeL institution. Research shows that academic writing is a challenge for EAL teaching and learning contexts across the globe in higher education institutions (HEIs). Academic writing is an important aspect of academic literacy in any institution of higher learning, more so in an ODeL institution. This has probed research that shows that academic writing is and continues to pose challenges for EAL teaching and learning contexts in higher education institutions. This study stems from the researcher’s experience in teaching academic writing to first-year students in the EAW101 module. The motivation for this study emerged from the fact that EAW101 is a writing module that has a high number of students in the Department of English Studies with an average of between 50-80 percent pass rate. These statistics elaborate on the argument that most students registered in this module struggle with academic writing, and they need intervention to assist and support them in achieving competence in the module. This study is underpinned by Community of Inquiry (CoI) framework and Transactional distance theory. This study adopted a qualitative research methodology and utilised a case study approach as a research design. Furthermore, the study gathered data from first year students and the EAW101 module’s student support initiatives. To collect data, focus group discussions, structured open-ended evaluation questions, and an observation schedule were used to gather data. The study is vital towards exploring academic writing challenges that first-year students in EAW101 encounter so that lecturers in the module may consider re-evaluating their methods of teaching to improve EAL students’ academic writing skills. This study may help lecturers towards enhancing academic writing in a ODeL context by assisting first year students through using student support interventions.

Keywords: academic writing, academic writing challenge, ODeL, EAL

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652 Utilization of Silicon for Sustainable Rice Yield Improvement in Acid Sulfate Soil

Authors: Bunjirtluk Jintaridth

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Utilization of silicon for sustainable rice cultivation in acid sulfate soils was studied for 2 years. The study was conducted on Rungsit soils in Amphoe Tanyaburi, Pathumtani Province. The objectives of this study were to assess the effect of high quality organic fertilizer in combination with silicon and chemical fertilizer on rice yield, chemical soil properties after using soil amendments, and also to assess the economic return. A Randomized Complete Block Design (RCBD) with 10 treatments and 3 replications were employed. The treatments were as follows: 1) control 2) chemical fertilizer (recommended by Land Development Department, LDD 3) silicon 312 kg/ha 4) high quality organic fertilizer at 1875 kg/ha (the recommendation rate by LDD) 5) silicon 156 kg/ha in combination with high quality organic fertilizer 1875 kg/ha 6) silicon at the 312 kg/ha in combination with high quality organic fertilizer 1875 kg/ha 7) silicon 156 kg/ha in combination with chemical fertilizer 8) silicon at the 312 kg/ha in combination with chemical fertilizer 9) silicon 156 kg/ha in combination with ½ chemical fertilizer rate, and 10) silicon 312 kg/ha in combination with ½ chemical fertilizer rate. The results of 2 years indicated the treatment tended to increase soil pH (from 5.1 to 4.7-5.5), percentage of organic matter (from 2.43 to 2.54 - 2.94%); avail. P (from 7.5 to 7-21 mg kg-1 P; ext. K (from 616 to 451-572 mg kg-1 K), ext Ca (from 1962 to 2042.3-4339.7 mg kg-1 Ca); ext Mg (from 1586 to 808.7-900 mg kg-1 Mg); but decrease the ext. Al (from 2.56 to 0.89-2.54 cmol kg-1 Al. Two years average of rice yield, the highest yield was obtained from silicon 156 kg/ha application in combination with high quality organic fertilizer 300 kg/rai (3770 kg/ha), or using silicon at the 312 kg/ha combination with high quality organic fertilizer 300 kg/rai. (3,750 kg/ha). It was noted that chemical fertilizer application with 156 and 312 kg/ha silicon gave only 3,260 และ 3,133 kg/ha, respectively. On the other hand, half rate of chemical fertilizer with 156 and 312 kg/ha with silicon gave the yield of 2,934 และ 3,218 kg/ha, respectively. While high quality organic fertilizer only can produce 3,318 kg/ha as compare to rice yield of 2,812 kg/ha from control. It was noted that the highest economic return was obtained from chemical fertilizer treated plots (886 dollars/ha). Silicon application at the rate of 156 kg/ha in combination with high quality organic fertilizer 1875 kg/ha gave the economic return of 846 dollars/ha, while 312 kg/ha of silicon with chemical fertilizer gave the lowest economic return (697 dollars/ha).

