Search results for: warehouse failure risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7919

Search results for: warehouse failure risk

6179 Impact of a Novel Technique of S-Shaped Tracheostoma in Pediatric Tracheostomy in Intensive Care Unit on Success and Procedure Related Complications

Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

Abstract:

Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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6178 Effect of Confinement on the Bearing Capacity and Settlement of Spread Foundations

Authors: Tahsin Toma Sabbagh, Ihsan Al-Abboodi, Ali Al-Jazaairry

Abstract:

Allowable-bearing capacity is the competency of soil to safely carries the pressure from the superstructure without experiencing a shear failure with accompanying excessive settlements. Ensuring a safe bearing pressure with respect to failure does not tolerate settlement of the foundation will be within acceptable limits. Therefore, settlement analysis should always be performed since most structures are settlement sensitive. When visualising the movement of a soil wedge in the bearing capacity criterion, both vertically and horizontally, it becomes clear that by confining the soil surrounding the foundation, both the bearing capacity and settlement values improve. In this study, two sizes of spread foundation were considered; (2×4) m and (3×5) m. These represent two real problem case studies of an existing building. The foundations were analysed in terms of dimension as well as position with respect to a confining wall (i.e., sheet piles on both sides). Assuming B is the least foundation dimension, the study comprised the analyses of three distances; (0.1 B), (0.5 B), and (0.75 B) between the sheet piles and foundations alongside three depths of confinement (0.5 B), (1 B), and (1.5 B). Nonlinear three-dimensional finite element analysis (ANSYS) was adopted to perform an analytical investigation on the behaviour of the two foundations contained by the case study. Results showed that confinement of foundations reduced the overall stresses near the foundation by 65% and reduced the vertical displacement by 90%. Moreover, the most effective distance between the confinement wall and the foundation was found to be 0.5 B.

Keywords: bearing capacity, cohesionless soils, soil confinement, soil modelling, spread footings

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6177 Stochastic Default Risk Estimation Evidence from the South African Financial Market

Authors: Mesias Alfeus, Kirsty Fitzhenry, Alessia Lederer

Abstract:

The present paper provides empirical studies to estimate defaultable bonds in the South African financial market. The main goal is to estimate the unobservable factors affecting bond yields for South African major banks. The maximum likelihood approach is adopted for the estimation methodology. Extended Kalman filtering techniques are employed in order to tackle the situation that the factors cannot be observed directly. Multi-dimensional Cox-Ingersoll-Ross (CIR)-type factor models are considered. Results show that default risk increased sharply in the South African financial market during COVID-19 and the CIR model with jumps exhibits a better performance.

Keywords: default intensity, unobservable state variables, CIR, α-CIR, extended kalman filtering

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6176 Silent Myocardial Infarction Presented with Homonymous Hemianopia in a Non-Diabetic Middle Aged Man

Authors: Seyed Fakhroddin Hejazi, Mohammad Saleh Sadeghi, Leili Iranirad

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Silent myocardial infarction is defined as the appearance of pathological Q waves in the electrocardiogram, without objective signs of myocardial infarction and any minimal or atypical symptoms. Although this condition has been known for a long time, but little is known about its phenomenon and the mechanisms of it remain unclear. Its coincidence with stroke is also still controversial. This case report introduces a middle-aged man with silent myocardial infarction presented with homonymous hemianopia, which except stage 1 hypertension, had no other major cardiovascular risk factors including diabetes mellitus, hypercholesterolemia, family history of cardiac diseases and smoking. In conclusion, this case report indicated that existence of only one cardiovascular risk factor would lead to the development of MI or stroke.

Keywords: silent myocardial infarction, homonymous hemianopia, stroke, hypertension

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6175 Zoonotic Risk Practices in Rural Households in the Penka-Michel Health District (West Cameroon)

Authors: Namekong Fokeng Armand

Abstract:

Background: Zoonoses are nowadays a serious public health problem in both developing and developed countries. They contribute to increase the economic burden. In case of emergence, rural populations are the most affected, hence the need to investigate risk practices in rural households of Penka-Michel (West Cameroon). Methods: This cross-sectional study was conducted from October to November 2021 among 200 heads of households living in the Penka-Michel health district (West Cameroon). It was done using a pre-tested and validated questionnaire, allowing to obtain socio-demographic, economic data, and data on zoonotic risk practices. Results: The participants [women (56%), men (44%)] worked mainly in the informal private sector (53%) and practiced agriculture secondarily (90%). Their highest level of education, for the most part, was a secondary school (50%); the average household size was 06 persons with a monthly income > 36270 FCFA (72%). 74% of household heads thought that animals can transmit diseases, and 17% had heard about zoonotic diseases through the media (65%). Rats caught in households (60%) were consumed there (74%), as was bush meat (61%) or dog meat (18%). For family food (90%), animals were slaughtered within the household (97%), rarely preceded by a veterinary inspection (6%). 87% of households practiced traditional rites with animal blood, 65% shared the same habitat as their animals, 41% did not systematically wash their hands after handling animals. More than 50% of households owned one or more dogs, usually strays (41%) and 48% of which were vaccinated (rabies). Many households had at least one: poultry (98%); pig (50%); dog (57%), cat (52%). 25% of households slaughtered sick animals for consumption, and 27% ate dead animals. Conclusion: This study identified numerous zoonotic risk practices in households in the Penka-Michel health district (West Cameroon). Concerted, multisectoral communication / awareness-raising actions are needed to break with these practices.

