Search results for: major adverse cardiac events
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10565

Search results for: major adverse cardiac events

8735 Customer Relationship Management - “Is It a Myth or a Reality in Indian Consumer Context”

Authors: Manish Manohar Hingorani

Abstract:

The purpose of the research is to find out the level of understanding, adoption, and implementation of CRM in Indian Businesses, either product/ service and the processes which should be followed to ensure minimal to no customer churn and further enhance loyalty. The study used comprehensive qualitative interviews of 36 respondents across mid and senior-level management in product and services organizations of Indian origin. The findings of the study exhibit a gap between the understanding, adoption and implementation of CRM in the Indian context. Different Industries have attributed different levels of understanding, adoption, and limited implementation studies on CRM to the Indian context exists in different industries, but studies related to the consequences of not understanding the true meaning of CRM at the grass root level and further than on non-adoption and non-implementation will have an adverse effect on the customer loyalty, and customer satisfaction leading to customer churn. As this was a qualitative approach, the analysis was content-based and discourse based. The responses were taken from mid to very-senior management decision-makers in organizations of Indian origin.

Keywords: customer relationship management, Indian consumer, customer loyalty, customer experience, customer satisfaction

Procedia PDF Downloads 95
8734 Developing an IT Management Policy: A Proposal

Authors: Robert Gilliland

Abstract:

In any organization, a potential issue can arise and become a problem when management deviates from the standard norms set in the system development process of an IT system and the policies that pertain to it. In these instances, cybersecurity is a big challenge that organizations have to face in safeguarding the data that they generate and use. When a new idea, task, or process begins, specific standards must be followed, along with the policies and procedures that ensure the safeguard of data in the information system within the company. A good IT Strategy and Policy should have individuals who are in charge of overseeing the design, development, implementation, and auditing of these policies. Auditors are people who check to make sure that the issue conforms with the plan that is in place. Management has the ability through the role of the manager to potentially abuse power is given and to direct specific ideas, events, projects, and outcomes that are contrary to the vision or goals of the company.

Keywords: strategic policy, policy management, new policy, strategic planning

Procedia PDF Downloads 136
8733 Furnishing Ancillary Alternatives for High Speed Corridors and Pedestrian Crossing: Elevated Cycle Track, an Expedient to Urban Space Prototype in New Delhi

Authors: Suneet Jagdev, Hrishabh Amrodia, Siddharth Menon, Abhishek Singh, Mansi Shivhare

Abstract:

Delhi, the National Capital, has undergone a surge in development rate, consequently engendering an unprecedented increase in population. Over the years the city has transformed into a car-centric infrastructure with high-speed corridors, flyovers and fast lanes. A considerable section of the population is hankering to rehabilitate to the good old cycling days, in order to contribute towards a green environment as well as to maintain their physical well-being. Furthermore, an extant section of Delhi’s population relies on cycles as their primary means of commuting in the city. Delhi has the highest number of cyclists and second highest number of pedestrians in the country. However, the tumultuous problems of unregulated traffic, inadequate space on roads, adverse weather conditions stifle them to opt for cycling. Lately, the city has been facing a conglomeration of problems such as haphazard traffic movement, clogged roads, congestion, pollution, accidents, safety issues, etc. In 1957, Delhi’s cyclists accounted for 36 per cent of trips which dropped down to a mere 4 per cent in 2008. The declining rate is due to unsafe roads and lack of proper cycle lanes. Now as the 10 percent of the city has cycle tracks. There is also a lack of public recreational activities in the city. These conundrums incite the need of a covered elevated cycling bridge track to facilitate the safe and smooth cycle commutation in the city which would also serve the purpose of an alternate urban public space over the cycle bridge reducing the cost as well as the space requirement for the same, developing a user–friendly transportation and public interaction system for urban areas in the city. Based on the archival research methodologies, the following research draws information and extracts records from the data accounts of the Delhi Metro Rail Corporation Ltd. as well as the Centre for Science and Environment, India. This research will predominantly focus on developing a prototype design for high speed elevated bicycle lanes based on different road typologies, which can be replicated with minor variations in similar situations, all across the major cities of our country including the proposed smart cities. Furthermore, how these cycling lanes could be utilized for the place making process accommodating cycle parking and renting spaces, public recreational spaces, food courts as well as convenient shopping facilities with appropriate optimization. How to preserve and increase the share of smooth and safe cycling commute cycling for the routine transportation of the urban community of the polluted capital which has been on a steady decline over the past few decades.