Keywords: rice, high quality organic fertilizer, acid sulfate soil, silicon

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651 Standard Protocol Selection for Acquisition of Breast Thermogram in Perspective of Early Breast Cancer Detection

Authors: Mrinal Kanti Bhowmik, Usha Rani Gogoi Jr., Anjan Kumar Ghosh, Debotosh Bhattacharjee

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In the last few decades, breast thermography has achieved an average sensitivity and specificity of 90% for breast tumor detection. Breast thermography is a non-invasive, cost-effective, painless and radiation-free breast imaging modality which makes a significant contribution to the evaluation and diagnosis of patients, suspected of having breast cancer. An abnormal breast thermogram may indicate significant biological risk for the existence or the development of breast tumors. Breast thermography can detect a breast tumor, when the tumor is in its early stage or when the tumor is in a dense breast. The infrared breast thermography is very sensitive to environmental changes for which acquisition of breast thermography should be performed under strictly controlled conditions by undergoing some standard protocols. Several factors like air, temperature, humidity, etc. are there to be considered for characterizing thermal images as an imperative tool for detecting breast cancer. A detailed study of various breast thermogram acquisition protocols adopted by different researchers in their research work is provided here in this paper. After going through a rigorous study of different breast thermogram acquisition protocols, a new standard breast thermography acquisition setup is proposed here in this paper for proper and accurate capturing of the breast thermograms. The proposed breast thermogram acquisition setup is being built in the Radiology Department, Agartala Government Medical College (AGMC), Govt. of Tripura, Tripura, India. The breast thermograms are captured using FLIR T650sc thermal camera with the thermal sensitivity of 20 mK at 30 degree C. The paper is an attempt to highlight the importance of different critical parameters of breast thermography like different thermography views, patient preparation protocols, acquisition room requirements, acquisition system requirements, etc. This paper makes an important contribution by providing a detailed survey and a new efficient approach on breast thermogram capturing.

Keywords: acquisition protocol, breast cancer, breast thermography, infrared thermography

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650 Using the Synchronous Online Flipped Learning Approach to Facilitate Student Podcasting

Authors: Yasmeen Coaxum

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The year 2020 became synonymous with the words “Emergency Remote Teaching,” which was imposed upon educators during the COVID-19 pandemic. Consequently, teachers were compelled to find new and engaging ways to educate their students outside of the face-to-face classroom setting. Now online instruction has become more of the norm rather than a way to manage educational expectations during a crisis. Therefore, implementing a strategic way to create online environments for students to thrive, create, and fully engage in their learning process is essential. The Synchronous Online Flipped Learning Approach or SOFLA® is a distance learning model that most closely replicates actual classroom teaching. SOFLA® includes structured, interactive, multimodal activities in an eight-step learning cycle with both asynchronous and synchronous components that foster autonomous and interactive learning among today’s online learners. The results of a pilot study in an Intensive English Program at a university, using SOFLA® methodology to facilitate podcasting in an online learning environment will be shared. Previous findings on student-produced podcasting projects have shown that students felt they improved their pronunciation, vocabulary, and speaking skills. However, few if any studies have been conducted on using a structured online flipped learning approach to facilitate such projects. Therefore, the purpose of this study is to assess the effect of using the SOFLA® framework to enhance optimum engagement in the online environment while using podcasts as the primary tool of instruction. Through data from interviews, questionnaires, and the results of formative and summative assessments, this study also investigates the affective and academic impact this flipped learning method combined with podcasting has on the students in terms of speaking confidence and vocabulary retention, and production. The steps of SOFLA will be illustrated, a video demonstration of the Anchor podcasting app will be shown, and final student projects and questionnaire responses will be shared. The specific context is a 14-week advanced level conversation and listening class. Participants vary in age but are all adult language learners representing a diverse array of countries.