Keywords: zoonoses, risky practices, rural households, penka-michel, cameroon

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6174 Experimental Investigation on Shear Behaviour of Fibre Reinforced Concrete Beams Using Steel Fibres

Authors: G. Beulah Gnana Ananthi, A. Jaffer Sathick, M. Abirami

Abstract:

Fibre reinforced concrete (FRC) has been widely used in industrial pavements and non-structural elements such as pipes, culverts, tunnels, and precast elements. The strengthening effect of fibres in the concrete matrix is achieved primarily due to the bridging effect of fibres at the crack interfaces. The workability of the concrete was reduced on addition of high percentages of steel fibres. The optimum percentage of addition of steel fibres varies with its aspect ratio. For this study, 1% addition of steel has resulted to be the optimum percentage for both Hooked and Crimped Steel Fibres and was added to the beam specimens. The fibres restrain efficiently the cracks and take up residual stresses beyond the cracking. In this sense, diagonal cracks are effectively stitched up by fibres crossing it. The failure of beams within the shear failure range changed from shear to flexure in the presence of sufficient steel fibre quantity. The shear strength is increased with the addition of steel fibres and had exceeded the enhancement obtained with the transverse reinforcement. However, such increase is not directly in proportion with the quantity of fibres used. Considering all the clarification made in the present experimental investigation, it is concluded that 1% of crimped steel fibres with an aspect ratio of 50 is the best type of steel fibres for replacement of transverse stirrups in high strength concrete beams when compared to the steel fibres with hooked ends.

Keywords: fibre reinforced concrete, steel fibre, shear strength, crack pattern

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6173 Correlation between Microalbuminuria and Hypertension in Type 2 Diabetic Patients

Authors: Alia Ali, Azeem Taj, Muhammed Joher Amin, Farrukh Iqbal, Zafar Iqbal

Abstract:

Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients were screened for microalbuminuria and raised blood pressure, attending the diabetic clinic of Shaikh Zayed Hospital, Lahore, Pakistan. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end-stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Keywords: hypertension, microalbuminuria, diabetic kidney disease, type 2 Diabetes mellitus

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6172 Experimental Investigations on Ultimate Bearing Capacity of Soft Soil Improved by a Group of End-Bearing Column

Authors: Mamata Mohanty, J. T. Shahu

Abstract:

The in-situ deep mixing is an effective ground improvement technique which involves columnar inclusion into soft ground to increase its bearing capacity and reduce settlement. The first part of the study presents the results of unconfined compression on cement-admixed clay prepared at different cement content and subjected to varying curing periods. It is found that cement content is a prime factor controlling the strength of the cement-admixed clay. Besides cement content, curing period is important parameter that adds to the strength of cement-admixed clay. Increase in cement content leads to significant increase in Unconfined Compressive Strength (UCS) values especially at cement contents greater than 8%. The second part of the study investigated the bearing capacity of the clay ground improved by a group of end-bearing column using model tests under plain-strain condition. This study mainly focus to examine the effect of cement contents on the ultimate bearing capacity and failure stress of the improved clay ground. The study shows that the bearing capacity of the improved ground increases significantly with increase in cement contents of the soil-cement columns. A considerable increase in the stiffness of the model ground and failure stress was observed with increase in cement contents.

Keywords: bearing capacity, cement content, curing time, unconfined compressive strength, undrained shear strength

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6171 Framework for Decision Support Tool for Quality Control and Management in Botswana Manufacturing Companies

Authors: Mogale Sabone, Thabiso Ntlole

Abstract:

The pressure from globalization has made manufacturing organizations to move towards three major competitive arenas: quality, cost, and responsiveness. Quality is a universal value and has become a global issue. In order to survive and be able to provide customers with good products, manufacturing organizations’ supporting systems, tools, and structures it uses must grow or evolve. The majority of quality management concepts and strategies that are practiced recently are aimed at detecting and correcting problems which already exist and serve to limit losses. In agile manufacturing environment there is no room for defect and error so it needs a quality management which is proactively directed at problem prevention. This proactive quality management avoids losses by focusing on failure prevention, virtual elimination of the possibility of premature failure, mistake-proofing, and assuring consistently high quality in the definition and design of creation processes. To achieve this, a decision support tool for quality control and management is suggested. Current decision support tools/methods used by most manufacturing companies in Botswana for quality management and control are not integrated, for example they are not consistent since some tests results data is recorded manually only whilst others are recorded electronically. It is only a set of procedures not a tool. These procedures cannot offer interactive decision support. This point brings to light the aim of this research which is to develop a framework which will help manufacturing companies in Botswana build a decision support tool for quality control and management.