Keywords: bicycle track, prototype, road safety, urban spaces

Procedia PDF Downloads 161
8732 The Effectiveness of Psychosocial Interventions for Survivors of Natural Disasters: A Systematic Review

Authors: Santhani M. Selveindran

Abstract:

Background: Natural disasters are traumatic global events that are becoming increasing more common, with significant psychosocial impact on survivors. This impact results not only in psychosocial distress but, for many, can lead to psychosocial disorders and chronic psychopathology. While there are currently available interventions that seek to prevent and treat these psychosocial sequelae, their effectiveness is uncertain. The evidence-base is emerging with more primary studies evaluating the effectiveness of various psychosocial interventions for survivors of natural disasters, which remains to be synthesized. Aim of Review: To identify, critically appraise and synthesize the current evidence-base on the effectiveness of psychosocial interventions in preventing or treating Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD) in adults and children who are survivors of natural disasters. Methods: A protocol was developed as a guide to carry out this review. A systematic search was conducted in eight international electronic databases, three grey literature databases, one dissertation and thesis repository, websites of six humanitarian and non-governmental organizations renowned for their work on natural disasters, as well as bibliographic and citation searching for eligible articles. Papers meeting the specific inclusion criteria underwent quality assessment using the Downs and Black checklist. Data were extracted from the included papers and analysed by way of narrative synthesis. Results: Database and website searching returned 3777 papers where 31 met the criteria for inclusion. Additional 2 papers were obtained through bibliographic and citation searching. Methodological quality of most papers was fair. Twenty-five studies evaluated psychological interventions, five, social interventions whereas three studies evaluated ‘mixed’ psychological and social interventions. All studies, irrespective of methodological quality, reported post-intervention reductions in symptom scores for PTSD, depression and/or anxiety and where assessed, reduced diagnosis of PTSD and MDD, and produced improvements in self-efficacy and quality of life. Statistically significant results were seen in 27 studies. However, three studies demonstrated that the evaluated interventions may not have been very beneficial. Conclusions: The overall positive results suggest that any psychosocial interventions are favourable and should be delivered to all natural disaster survivors, irrespective of age, country, and phase of disaster. Yet, heterogeneity and methodological shortcomings of the current evidence-base makes it difficult to draw definite conclusions needed to formulate categorical guidance or frameworks. Further, rigorously conducted research is needed in this area, although the feasibility of such, given the context and nature of the problem, is also recognized.

Keywords: psychosocial interventions, natural disasters, survivors, effectiveness

Procedia PDF Downloads 155
8731 Protective Effect of hsa-miR-124 against to Bacillus anthracis Toxins on Human Macrophage Cells

Authors: Ali Oztuna, Meral Sarper, Deniz Torun, Fatma Bayrakdar, Selcuk Kilic, Mehmet Baysallar

Abstract:

Bacillus anthracis is one of the biological agents most likely to be used in case of bioterrorist attack as well as being the cause of anthrax. The bacterium's major virulence factors are the anthrax toxins and an antiphagocytic polyglutamic capsule. TEM8 (ANTXR1) and CMG2 (ANTXR2) are ubiquitously expressed type I transmembrane proteins, and ANTXR2 is the major receptor for anthrax toxins. MicroRNAs are 21-24 bp small noncoding RNAs that regulate gene expression by base pairing with the 3' UTR (untranslated regions) of their target mRNAs resulting in mRNA degradation and/or translational repression. MicroRNAs contribute to regulation of most biological processes and influence numerous pathological states like infectious disease. In this study, post-exposure (toxins) protective effect of the hsa-miR-124-3p against Bacillus anthracis was examined. In this context, i) THP-1 and U937 cells were differentiated to MΦ macrophage, ii) miRNA transfection efficiencies were evaluated by flow cytometry and qPCR, iii) protection against Bacillus anthracis toxins were investigated by XTT, cAMP ELISA and MEK2 cleavage assays. Acknowledgements: This work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Grant SBAG-218S467.