Keywords: mall online flipped learning, podcasting, productive vocabulary

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649 Service Evaluation of Consent for Hand and Wrist Surgery and Formulation of Evidence-Based Guidelines

Authors: Parsa Keyvani, Alistair Phillips, David Warwick

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Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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648 Insecticidal Effect of a Botanical Plant Extracts (Ultra Act®) on Bactrocera oleae (Diptera:Tephritidae) Preimaginal Development and Pupa Survival

Authors: Imen Blibech, Mohieddine Ksantini, Manohar Shete

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Bactrocera oleae is one of the most economically damaging insects of olive in Tunisia and other producing countries of olive trees. As a reliable alternative to synthetic chemical insecticides, botanical insecticides are considered natural control methods safe for the environment and human health. The certified botanical insecticide ULTRA-ACT® effectively on large scale of insects is approved per Indian and International organic standards certified organic pesticides. Olives with signs of olive fly infestation were collected from productive olive trees in three Sahel localities of Tunisia. Infested fruits were separated daily for larval stage control purposes, into new rearing boxes under microclimatic conditions at 75% R.H, 25 ± 3°C and 8 L-16D. Treatment with ULTRA-ACT® extract solutions was made by dipping methods; each fruit was pipetted in 5 mL of extract for 10 seconds then air- dried. Five doses of ULTRA-ACT® were used for a bioassay, plus a water-only control. A total of 200 infested olive fruits were treated in separate dishes with a proportion of 10 olives per dish. A total of 20 dishes were used for each concentration treatment as well as 20 dished utilized as control. The bioassay was conducted with 3 replicates. The development of the larval and pupal stages was recorded since the egg hatching until emergence of adults. It was determined that ULTRA-ACT® extracts on succeeding concentrations; 0.25, 0.5, 1 and 2% show significant effect on the biology of the pest. Increased concentration decreased significantly adult emergence from pupae and affect the egg hatchability percentage. Therefore, larval mortality increased insignificantly with the increase of the product concentration. The 2nd instar larvae were more susceptible to the product and after 72 hours the maximum mortality (75%) was observed with ULTRA-ACT® 2%. The present work aimed to give a possible and efficient alternative solution for B. oleae biological control with a promising botanical insecticide.

Keywords: Bactrocera oleae, olive insect pest, Ultra Act®, larval mortality, pupal emergency, biological control

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647 Selection of Indigenous Tree Species and Microbial Inoculation for the Restoration of Degraded Uplands

Authors: Nelly S. Aggangan, Julieta A. Anarna

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Indigenous tree species are priority planting materials for the National Greening Program of the Department of Environment and Natural Resources. Areas for reforestation are marginal grasslands where plant growth is stunted and seedling survival is low. This experiment was conducted to compare growth rates and seedling survival of seven indigenous reforestation species. Narra (Pterocarpus indicus), salago (Wikstroemia lanceolata), kisubeng (Sapindus saponaria), tuai (Biscofia javanica), batino (Alstonia macrophylla), bani (Pongamina pinnata) and ipil (Intsia bijuga) were inoculated with Mykovam® (mycorrhizal fungi) and Bio-N® (N2-fixing bacteria) during pricking. After five months in the nursery, the treated seedlings were planted in degraded upland acidic red soil in Cavinti, Laguna (Luzon). During outplanting, all mycorrhiza inoculated seedlings had 50-80% mycorrhizal roots while the control ones had 5-10% mycorrhizal roots. Mykovam increased height of narra, salago and kisubeng. Stem diameter was bigger in mycorrhizal salago than the control. After two years in the field, Mykovam®+Bio-N® inoculated narra, salago and bani gave 95% survival while non-mycorrhizal tuai gave the lowest survival (25%). Inoculated seedlings grew faster than the control. Highest height increase was in batino (103%), followed by bani (95%), ipil (59%), narra (58%), tuai (53%) and kisubeng was the lowest (10%). Stem diameter was increased by Mykovam® from 13-39% over the control. Highest stem diameter was obtained from narra (50%), followed by bani (40%), batino (36%), ipil (33%), salago (28%), kisubeng and tuai (12%) had the lowest. In conclusion, Mykovam® inoculated batino, bani, narra, salago and ipil can be selected to restore degraded upland acidic red soil in the Philippines.