Keywords: decision support tool, manufacturing, quality control, quality management

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6170 The Impact of Transaction Costs on Rebalancing an Investment Portfolio in Portfolio Optimization

Authors: B. Marasović, S. Pivac, S. V. Vukasović

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Constructing a portfolio of investments is one of the most significant financial decisions facing individuals and institutions. In accordance with the modern portfolio theory maximization of return at minimal risk should be the investment goal of any successful investor. In addition, the costs incurred when setting up a new portfolio or rebalancing an existing portfolio must be included in any realistic analysis. In this paper rebalancing an investment portfolio in the presence of transaction costs on the Croatian capital market is analyzed. The model applied in the paper is an extension of the standard portfolio mean-variance optimization model in which transaction costs are incurred to rebalance an investment portfolio. This model allows different costs for different securities, and different costs for buying and selling. In order to find efficient portfolio, using this model, first, the solution of quadratic programming problem of similar size to the Markowitz model, and then the solution of a linear programming problem have to be found. Furthermore, in the paper the impact of transaction costs on the efficient frontier is investigated. Moreover, it is shown that global minimum variance portfolio on the efficient frontier always has the same level of the risk regardless of the amount of transaction costs. Although efficient frontier position depends of both transaction costs amount and initial portfolio it can be concluded that extreme right portfolio on the efficient frontier always contains only one stock with the highest expected return and the highest risk.

Keywords: Croatian capital market, Markowitz model, fractional quadratic programming, portfolio optimization, transaction costs

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6169 Spatial Variability of Soil Metal Contamination to Detect Cancer Risk Zones in Coimbatore Region of India

Authors: Aarthi Mariappan, Janani Selvaraj, P. B. Harathi, M. Prashanthi Devi

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Anthropogenic modification of the urban environment has largely increased in the recent years in order to sustain the growing human population. Intense industrial activity, permanent and high traffic on the roads, a developed subterranean infrastructure network, land use patterns are just some specific characteristics. Every day, the urban environment is polluted by more or less toxic emissions, organic or metals wastes discharged from specific activities such as industrial, commercial, municipal. When these eventually deposit into the soil, the physical and chemical properties of the surrounding soil is changed, transforming it into a human exposure indicator. Metals are non-degradable and occur cumulative in soil due to regular deposits are a result of permanent human activity. Due to this, metals are a contaminant factor for soil when persistent over a long period of time and a possible danger for inhabitant’s health on prolonged exposure. Metals accumulated in contaminated soil may be transferred to humans directly, by inhaling the dust raised from top soil, or by ingesting, or by dermal contact and indirectly, through plants and animals grown on contaminated soil and used for food. Some metals, like Cu, Mn, Zn, are beneficial for human’s health and represent a danger only if their concentration is above permissible levels, but other metals, like Pb, As, Cd, Hg, are toxic even at trace level causing gastrointestinal and lung cancers. In urban areas, metals can be emitted from a wide variety of sources like industrial, residential, commercial activities. Our study interrogates the spatial distribution of heavy metals in soil in relation to their permissible levels and their association with the health risk to the urban population in Coimbatore, India. Coimbatore region is a high cancer risk zone and case records of gastro intestinal and respiratory cancer patients were collected from hospitals and geocoded in ArcGIS10.1. The data of patients pertaining to the urban limits were retained and checked for their diseases history based on their diagnosis and treatment. A disease map of cancer was prepared to show the disease distribution. It has been observed that in our study area Cr, Pb, As, Fe and Mg exceeded their permissible levels in the soil. Using spatial overlay analysis a relationship between environmental exposure to these potentially toxic elements in soil and cancer distribution in Coimbatore district was established to show areas of cancer risk. Through this, our study throws light on the impact of prolonged exposure to soil contamination in soil in the urban zones, thereby exploring the possibility to detect cancer risk zones and to create awareness among the exposed groups on cancer risk.