Keywords: ANTXR2, hsa-miR-124-3p, MΦ macrophage, THP-1, U937

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8730 The Contribution of Translation to Arabic and Islamic Civilization during the Golden Age (661–1258)

Authors: Smail Hadj Mahammed

Abstract:

Translation is not merely a process of conveying the meaning from one particular language into another to overcome language barriers and ensure a good understanding; it is also a work of civilization and progress. Without the translation of Greek, Indian and Persian works, Arabic and Islamic Civilization would not have taken off, and without the translations of Arabic works into Latin, and then into European languages, the scientific and technological revolution of the modern world would not have taken place. In this context, the present paper seeks to investigate how the translation movement contributed to the Arabic and Islamic Civilizations during the Golden Age. The research paper consists of three major parts: the first part provides a brief historical overview of the translation movement during the golden age, which witnessed two important eras: the Umayyad and Abbasid eras. The second part shows the main reasons why translation was a prominent cultural activity during the Golden Age and why it gained great interest from the Arabs. The last part highlights the constructive contribution of translation to the Arabic and Islamic Civilization during the period (661–1258). The results demonstrate that Arabic translation movement was unprecedented in the transmission of knowledge in the whole history of humankind and that translation during the Golden Age had significantly assisted in enriching the Arabic and Islamic civilizations, which had absorbed major and important scientific works of old Greek, Indian and Persian civilizations.

Keywords: Arabic and Islamic civilization, contribution, golden age, translation

Procedia PDF Downloads 112
8729 Uses of Fibrinogen Concentrate in the Management of Trauma-Induced Coagulopathy in the Prehospital Environment: A Scoping Review

Authors: Nura Khattab, Fayad Al-Haimus, Teruko Kishibe, Netanel Krugliak, Melissa McGowan, Brodie Nolan

Abstract:

Trauma-induced coagulopathy remains a significant contributor to mortality in severely injured patients. Fibrinogen is essential for early hemostasis and is recognized as the first coagulation factor to fall below critical levels, compromising the coagulation cascade. Early administration of fibrinogen concentrate may be feasible and effective to prevent coagulopathy. We conducted this scoping review to characterize the existing quantity of literature, and to explore the usage of prehospital fibrinogen concentrate products in improving clinical outcomes in trauma patients. Methods: A search strategy was developed in consultation with an information specialist. We searched MEDLINE, Embase, Cochrane, and Scopus from inception to May 6th 2024. English studies evaluating prehospital/military usage of fibrinogen concentrate in trauma patients were included. Studies were assessed by three independent reviewers for meeting inclusion and exclusion criteria. Reference lists of included articles were reviewed to identify additional studies meeting inclusion criteria. Clinical endpoints regarding fibrinogen concentrate were extracted and synthesized. Results: The literature search returned 1301 articles with seven studies meeting the inclusion criteria. Five studies (71%) were conducted in civilian settings and two studies (29%) were conducted in military settings. Of the included studies, three (43%) utilized a randomized control trial. We identified seven outcomes that compared varying concentrations of fibrinogen or fibrinogen concentrate to a placebo group. The outcomes included overall mortality, death from hemorrhage, thromboembolic events, clotting time, maximum clot firmness, clot stability at ER admission, and fibrinogen concentration at ER admission. Apart from thromboembolic events, all other reported outcomes showed statistically significant differences in group comparisons, determined using p values. The four (57%) non-clinical studies underscored the robustness, practicality, and degree of fibrinogen concentrate utilization in military environments and retrieval services. Conclusion: Preliminary research suggests that prehospital fibrinogen concentrate administration in traumatic bleeding patients is both feasible and effective, improving mortality and clotting parameters. While implementing a time-saving and proactive approach with fibrinogen holds potential for enhancing trauma care, the current evidence is limited. Further studies in this novel field are warranted.