Keywords: Azospirillum spp., Bio-N®, Mykovam®, nitrogen fixing bacteria, acidic red soil

Procedia PDF Downloads 287
646 Age Estimation from Teeth among North Indian Population: Comparison and Reliability of Qualitative and Quantitative Methods

Authors: Jasbir Arora, Indu Talwar, Daisy Sahni, Vidya Rattan

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Introduction: Age estimation is a crucial step to build the identity of a person, both in case of deceased and alive. In adults, age can be estimated on the basis of six regressive (Attrition, Secondary dentine, Dentine transparency, Root resorption, Cementum apposition and Periodontal Disease) changes in teeth qualitatively using scoring system and quantitatively by micrometric method. The present research was designed to establish the reliability of qualitative (method 1) and quantitative (method 2) of age estimation among North Indians and to compare the efficacy of these two methods. Method: 250 single-rooted extracted teeth (18-75 yrs.) were collected from Department of Oral Health Sciences, PGIMER, Chandigarh. Before extraction, periodontal score of each tooth was noted. Labiolingual sections were prepared and examined under light microscope for regressive changes. Each parameter was scored using Gustafson’s 0-3 point score system (qualitative), and total score was calculated. For quantitative method, each regressive change was measured quantitatively in form of 18 micrometric parameters under microscope with the help of measuring eyepiece. Age was estimated using linear and multiple regression analysis in Gustafson’s method and Kedici’s method respectively. Estimated age was compared with actual age on the basis of absolute mean error. Results: In pooled data, by Gustafson’s method, significant correlation (r= 0.8) was observed between total score and actual age. Total score generated an absolute mean error of ±7.8 years. Whereas, for Kedici’s method, a value of correlation coefficient of r=0.5 (p<0.01) was observed between all the eighteen micrometric parameters and known age. Using multiple regression equation, age was estimated, and an absolute mean error of age was found to be ±12.18 years. Conclusion: Gustafson’s (qualitative) method was found to be a better predictor for age estimation among North Indians.

Keywords: forensic odontology, age estimation, North India, teeth

Procedia PDF Downloads 232
645 The Role of Continuing Professional Education in Interpretive Guiding in South Africa

Authors: Duduzile Dlamini-Boemah, Haretsebe Manwa, Lisebo Tseane-Gumbi

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The demands and expectations of twenty-first century tourists have changed, and they continue to have an impact on tour guiding in cultural and natural tourist attractions. The traditional communicative role of the tour guide as a mere presenter is not sufficient anymore; instead, there are expectations from the tourists of guides who provide effective interpretive guiding. It is always questionable if tour guides in South Africa are equipped with the skills for effective interpretation, yet limited research has been conducted to investigate the continuing professional education of tour guides in South Africa. Instead, much attention has been given to aspects of registration and certification of tour guides in South Africa. Concerns have been raised about tour guiding and have led to the development of a strategy by the Department of Tourism to professionalise tourists guiding that includes training. However, the necessity for tourism training in tour guiding in South Africa was raised as early as in the 1980s, the paper argues that there is a further need to emphasise continuing professional education in interpretive guiding in South Africa. In this study, continuing education and training are considered to involve the upgrading of the skills and knowledge of interpretation of those who are already working as tour guides at the cultural and natural attractions. The study is guided by the empowerment theory. The aim of this paper is to present issues of effective interpretive guiding and continuing professional education in interpretive guiding in South Africa. This study is based on the literature survey of secondary sources such as academic journal articles, government documents, and reports and books. The conclusions indicate that there is a need for training in interpretive delivery techniques in South Africa. The need for interpretive training in interpretive delivery techniques is attributed by the call to allow people to use indigenous knowledge, rather than formal education as a basis for becoming a field guide as well as affording the previously disadvantaged individuals to access training opportunities as tourist guides.

Keywords: continuing education, interpretive delivery skills, interpretive guiding, tour guide

Procedia PDF Downloads 159
644 Savi Scout versus Wire-Guided Localization in Non-palpable Breast Lesions – Comparison of Breast Tissue Volume and Weight and Excision Safety Margin

Authors: Walid Ibrahim, Abdul Kasem, Sudeendra Doddi, Ilaria Giono, Tareq Sabagh, Muhammad Ammar, Nermin Osman