Keywords: soil contamination, cancer risk, spatial analysis, India

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6168 Hospital Workers’ Psychological Resilience after 2015 Middle East Respiratory Syndrome Outbreak

Authors: Myoungsoon You, Heejung Son

Abstract:

During a pandemic, hospital workers should protect not only their vulnerable patients but also themselves from the consequences of rapidly spreading infection. However, the evidence on the psychological impact of an outbreak on hospital workers is limited. In this study, we aim to assess hospital workers’ psychological well-being and function at the workplace after an outbreak, by focusing on ‘psychological resilience’. Specifically, the effects of risk appraisal, emotional experience, and coping ability on resilience indicated by the likelihood of post-traumatic syndrome disorder and willingness to work were investigated. Such role and position of each factor were analyzed using a path model, and the result was compared between the healthcare worker and non-healthcare worker groups. In the investigation, 280 hospital workers who experienced the 2015 Middle East Respiratory Syndrome outbreak in South Korea have participated. The result presented, in both groups, the role of the appraisal of risk and coping ability appeared consistent with a previous research, that was, the former interrupted resilience while the latter facilitated it. In addition, the role of emotional experience was highlighted as, in both groups, emotional disruption not only directly associated with low resilience but mediated the effect of perceived risk on resilience. The differences between the groups were also identified, which were, the role of emotional experience and coping ability was more prominent in the non-HCW group in explaining resilience. From the results, implications on how to support hospital personnel during an outbreak in a way to facilitate their resilience after the outbreak were drawn.

Keywords: hospital workers, emotions, infectious disease outbreak, psychological resilience

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6167 A Study of Electric Generation Characteristics for Thin-Film Piezoelectric PbZrTiO₃ Ceramic Plate during the Static and Cyclic Loading Conditions

Authors: Tsukasa Ogawa, Mitsuhiro Okayasu

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To examine the generation properties of electric power for piezoelectric (PbZrTiO3) ceramic plates, the electric-power generation characteristics were examined experimentally and numerically during cyclic bending under various loading fixtures with different contact condition, i.e., point and area contact. In the low applied loading condition between 10 and 50 N, increasing the load-contact area on the piezoelectric ceramic led to a nonlinear decrease in the generated voltage. Decreasing contact area, including the point contact, basically enhanced the generated voltage, although the voltage saturated during loading when the contact area is less than ϕ5 mm, which was attributed to the high strain status, resulting in the material failure, i.e., high stress concentration. In this case, severe plastic deformation and the domain switching were dominated failure modes in the ceramic. From this approach, it is clear that the applied load became more larger (50 ~100 N), larger contact area (ϕ10 ~ ϕ20 mm) became advantageous for power generation. Based upon this cyclic loading was carried out to investigate the fatigue characteristics of the piezoelectric ceramic late. For all contact conditions, electric voltage dropped in the beginning of the cyclic loading, although the higher electric generation was stable in the further cyclic loading for the contact area of ϕ10 ~ ϕ20 mm. In constant, further decrement of electric generation occurred for the point contact condition, and the low electric voltage was generated for the larger contact condition.

Keywords: electric power generation, piezoelectric ceramic, lead zirconate titanate ceramic, loading conditions

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6166 Ports and Airports: Gateways to Vector-Borne Diseases in Portugal Mainland

Authors: Maria C. Proença, Maria T. Rebelo, Maria J. Alves, Sofia Cunha

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Vector-borne diseases are transmitted to humans by mosquitos, sandflies, bugs, ticks, and other vectors. Some are re-transmitted between vectors, if the infected human has a new contact when his levels of infection are high. The vector is infected for lifetime and can transmit infectious diseases not only between humans but also from animals to humans. Some vector borne diseases are very disabling and globally account for more than one million deaths worldwide. The mosquitoes from the complex Culex pipiens sl. are the most abundant in Portugal, and we dispose in this moment of a data set from the surveillance program that has been carried on since 2006 across the country. All mosquitos’ species are included, but the large coverage of Culex pipiens sl. and its importance for public health make this vector an interesting candidate to assess risk of disease amplification. This work focus on ports and airports identified as key areas of high density of vectors. Mosquitoes being ectothermic organisms, the main factor for vector survival and pathogen development is temperature. Minima and maxima local air temperatures for each area of interest are averaged by month from data gathered on a daily basis at the national network of meteorological stations, and interpolated in a geographic information system (GIS). The range of temperatures ideal for several pathogens are known and this work shows how to use it with the meteorological data in each port and airport facility, to focus an efficient implementation of countermeasures and reduce simultaneously risk transmission and mitigation costs. The results show an increased alert with decreasing latitude, which corresponds to higher minimum and maximum temperatures and a lower amplitude range of the daily temperature.

Keywords: human health, risk assessment, risk management, vector-borne diseases

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6165 Risk Factors for Maternal and Neonatal Morbidities Associated with Operative Vaginal Deliveries

Authors: Maria Reichenber Arcilla

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Objective: To determine the risk factors for maternal and neonatal complications associated with operative vaginal deliveries. Methods: A retrospective chart review of 435 patients who underwent operative vaginal deliveries was done. Patient profiles – age, parity, AOG, duration of labor – and outcomes – birthweight, maternal and neonatal complications - were tabulated and multivariable analysis and logistic regression were performed using SPSS® Statistics Base. Results and Conclusion: There was no significant difference in the incidence of maternal and neonatal complications between those that underwent vacuum and forceps extraction. Among the variables analysed, parity and duration of labor reached statistical significance. The odds of maternal complications were 3 times higher among nulliparous patients. Neonatal complications were seen in those whose labor lasted more than 9 hours.