Keywords: fibrinogen concentrate, prehospital, military, trauma, trauma-induced coagulopathy

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8728 Exploiting the Tumour Microenvironment in Order to Optimise Sonodynamic Therapy for Cancer

Authors: Maryam Mohammad Hadi, Heather Nesbitt, Hamzah Masood, Hashim Ahmed, Mark Emberton, John Callan, Alexander MacRobert, Anthony McHale, Nikolitsa Nomikou

Abstract:

Sonodynamic therapy (SDT) utilises ultrasound in combination with sensitizers, such as porphyrins, for the production of cytotoxic reactive oxygen species (ROS) and the confined ablation of tumours. Ultrasound can be applied locally, and the acoustic waves, at frequencies between 0.5-2 MHz, are transmitted efficiently through tissue. SDT does not require highly toxic agents, and the cytotoxic effect only occurs upon ultrasound exposure at the site of the lesion. Therefore, this approach is not associated with adverse side effects. Further highlighting the benefits of SDT, no cancer cell population has shown resistance to therapy-triggered ROS production or their cytotoxic effects. This is particularly important, given the as yet unresolved issues of radiation and chemo-resistance, to the authors’ best knowledge. Another potential future benefit of this approach – considering its non-thermal mechanism of action – is its possible role as an adjuvant to immunotherapy. Substantial pre-clinical studies have demonstrated the efficacy and targeting capability of this therapeutic approach. However, SDT has yet to be fully characterised and appropriately exploited for the treatment of cancer. In this study, a formulation based on multistimulus-responsive sensitizer-containing nanoparticles that can accumulate in advanced prostate tumours and increase the therapeutic efficacy of SDT has been developed. The formulation is based on a polyglutamate-tyrosine (PGATyr) co-polymer carrying hematoporphyrin. The efficacy of SDT in this study was demonstrated using prostate cancer as the translational exemplar. The formulation was designed to respond to the microenvironment of advanced prostate tumours, such as the overexpression of the proteolytic enzymes, cathepsin-B and prostate-specific membrane antigen (PSMA), that can degrade the nanoparticles, reduce their size, improving both diffusions throughout the tumour mass and cellular uptake. The therapeutic modality was initially tested in vitro using LNCaP and PC3 cells as target cell lines. The SDT efficacy was also examined in vivo, using male SCID mice bearing LNCaP subcutaneous tumours. We have demonstrated that the PGATyr co-polymer is digested by cathepsin B and that digestion of the formulation by cathepsin-B, at tumour-mimicking conditions (acidic pH), leads to decreased nanoparticle size and subsequent increased cellular uptake. Sonodynamic treatment, at both normoxic and hypoxic conditions, demonstrated ultrasound-induced cytotoxic effects only for the nanoparticle-treated prostate cancer cells, while the toxicity of the formulation in the absence of ultrasound was minimal. Our in vivo studies in immunodeficient mice, using the hematoporphyrin-containing PGATyr nanoparticles for SDT, showed a 50% decrease in LNCaP tumour volumes within 24h, following IV administration of a single dose. No adverse effects were recorded, and body weight was stable. The results described in this study clearly demonstrate the promise of SDT to revolutionize cancer treatment. It emphasizes the potential of this therapeutic modality as a fist line treatment or in combination treatment for the elimination or downstaging of difficult to treat cancers, such as prostate, pancreatic, and advanced colorectal cancer.