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Background: wire-guided localization (WL) is the most widely used method for the localization of non-palpable breast lesions. SAVI SCOUT occult lesion localization (SSL) is a new technique in breast-conservative surgery. SSL has the potential benefit of improving radiology workflow as well as accurate localization. Purpose: The purpose of this study is to compare the breast tissue specimen volume and weight and margin excision between WL and SSL. Materials and methods: A single institution retrospective analysis of 377 female patients who underwent wide local breast excision with SAVI SCOUT and or wire-guided technique between 2018 and 2021 in a UK University teaching hospital. Breast department. Breast tissue specimen volume and weight, and margin excision have been evaluated in the three groups of different localization. Results: Three hundred and seventy-seven patients were studied. Of these, 261 had wire localization, 88 had SCOUT and 28 had dual localization techniques. Tumor size ranged from 1 to 75mm (Median 20mm). The pathology specimen weight ranged from 1 to 466gm (Median 46.8) and the volume ranged from 1.305 to 1560cm³ (Median 106.32 cm³). SCOUT localization was associated with a significantly low specimen weight than wire or the dual technique localization (Median 41gm vs 47.3gm and 47gm, p = 0.029). SCOUT was not associated with better specimen volume with a borderline significance in comparison to wire and combined techniques (Median 108cm³ vs 105cm³ and 105cm³, p = 0.047). There was a significant correlation between tumor size and pathology specimen weight in the three groups. SCOUT showed a better >2mm safety margin in comparison to the other 2 techniques (p = 0.031). Conclusion: Preoperative SCOUT localization is associated with better specimen weight and better specimen margin. SCOUT did not show any benefits in terms of specimen volume which may be due to difficulty in getting the accurate specimen volume due to the irregularity of the soft tissue specimen.

Keywords: scout, wire, localization, breast

Procedia PDF Downloads 88
643 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review

Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

Procedia PDF Downloads 56
642 Robots for City Life: Design Guidelines and Strategy Recommendations for Introducing Robots in Cities

Authors: Akshay Rege, Lara Gomaa, Maneesh Kumar Verma, Sem Carree

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The aim of this paper is to articulate design strategies and recommendations for introducing robots into the city life of people based on experiments conducted with robots and semi-autonomous systems in three cities in the Netherlands. This research was carried out by the Spot robotics team of Impact Lab housed within YES!Delft, a start-up accelerator located in Delft, The Netherlands. The premise of this research is to inform the development of the ‘region of the future’ by the Municipality of Rotterdam-Den Haag (MRDH). The paper starts by reporting the desktop research carried out to find and develop multiple use cases for robots to support humans in various activities. Further, the paper reports the user research carried out by crowdsourcing responses collected in public spaces of Rotterdam-Den Haag region and on the internet. Furthermore, based on the knowledge gathered in the initial research, practical experiments were carried out using robots and semi-autonomous systems in order to test and validate our initial research. These experiments were conducted in three cities in the Netherlands which were Rotterdam, The Hague, and Delft. Custom sensor box, Drone, and Boston Dynamics' Spot robot were used to conduct these experiments. Out of thirty use cases, five were tested with experiments which were skyscraper emergency evacuation, human transportation and security, bike lane delivery, mobility tracking, and robot drama. The learnings from these experiments provided us with insights into human-robot interaction and symbiosis in cities which can be used to introduce robots in cities to support human activities, ultimately enabling the transitioning from a human only city life towards a blended one where robots can play a role. Based on these understandings, we formulated design guidelines and strategy recommendations for incorporating robots in the Rotterdam-Den Haag’s region of the future. Lastly, we discuss how our insights in the Rotterdam-Den Haag region can inspire and inform the incorporation of robots in different cities of the world.

Keywords: city life, design guidelines, human-robot Interaction, robot use cases, robotic experiments, strategy recommendations, user research

Procedia PDF Downloads 83
641 Comparison of Peri- and Post-Operative Outcomes of Three Left Atrial Incisions: Conventional Direct, Transseptal and Superior Septal Left Atriotomy

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

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Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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640 Evaluating the Opioid Epidemic in a Large County Jail and Determining Who Is Most at Risk

Authors: Conchita Martin de Bustamante, Christopher S. Kung, Brianne Lacy, Eunsol Park, Hien Piotrowski, Mustafa Husain, Waseem Ahmed