Keywords: operative vaginal deliveries, maternal, neonatal, morbidity

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6164 Resilience Building, the Case of Dire Dawa Community, Ethiopia

Authors: Getachew Demesa Bexa

Abstract:

Building resilience to withstand extreme weather events through reduction and mitigation measures towards predicted disasters with appropriate contingency plans complemented by timely and effective emergency response demands committed and integrated/coordinated efforts. The 2006 flood disaster that claimed more than 200 people in Dire Dawa town shifted the paradigm from reactive to proactive engagement among government, NGOs and communities to contain future disasters through resilience building. Dire Dawa CMDRR Association is a model community organization that demonstrated the basic minimum and turning adversity into opportunity by mobilizing vulnerable community members. Meanwhile the birth of African Centre for Disaster Risk Management is a milestone in changing the image of the country and beyond in resilience building while linking relief and development.

Keywords: Dire Dawa, disaster, resilience, risk management

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6163 Effect of Grain Size and Stress Parameters on Ratcheting Behaviour of Two Different Single Phase FCC Metals

Authors: Jayanta Kumar Mahato, Partha Sarathi De, Amrita Kundu, P. C. Chakraborti

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Ratcheting is one of the most important phenomena to be considered for design and safety assessment of structural components subjected to stress controlled asymmetric cyclic loading in the elasto-plastic domain. In the present study uniaxial ratcheting behavior of commercially pure annealed OFHC copper and aluminium with two different grain sizes has been investigated. Stress-controlled tests have been conducted at various combinations of stress amplitude and mean stress. These stresses were selected in such a way that the ratio of equivalent stress amplitude (σₐeq) to ultimate tensile strength (σUTS) of the selected materials remains constant. It is found that irrespective of grain size the ratcheting fatigue lives decrease with the increase of both stress amplitude and mean stress following power relationships. However, the effect of stress amplitude on ratcheting lives is observed higher as compared to mean stress for both the FCC metals. It is also found that for both FCC metals ratcheting fatigue lives at a constant ratio of equivalent stress amplitude (σ ₐeq) to ultimate tensile strength (σUTS) are more in case fine grain size. So far ratcheting strain rate is concerned, it decreases rapidly within first few cycles and then a steady state is reached. Finally, the ratcheting strain rate increases up to the complete failure of the specimens due to a very large increase of true stress for a substantial reduction in cross-sectional area. The steady state ratcheting strain rate increases with the increase in both stress amplitude and mean stress. Interestingly, a unique perfectly power relationship between steady state ratcheting strain rate and cycles to failure has been found irrespective of stress combination for both FCC metals. Similar to ratcheting strain rate, the strain energy density decreases rapidly within first few cycles followed by steady state and then increases up to a failure of the specimens irrespective of stress combinations for both FCC metals; but strain energy density at steady state decreases with increase in mean stress and increases with the increase of stress amplitude. From the fractography study, it is found that the void density increases with the increase of maximum stress, but the void size and void density are almost same for any combination of stress parameters considering constant maximum stress.

Keywords: ratcheting phenomena, grain size, stress parameter, ratcheting lives, ratcheting strain rate

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6162 The Risk of Bleeding in Knee or Shoulder Injections in Patients on Warfarin Treatment

Authors: Muhammad Yasir Tarar

Abstract:

Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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6161 Attachment Patterns in a Sample of South African Children at Risk in Middle Childhood

Authors: Renate Gericke, Carol Long

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Despite the robust empirical support of attachment, advancement in the description and conceptualization of attachment has been slow and has not significantly advanced beyond the identification of attachment security or type (namely, secure, avoidant, ambivalent and disorganized). This has continued despite papers arguing for theoretical refinement in the classification of attachment presentations. For thinking and practice to advance, it is critically important that these categories and their assessment be interrogated in different contexts and across developmental age. To achieve this, a quantitative design was used with descriptive and inferential statistics, and general linear models were employed to analyze the data. The Attachment Story Completion Test (ASCT) was administered to 105 children between the ages of eight and twelve from socio-economically deprived contexts with high exposure to trauma. A staggering 93% of the children had insecure attachments (specifically, avoidant 37%, disorganized 34% and ambivalent 22%) and attachment was more complex than currently conceptualized in the attachment literature. Primary attachment did not only present as one of four discreet categories, but 70% of the sample had a complex attachment with more than one type of maternal attachment style. Attachment intensity also varied along a continuum (between 1 and 5). The findings have implications for a) research that has not considered the potential complexity of attachment or attachment intensity, b) policy to more actively support mother-infant dyads, particularly in high-risk contexts and c) question the applicability of a western conceptualization of a primary maternal attachment figure in non-western collectivist societies.