Keywords: sonodynamic therapy, nanoparticles, tumour ablation, ultrasound

Procedia PDF Downloads 138
8727 A New Approach to Retrofit Steel Moment Resisting Frame Structures after Mainshock

Authors: Amir H. Farivarrad, Kiarash M. Dolatshahi

Abstract:

During earthquake events, aftershocks can significantly increase the probability of collapse of buildings, especially for those with induced damages during the mainshock. In this paper, a practical approach is proposed for seismic rehabilitation of mainshock-damaged buildings that can be easily implemented within few days after the mainshock. To show the efficacy of the proposed method, a case study nine story steel moment frame building is chosen which was designed to pre-Northridge codes. The collapse fragility curve for the aftershock is presented for both the retrofitted and non-retrofitted structures. Comparison of the collapse fragility curves shows that the proposed method is indeed applicable to reduce the seismic collapse risk.

Keywords: aftershock, the collapse fragility curve, seismic rehabilitation, seismic retrofitting

Procedia PDF Downloads 433
8726 Compromising Relevance for Elegance: A Danger of Dominant Growth Models for Backward Economies

Authors: Givi Kupatadze

Abstract:

Backward economies are facing a challenge of achieving sustainable high economic growth rate. Dominant growth models represent a roadmap in framing economic development strategy. This paper examines a relevance of the dominant growth models for backward economies. Cobb-Douglas production function, the Harrod-Domar model of economic growth, the Solow growth model and general formula of gross domestic product are examined to undertake a comprehensive study of the dominant growth models. Deductive research method allows to uncover major weaknesses of the dominant growth models and to come up with practical implications for economic development strategy. The key finding of the paper shows, contrary to what used to be taught by textbooks of economics, that constant returns to scale property of the dominant growth models are a mere coincidence and its generalization over space and time can be regarded as one of the most unfortunate mistakes in the whole field of political economy. The major suggestion of the paper for backward economies is that understanding and considering taxonomy of economic activities based on increasing and diminishing returns to scale represent a cornerstone of successful economic development strategy.

Keywords: backward economies, constant returns to scale, dominant growth models, taxonomy of economic activities

Procedia PDF Downloads 375
8725 An Assessment of Rice Yield Improvement Among Smallholder Rice Farmers in Asunafo North Municipality of Ghana

Authors: Isaac Diaka, Matsui Kenichi

Abstract:

Ghana’s rice production has increased mainly because of increased cultivated areas. On this point, scholars who promoted crop production increase for food security have overlooked the fact that its per-acre yield has not increased. Also, Ghana’s domestic rice production has not contributed much to domestic rice consumption especially in major cities where consumers tend to rely on imported rice from Asia. Considering these points, the paper seeks to understand why smallholder rice farmers have not been able to increase per acre rice yield. It also examines smallholder rice farmers’ rice yield improvement needs, and the relationship that exist between rice farmers’ socioeconomic factors and their yield levels by rice varieties. The study adopted a simple random sampling technique to select 154 rice farmers for a questionnaire survey between October and November 2020. The data was analyzed by performing a correlation analysis, an independent t-test, and Kendall’s coefficient of concordance. The results showed that 58.4% of the respondents cultivated popular high-yield varieties like AGRA and Jasmine. The rest used local varieties. Regarding respondents’ yield differentials, AGRA and Jasmine had an average yield of 2.6 mt/ha, which is higher than that of local varieties (1.6mt/ha). The study found untimely availability of improved seed varieties and high cost of inputs some of the major reasons affecting yield in the area. For respondents’ yield improvement needs, Kendall’s coefficient of concordance showed that access to improved varieties, irrigation infrastructure, and row planting were respondents’ major technological needs. As to their non-technological needs, the respondents needed timely information about rice production, access to credit support options, and extension services. The correlation analysis revealed that farm size and off-farm income exhibited a positive and negative association towards respondents’ yield level, respectively. This paper then discusses recommendations for providing with improved rice production technologies to farmers.

Keywords: Ghana, rice, smallholder farmers, yield improvement.