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Objective: To explore the comorbidity of mental health conditions (major depressive disorder, borderline personality disorder, generalized anxiety disorder, and schizophrenia) with opioid use disorder in people incarcerated at a large urban jail. Background Schizophrenia, depression, bipolar disorder, and anxiety are all serious mental health conditions that are highly prevalent amongst incarcerated patients. However, it is seldom the only disorder these patients are suffering from. According to the US Department of Justice, about half of US prisoners, both at the state and federal level, suffer from substance use disorders. Although the opioid epidemic has been studied greatly in the recent years amongst the general population, little has been explored on how the opioid crisis has affected incarcerated patients in local jails, particularly regarding which of these patients are most susceptible. Method The cohort consisted of 507 people incarcerated at a large county jail who were evaluated by mental health providers in December 2020. A retrospective review was performed to evaluate associations between mental health diagnoses, substance use disorder, and other demographic variables. Results Participants had been diagnosed with various mental health conditions, including MDD (22.6%, n = 115), GAD (33.7%, n = 171), Schizophrenia (15.2%, n = 77) and BPD (27%, n = 137). Preliminary Chi square tests were conducted for these conditions against marijuana, alcohol, cocaine, opioid, methamphetamine, benzodiazepines, and sedative use disorders. The results showed significant associations between Schizophrenia (p = 0.013), GAD (p M 0.001), and MDD (p = 0.029) with opioid use disorders. Conclusions Determining the extent of these comorbid substance use and mental health disorders within an incarcerated population can help influence treatment plans for future incarcerated patients. Many federal and state jail systems lack pharmacological substance use intervention and the prevalence of these co-morbid conditions can shed light on the importance of treating conditions concurrently upon intake.

Keywords: mental health conditions, opioids, substance use disorder, comorbidity

Procedia PDF Downloads 132
639 Seismic Assessment of Non-Structural Component Using Floor Design Spectrum

Authors: Amin Asgarian, Ghyslaine McClure

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Experiences in the past earthquakes have clearly demonstrated the necessity of seismic design and assessment of Non-Structural Components (NSCs) particularly in post-disaster structures such as hospitals, power plants, etc. as they have to be permanently functional and operational. Meeting this objective is contingent upon having proper seismic performance of both structural and non-structural components. Proper seismic design, analysis, and assessment of NSCs can be attained through generation of Floor Design Spectrum (FDS) in a similar fashion as target spectrum for structural components. This paper presents the developed methodology to generate FDS directly from corresponding Uniform Hazard Spectrum (UHS) (i.e. design spectra for structural components). The methodology is based on the experimental and numerical analysis of a database of 27 real Reinforced Concrete (RC) buildings which are located in Montreal, Canada. The buildings were tested by Ambient Vibration Measurements (AVM) and their dynamic properties have been extracted and used as part of the approach. Database comprises 12 low-rises, 10 medium-rises, and 5 high-rises and they are mostly designated as post-disaster\emergency shelters by the city of Montreal. The buildings are subjected to 20 compatible seismic records to UHS of Montreal and Floor Response Spectra (FRS) are developed for every floors in two horizontal direction considering four different damping ratios of NSCs (i.e. 2, 5, 10, and 20 % viscous damping). Generated FRS (approximately 132’000 curves) are statistically studied and the methodology is proposed to generate the FDS directly from corresponding UHS. The approach is capable of generating the FDS for any selection of floor level and damping ratio of NSCs. It captures the effect of: dynamic interaction between primary (structural) and secondary (NSCs) systems, higher and torsional modes of primary structure. These are important improvements of this approach compared to conventional methods and code recommendations. Application of the proposed approach are represented here through two real case-study buildings: one low-rise building and one medium-rise. The proposed approach can be used as practical and robust tool for seismic assessment and design of NSCs especially in existing post-disaster structures.

Keywords: earthquake engineering, operational and functional components, operational modal analysis, seismic assessment and design

Procedia PDF Downloads 202
638 Reducing the Urban Heat Island Effect by Urban Design Strategies: Case Study of Aksaray Square in Istanbul

Authors: Busra Ekinci

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Urban heat island term becomes one of the most important problem in urban areas as a reflection of global warming in local scale last years. Many communities and governments are taking action to reduce heat island effects on urban areas where the half of the world's population live today. At this point, urban design turned out to be an important practice and research area for providing an environmentally sensitive urban development. In this study, mitigating strategies of urban heat island effects by urban design are investigated in Aksaray Square and surroundings in Istanbul. Aksaray is an important historical and commercial center of Istanbul, which has an increasing density due to be the node of urban transportation. Also, Istanbul Metropolitan Municipality prepared an urban design project to respond the needs of growing population in the area for 2018. The purpose of the study is emphasizing the importance of urban design objectives and strategies that are developed to reduce the heat island effects on urban areas. Depending on this, the urban heat island effect of the area was examined based on the albedo (reflectivity) parameter which is the most effective parameter in the formation of the heat island effect in urban areas. Albedo values were calculated by Albedo Viewer web application model that was developed by Energy and Environmental Engineering Department of Kyushu University in Japan. Albedo parameter had examined for the present situation and the planned situation with urban design project. The results show that, the current area has urban heat island potential. With the Aksaray Square Project, the heat island effect on the area can be reduced, but would not be completely prevented. Therefore, urban design strategies had been developed to reduce the island effect in addition to the urban design project of the area. This study proves that urban design objectives and strategies are quite effective to reduce the heat island effects, which negatively affect the social environment and quality of life in urban areas.