Keywords: attachment, children at risk, middle childhood, non-western context

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6160 Using Seismic and GPS Data for Hazard Estimation in Some Active Regions in Egypt

Authors: Abdel-Monem Sayed Mohamed

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Egypt rapidly growing development is accompanied by increasing levels of standard living particular in its urban areas. However, there is a limited experience in quantifying the sources of risk management in Egypt and in designing efficient strategies to keep away serious impacts of earthquakes. From the historical point of view and recent instrumental records, there are some seismo-active regions in Egypt, where some significant earthquakes had occurred in different places. The special tectonic features in Egypt: Aswan, Greater Cairo, Red Sea and Sinai Peninsula regions are the territories of a high seismic risk, which have to be monitored by up-to date technologies. The investigations of the seismic events and interpretations led to evaluate the seismic hazard for disaster prevention and for the safety of the dense populated regions and the vital national projects as the High Dam. In addition to the monitoring of the recent crustal movements, the most powerful technique of satellite geodesy GPS are used where geodetic networks are covering such seismo-active regions. The results from the data sets are compared and combined in order to determine the main characteristics of the deformation and hazard estimation for specified regions. The final compiled output from the seismological and geodetic analysis threw lights upon the geodynamical regime of these seismo-active regions and put Aswan and Greater Cairo under the lowest class according to horizontal crustal strains classifications. This work will serve a basis for the development of so-called catastrophic models and can be further used for catastrophic risk management. Also, this work is trying to evaluate risk of large catastrophic losses within the important regions including the High Dam, strategic buildings and archeological sites. Studies on possible scenarios of earthquakes and losses are a critical issue for decision making in insurance as a part of mitigation measures.

Keywords: b-value, Gumbel distribution, seismic and GPS data, strain parameters

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6159 Hierarchical Optimization of Composite Deployable Bridge Treadway Using Particle Swarm Optimization

Authors: Ashraf Osman

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Effective deployable bridges that are characterized by an increased capacity to weight ratio are recently needed for post-disaster rapid mobility and military operations. In deployable bridging, replacing metals as the fabricating material with advanced composite laminates as lighter alternatives with higher strength is highly advantageous. This article presents a hierarchical optimization strategy of a composite bridge treadway considering maximum strength design and bridge weight minimization. Shape optimization of a generic deployable bridge beam cross-section is performed to achieve better stress distribution over the bridge treadway hull. The developed cross-section weight is minimized up to reserving the margins of safety of the deployable bridging code provisions. Hence, the strength of composite bridge plates is maximized through varying the plies orientation. Different loading cases are considered of a tracked vehicle patch load. The orthotropic plate properties of a composite sandwich core are used to simulate the bridge deck structural behavior. Whereas, the failure analysis is conducted using Tsai-Wu failure criterion. The naturally inspired particle swarm optimization technique is used in this study. The proposed technique efficiently reduced the weight to capacity ratio of the developed bridge beam.

Keywords: CFRP deployable bridges, disaster relief, military bridging, optimization of composites, particle swarm optimization

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6158 Soil Transmitted Helminth Infection and Associated Risk Factors among School Children in a Selected Barangay in the Philippines

Authors: Gil Soriano, Aubreyrose Casilang

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Soil-transmitted helminth infection remains to be one of the leading public health problem worldwide, which is common in the rural developing regions especially among children. This study aimed to detect the presence of soil transmitted helminths among children and its associated transmission factors. Descriptive cross sectional research was the design used in the study and questionnaires were administered. Stool samples were collected among the samples (n=108) and were analyzed using kato thick method. Results showed that 61 out of 108 respondents are infected by soil transmitted helminth infection with A. lumbricoides the highest, followed by hookworm and T. trichuria. Parent's educational attainment, hand washing practices, and water sources were found to be associated with presence of Soil Transmitted Helminth infection.

Keywords: associated risk factors, barangay, school children, soil transmitted helminth infection

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6157 Suicide Wrongful Death: Standard of Care Problems Involving the Inaccurate Discernment of Lethal Risk When Focusing on the Elicitation of Suicide Ideation

Authors: Bill D. Geis

Abstract:

Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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6156 Legal Rights of Parents of Justice-Involved Youth in the United Arab Emirates

Authors: Yusra Ibrahim

Abstract:

Parental involvement in their children’s education and behavioral modification is important. This article provides a policy analysis that describes laws and public education regulations concerning justice-involved youth and youth at risk of delinquency in the United Arab Emirates. The article aims to clarify the UAE laws for parents and guardians regarding their involvement in addressing school violations and crimes committed by their children, particularly those with emotional and behavioral disorders, youths at risk for delinquency, and justice-involved youths. The article concludes with implications for parents, policymakers, and educators and suggests ways to improve services and support for these parents and their youth.

Keywords: justice-involved youth, parents, incarceration, incarcerated youth, United Arab Emirates.