Procedia PDF Downloads 93
8724 Composition, Velocity, and Mass of Projectiles Generated from a Chain Shot Event

Authors: Eric Shannon, Mark J. McGuire, John P. Parmigiani

Abstract:

A hazard associated with the use of timber harvesters is chain shot. Harvester saw chain is subjected to large dynamic mechanical stresses which can cause it to fracture. The resulting open loop of saw chain can fracture a second time and create a projectile consisting of several saw-chain links referred to as a chain shot. Its high kinetic energy enables it to penetrate operator enclosures and be a significant hazard. Accurate data on projectile composition, mass, and speed are needed for the design of both operator enclosures resistant to projectile penetration and for saw chain resistant to fracture. The work presented here contributes to providing this data through the use of a test machine designed and built at Oregon State University. The machine’s enclosure is a standard shipping container. To safely contain any anticipated chain shot, the container was lined with both 9.5 mm AR500 steel plates and 50 mm high-density polyethylene (HDPE). During normal operation, projectiles are captured virtually undamaged in the HDPE enabling subsequent analysis. Standard harvester components are used for bar mounting and chain tensioning. Standard guide bars and saw chains are used. An electric motor with flywheel drives the system. Testing procedures follow ISO Standard 11837. Chain speed at break was approximately 45.5 m/s. Data was collected using both a 75 cm solid bar (Oregon 752HSFB149) and 90 cm solid bar (Oregon 902HSFB149). Saw chains used were 89 Drive Link .404”-18HX loops made from factory spools. Standard 16-tooth sprockets were used. Projectile speed was measured using both a high-speed camera and a chronograph. Both rotational and translational kinetic energy are calculated. For this study 50 chain shot events were executed. Results showed that projectiles consisted of a variety combinations of drive links, tie straps, and cutter links. Most common (occurring in 60% of the events) was a drive-link / tie-strap / drive-link combination having a mass of approximately 10.33 g. Projectile mass varied from a minimum of 2.99 g corresponding to a drive link only to a maximum of 18.91 g corresponding to a drive-link / tie-strap / drive-link / cutter-link / drive-link combination. Projectile translational speed was measured to be approximately 270 m/s and rotational speed of approximately 14000 r/s. The calculated translational and rotational kinetic energy magnitudes each average over 600 J. This study provides useful information for both timber harvester manufacturers and saw chain manufacturers to design products that reduce the hazards associated with timber harvesting.

Keywords: chain shot, timber harvesters, safety, testing

Procedia PDF Downloads 147
8723 Applying the View of Cognitive Linguistics on Teaching and Learning English at UFLS - UDN

Authors: Tran Thi Thuy Oanh, Nguyen Ngoc Bao Tran

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In the view of Cognitive Linguistics (CL), knowledge and experience of things and events are used by human beings in expressing concepts, especially in their daily life. The human conceptual system is considered to be fundamentally metaphorical in nature. It is also said that the way we think, what we experience, and what we do everyday is very much a matter of language. In fact, language is an integral factor of cognition in that CL is a family of broadly compatible theoretical approaches sharing the fundamental assumption. The relationship between language and thought, of course, has been addressed by many scholars. CL, however, strongly emphasizes specific features of this relation. By experiencing, we receive knowledge of lives. The partial things are ideal domains, we make use of all aspects of this domain in metaphorically understanding abstract targets. The paper refered to applying this theory on pragmatics lessons for major English students at University of Foreign Language Studies - The University of Da Nang, Viet Nam. We conducted the study with two third – year students groups studying English pragmatics lessons. To clarify this study, the data from these two classes were collected for analyzing linguistic perspectives in the view of CL and traditional concepts. Descriptive, analytic, synthetic, comparative, and contrastive methods were employed to analyze data from 50 students undergoing English pragmatics lessons. The two groups were taught how to transfer the meanings of expressions in daily life with the view of CL and one group used the traditional view for that. The research indicated that both ways had a significant influence on students' English translating and interpreting abilities. However, the traditional way had little effect on students' understanding, but the CL view had a considerable impact. The study compared CL and traditional teaching approaches to identify benefits and challenges associated with incorporating CL into the curriculum. It seeks to extend CL concepts by analyzing metaphorical expressions in daily conversations, offering insights into how CL can enhance language learning. The findings shed light on the effectiveness of applying CL in teaching and learning English pragmatics. They highlight the advantages of using metaphorical expressions from daily life to facilitate understanding and explore how CL can enhance cognitive processes in language learning in general and teaching English pragmatics to third-year students at the UFLS - UDN, Vietnam in personal. The study contributes to the theoretical understanding of the relationship between language, cognition, and learning. By emphasizing the metaphorical nature of human conceptual systems, it offers insights into how CL can enrich language teaching practices and enhance students' comprehension of abstract concepts.