Keywords: Albedo, urban design, urban heat island, sustainable design

Procedia PDF Downloads 566
637 Incident Management System: An Essential Tool for Oil Spill Response

Authors: Ali Heyder Alatas, D. Xin, L. Nai Ming

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An oil spill emergency can vary in size and complexity, subject to factors such as volume and characteristics of spilled oil, incident location, impacted sensitivities and resources required. A major incident typically involves numerous stakeholders; these include the responsible party, response organisations, government authorities across multiple jurisdictions, local communities, and a spectrum of technical experts. An incident management team will encounter numerous challenges. Factors such as limited access to location, adverse weather, poor communication, and lack of pre-identified resources can impede a response; delays caused by an inefficient response can exacerbate impacts caused to the wider environment, socio-economic and cultural resources. It is essential that all parties work based on defined roles, responsibilities and authority, and ensure the availability of sufficient resources. To promote steadfast coordination and overcome the challenges highlighted, an Incident Management System (IMS) offers an essential tool for oil spill response. It provides clarity in command and control, improves communication and coordination, facilitates the cooperation between stakeholders, and integrates resources committed. Following the preceding discussion, a comprehensive review of existing literature serves to illustrate the application of IMS in oil spill response to overcome common challenges faced in a major-scaled incident. With a primary audience comprising practitioners in mind, this study will discuss key principles of incident management which enables an effective response, along with pitfalls and challenges, particularly, the tension between government and industry; case studies will be used to frame learning and issues consolidated from previous research, and provide the context to link practice with theory. It will also feature the industry approach to incident management which was further crystallized as part of a review by the Joint Industry Project (JIP) established in the wake of the Macondo well control incident. The authors posit that a common IMS which can be adopted across the industry not only enhances response capacity towards a major oil spill incident but is essential to the global preparedness effort.

Keywords: command and control, incident management system, oil spill response, response organisation

Procedia PDF Downloads 143
636 Music Educators for Peace: Synchronizing Music and Pedagogical Experiences to Re-Build Social Fabric in Colombia's Post-Conflict

Authors: Julian Dario Castro Cifuentes

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In Colombia, the armed conflict has lasted for more than sixty years bringing poverty, internal displacement of people, deaths from both government and insurgent forces and other violence-related problems that has damaged its social fabric. In 2016, the peace process between the Colombian government and the FARC rebels brought the possibility of ending this war and a new set of challenges to Colombian society in order to achieve pacific coexistence and reconciliation. In this scenario, there have been different efforts from diverse social actors in order to build peace and reconciliation mainly within the victims of the armed conflict. In the case of music, there have been multiple programs for social transformation through music and pedagogical experiences. Nevertheless, the need to strengthen this initiative by giving ‘peace building oriented’ pedagogical tools to the musicians that lead this experiences and understanding which aspects make this practices ‘musically meaningful’, has been recognized. For this reason, the purpose of this study is to discuss the convergences and divergences of music, and educational experiences applied to peacebuilding in the context of Colombia’s post-conflict. In this research, the hermeneutic phenomenology paradigm is applied in a case study of a peace building music education experience in the department of Nariño, Colombia articulated with the program ‘Manos a la Paz’. Two particular experiences, one on musical practice and another on music education are taken as a unit of analysis to understand its essence and structure in order to find ways to articulate efforts in peace building actions from music. This study shows how the existent gap between music experience and its subjacent pedagogical knowledge, can be reduced through deconstruction of the music and pedagogical experience. The ‘Manos a la Paz’ program showed how a peace building approach to music education can make major contributions to Pacific Coexistence and Reconciliation in Colombia’s Post-Conflict.

Keywords: music education, music for peace, music pedagogy, peace building, social fabric

Procedia PDF Downloads 215
635 Osteoarticular Manifestations and Abnormalities of Bone Metabolism in Celiac Disease

Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

Procedia PDF Downloads 314