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6155 Seismic Assessment of a Pre-Cast Recycled Concrete Block Arch System

Authors: Amaia Martinez Martinez, Martin Turek, Carlos Ventura, Jay Drew

Abstract:

This study aims to assess the seismic performance of arch and dome structural systems made from easy to assemble precast blocks of recycled concrete. These systems have been developed by Lock Block Ltd. Company from Vancouver, Canada, as an extension of their currently used retaining wall system. The characterization of the seismic behavior of these structures is performed by a combination of experimental static and dynamic testing, and analytical modeling. For the experimental testing, several tilt tests, as well as a program of shake table testing were undertaken using small scale arch models. A suite of earthquakes with different characteristics from important past events are chosen and scaled properly for the dynamic testing. Shake table testing applying the ground motions in just one direction (in the weak direction of the arch) and in the three directions were conducted and compared. The models were tested with increasing intensity until collapse occurred; which determines the failure level for each earthquake. Since the failure intensity varied with type of earthquake, a sensitivity analysis of the different parameters was performed, being impulses the dominant factor. For all cases, the arches exhibited the typical four-hinge failure mechanism, which was also shown in the analytical model. Experimental testing was also performed reinforcing the arches using a steel band over the structures anchored at both ends of the arch. The models were tested with different pretension levels. The bands were instrumented with strain gauges to measure the force produced by the shaking. These forces were used to develop engineering guidelines for the design of the reinforcement needed for these systems. In addition, an analytical discrete element model was created using 3DEC software. The blocks were designed as rigid blocks, assigning all the properties to the joints including also the contribution of the interlocking shear key between blocks. The model is calibrated to the experimental static tests and validated with the obtained results from the dynamic tests. Then the model can be used to scale up the results to the full scale structure and expanding it to different configurations and boundary conditions.

Keywords: arch, discrete element model, seismic assessment, shake-table testing

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6154 A Realist Review of Influences of Community-Based Interventions on Noncommunicable Disease Risk Behaviors

Authors: Ifeyinwa Victor-Uadiale, Georgina Pearson, Sophie Witter, D. Reidpath

Abstract:

Introduction: Smoking, alcohol misuse, unhealthy diet, and physical inactivity are the primary drivers of noncommunicable diseases (NCD), including cardiovascular diseases, cancers, respiratory diseases, and diabetes, worldwide. Collectively, these diseases are the leading cause of all global deaths, most of which are premature, affecting people between 30 and 70 years. Empirical evidence suggests that these risk behaviors can be modified by community-based interventions (CBI). However, there is little insight into the mechanisms and contextual factors of successful community interventions that impact risk behaviours for chronic diseases. This study examined “Under what circumstances, for whom, and how, do community-based interventions modify smoking, alcohol use, unhealthy diet, and physical inactivity among adults”. Adopting the Capability (C), Opportunity (O), Motivation (M), Behavior (B) (COM-B) framework for behaviour change, it sought to: (1) identify the mechanisms through which CBIs could reduce tobacco use and alcohol consumption and increase physical activity and the consumption of healthy diets and (2) examine the contextual factors that trigger the impact of these mechanisms on these risk behaviours among adults. Methods: Pawson’s realist review method was used to examine the literature. Empirical evidence and theoretical understanding were combined to develop a realist program theory that explains how CBIs influence NCD risk behaviours. Documents published between 2002 and 2020 were systematically searched in five electronic databases (CINAHL, Cochrane Library, Medline, ProQuest Central, and PsycINFO). They were included if they reported on community-based interventions aimed at cardiovascular diseases, cancers, respiratory diseases, and diabetes in a global context; and had an outcome targeted at smoking, alcohol, physical activity, and diet. Findings: Twenty-nine scientific documents were retrieved and included in the review. Over half of them (n = 18; 62%) focused on three of the four risk behaviours investigated in this review. The review identified four mechanisms: capability, opportunity, motivation, and social support that are likely to change the dietary and physical activity behaviours in adults given certain contexts. There were weak explanations of how the identified mechanisms could likely change smoking and alcohol consumption habits. In addition, eight contextual factors that may affect how these mechanisms impact physical activity and dietary behaviours were identified: suitability to work and family obligations, risk status awareness, socioeconomic status, literacy level, perceived need, availability and access to resources, culture, and group format. Conclusion: The findings suggest that CBIs are likely to improve the physical activity and dietary habits of adults if the intervention function seeks to educate, incentivize, change the environment, and model the right behaviours. The review applies and advances theory, realist research, and the design and implementation of community-based interventions for NCD prevention.