Keywords: cognitive linguisitcs, lakoff and johnson, pragmatics, UFLS

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8722 Consultation Time and Its Impact on Length of Stay in the Emergency Department

Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

Abstract:

Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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8721 Climate Change and Extreme Weather: Understanding Interconnections and Implications

Authors: Johnstone Walubengo Wangusi

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Climate change is undeniably altering the frequency, intensity, and geographic distribution of extreme weather events worldwide. In this paper, we explore the complex interconnections between climate change and extreme weather phenomena, drawing upon research from atmospheric science, geology, and climatology. We examine the underlying mechanisms driving these changes, the impacts on natural ecosystems and human societies, and strategies for adaptation and mitigation. By synthesizing insights from interdisciplinary research, this paper aims to provide a comprehensive understanding of the multifaceted relationship between climate change and extreme weather, informing efforts to address the challenges posed by a changing climate.

Keywords: climate change, extreme weather, atmospheric science, geology, climatology, impacts, adaptation, mitigation

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8720 Harnessing the Potential of Renewable Energy Sources to Reduce Fossil Energy Consumption in the Wastewater Treatment Process

Authors: Hen Friman

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Various categories of aqueous solutions are discharged within residential, institutional, commercial, and industrial structures. To safeguard public health and preserve the environment, it is imperative to subject wastewater to treatment processes that eliminate pathogens (such as bacteria and viruses), nutrients (such as nitrogen and phosphorus), and other compounds. Failure to address untreated sewage accumulation can result in an array of adverse consequences. Israel exemplifies a special case in wastewater management. Appropriate wastewater treatment significantly benefits sectors such as agriculture, tourism, horticulture, and industry. Nevertheless, untreated sewage in settlements lacking proper sewage collection or transportation networks remains an ongoing and substantial threat. Notably, the process of wastewater treatment entails substantial energy consumption. Consequently, this study explores the integration of solar energy as a renewable power source within the wastewater treatment framework. By incorporating renewable energy sources into the process, costs can be minimized, and decentralized facilities can be established even in areas lacking adequate infrastructure for traditional treatment methods.

Keywords: renewable energy, solar energy, innovative, wastewater treatment

Procedia PDF Downloads 108
8719 Regional Analysis of Freight Movement by Vehicle Classification

Authors: Katerina Koliou, Scott Parr, Evangelos Kaisar

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The surface transportation of freight is particularly vulnerable to storm and hurricane disasters, while at the same time, it is the primary transportation mode for delivering medical supplies, fuel, water, and other essential goods. To better plan for commercial vehicles during an evacuation, it is necessary to understand how these vehicles travel during an evacuation and determine if this travel is different from the general public. The research investigation used Florida's statewide continuous-count station traffic volumes, where then compared between years, to identify locations where traffic was moving differently during the evacuation. The data was then used to identify days on which traffic was significantly different between years. While the literature on auto-based evacuations is extensive, the consideration of freight travel is lacking. To better plan for commercial vehicles during an evacuation, it is necessary to understand how these vehicles travel during an evacuation and determine if this travel is different from the general public. The goal of this research was to investigate the movement of vehicles by classification, with an emphasis on freight during two major evacuation events: hurricanes Irma (2017) and Michael (2018). The methodology of the research was divided into three phases: data collection and management, spatial analysis, and temporal comparisons. Data collection and management obtained continuous-co station data from the state of Florida for both 2017 and 2018 by vehicle classification. The data was then processed into a manageable format. The second phase used geographic information systems (GIS) to display where and when traffic varied across the state. The third and final phase was a quantitative investigation into which vehicle classifications were statistically different and on which dates statewide. This phase used a two-sample, two-tailed t-test to compare sensor volume by classification on similar days between years. Overall, increases in freight movement between years prevented a more precise paired analysis. This research sought to identify where and when different classes of vehicles were traveling leading up to hurricane landfall and post-storm reentry. Of the more significant findings, the research results showed that commercial-use vehicles may have underutilized rest areas during the evacuation, or perhaps these rest areas were closed. This may suggest that truckers are driving longer distances and possibly longer hours before hurricanes. Another significant finding of this research was that changes in traffic patterns for commercial-use vehicles occurred earlier and lasted longer than changes for personal-use vehicles. This finding suggests that commercial vehicles are perhaps evacuating in a fashion different from personal use vehicles. This paper may serve as the foundation for future research into commercial travel during evacuations and explore additional factors that may influence freight movements during evacuations.