Keywords: community-based interventions, noncommunicable disease, realist program theory, risk behaviors

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6153 Designing Electronic Kanban in Assembly Line Tailboom at XYZ Corp to Reducing Lead Time

Authors: Nadhifah A. Nugraha, Dida D. Damayanti, Widia Juliani

Abstract:

Airplanes manufacturing is growing along with the increasing demand from consumers. The helicopter's tail called Tailboom is a product of the helicopter division at XYZ Corp, where the Tailboom assembly line is a pull system. Based on observations of existing conditions that occur at XYZ Corp, production is still unable to meet the demands of consumers; lead time occurs greater than the plan agreed upon by the consumers. In the assembly process, each work station experiences a lack of parts and components needed to assemble components. This happens because of the delay in getting the required part information, and there is no warning about the availability of parts needed, it makes some parts unavailable in assembly warehouse. The lack of parts and components from the previous work station causes the assembly process to stop, and the assembly line also stops at the next station. In its completion, the production time was late and not on the schedule. In resolving these problems, the controlling process is needed, which is controlling the assembly line to get all components and subassembly in the right amount and at the right time. This study applies one of Just In Time tools, namely Kanban and automation, should be added as efficiently and effectively communication line becomes electronic Kanban. The problem can be solved by reducing non-value added time, such as waiting time and idle time. The proposed results of controlling the assembly line of Tailboom result in a smooth assembly line without waiting, reduced lead time, and achieving production time according to the schedule agreed with the consumers.

Keywords: kanban, e-Kanban, lead time, pull system

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6152 Comparison of Cardiometabolic Risk Factors in Lean Versus Overweight/Obese Peri-Urban Female Adolescent School Learners in Mthatha, South Africa: A Pilot Case Control Study

Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

Abstract:

Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

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6151 Driving towards Better Health: A Cross-Sectional Study of the Prevalence and Correlates of Obesity among Commercial Drivers in East London, South Africa

Authors: Daniel Ter Goon, Aanuoluwa O. Adedokun, Eyitayo Omolara Owolabi, Oladele Vincent Adeniyi, Anthony Idowu Ajayi

Abstract:

Background: The unhealthy food choices and sedentary lifestyle of commercial drivers predisposes them to obesity and obesity related diseases. Yet, no attention has been paid to obesity burden among this high risk group in South Africa. This study examines the prevalence of obesity and its risk factors among commercial drivers in East London, South Africa. Methods: This cross-sectional study utilized the WHO STEP wise approach to screen for obesity among 403 drivers in Buffalo City Metropolitan Municipality (BCMM), South Africa. Anthropometric, blood pressure and blood glucose measurements were taken following a standard procedure. Overweight and obesity was defined as a body mass index (BMI) of 25.0 kgm⁻²–29.9 kg/m² and≥ 30 kg/ m², respectively. Bivariate and multivariate analysis were used to determine the prevalence and determinants of obesity. Result: The mean age of the participants was 43.3 (SD12.5) years, mean height (cm) and weight (kg) were 170.1(6.2cm) and 83(SD18.7), respectively. The prevalence of overweight and obesity was 34.0% and 38.0%, respectively. After adjusting for confounding factors, only age (OR 1.6, CI 1.0-2.7), hypertension (OR 3.6, CI 2.3-5.7) and non-smoking (OR 2.0, CI 1.3-3.1) were independent predictors of obesity. Conclusion: The prevalence of overweight and obesity is high among commercial drivers. Age, hypertension, and non-smoking were independent predictors of obesity among the sample. Measures aimed at promoting health and reducing obesity should be prioritized among this group.

Keywords: obesity and overweight, commercial taxi drivers, risk factors, South Africa

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6150 Clinical and Sleep Features in an Australian Population Diagnosed with Mild Cognitive Impairment

Authors: Sadie Khorramnia, Asha Bonney, Kate Galloway, Andrew Kyoong

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Sleep plays a pivotal role in the registration and consolidation of memory. Multiple observational studies have demonstrated that self-reported sleep duration and sleep quality are associated with cognitive performance. Montreal Cognitive Assessment questionnaire is a screening tool to assess mild cognitive (MCI) impairment with a 90% diagnostic sensitivity. In our current study, we used MOCA to identify MCI in patients who underwent sleep study in our sleep department. We then looked at the clinical risk factors and sleep-related parameters in subjects found to have mild cognitive impairment but without a diagnosis of sleep-disordered breathing. Clinical risk factors, including physician, diagnosed hypertension, diabetes, and depression and sleep-related parameters, measured during sleep study, including percentage time of each sleep stage, total sleep time, awakenings, sleep efficiency, apnoea hypopnoea index, and oxygen saturation, were evaluated. A total of 90 subjects who underwent sleep study between March 2019 and October 2019 were included. Currently, there is no pharmacotherapy available for MCI; therefore, identifying the risk factors and attempting to reverse or mitigate their effect is pivotal in slowing down the rate of cognitive deterioration. Further characterization of sleep parameters in this group of patients could open up opportunities for potentially beneficial interventions.

Keywords: apnoea hypopnea index, mild cognitive impairment, sleep architecture, sleep study

Procedia PDF Downloads 132