Keywords: evacuation, freight, travel time, evacuation

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8718 Autonomous Flight Performance Improvement of Load-Carrying Unmanned Aerial Vehicles by Active Morphing

Authors: Tugrul Oktay, Mehmet Konar, Mohamed Abdallah Mohamed, Murat Aydin, Firat Sal, Murat Onay, Mustafa Soylak

Abstract:

In this paper, it is aimed to improve autonomous flight performance of a load-carrying (payload: 3 kg and total: 6kg) unmanned aerial vehicle (UAV) through active wing and horizontal tail active morphing and also integrated autopilot system parameters (i.e. P, I, D gains) and UAV parameters (i.e. extension ratios of wing and horizontal tail during flight) design. For this purpose, a loadcarrying UAV (i.e. ZANKA-II) is manufactured in Erciyes University, College of Aviation, Model Aircraft Laboratory is benefited. Optimum values of UAV parameters and autopilot parameters are obtained using a stochastic optimization method. Using this approach autonomous flight performance of UAV is substantially improved and also in some adverse weather conditions an opportunity for safe flight is satisfied. Active morphing and integrated design approach gives confidence, high performance and easy-utility request of UAV users.

Keywords: unmanned aerial vehicles, morphing, autopilots, autonomous performance

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8717 Organizational Ideologies and Their Embeddedness in Fashion Show Productions in Shanghai and London Fashion Week: International-Based-Chinese Independent Designers' Participatory Behaviors in Different Fashion Cities

Authors: Zhe Wang

Abstract:

The fashion week, as a critical international fashion event in shaping world fashion cities, is one of the most significant world events that serves as the core medium for designers to stage new collections. However, its role in bringing about and shaping design ideologies of major fashion cities have long been neglected from a fashion ecosystem perspective. With the expanding scale of international fashion weeks in terms of culture and commerce, the organizational structures of these fashion weeks are becoming more complex. In the emerging fashion city, typified by Shanghai, a newly-formed 'hodgepodge' transforming the current global fashion ecosystem. A city’s legitimate fashion institutions, typically the organizers of international fashion weeks, have cultivated various cultural characteristics via rules and regulations pertaining to international fashion weeks. Under these circumstances, designers’ participatory behaviors, specifically show design and production, are influenced by the cultural ideologies of official organizers and institutions. This research compares international based Chinese (IBC) independent designers’ participatory behavior in London and Shanghai Fashion Weeks: specifically, the way designers present their clothing and show production. both of which are found to be profoundly influenced by cultural and design ideologies of fashion weeks. They are, to a large degree, manipulated by domestic institutions and organizers. Shanghai fashion week has given rise to a multiple, mass-ended entertainment carnival design and cultural ideology in Shanghai, thereby impacting the explicit cultural codes or intangible rules that IBC designers must adhere to when designing and producing fashion shows. Therefore, influenced by various cultural characteristics in the two cities, IBC designers’ show design and productions, in turn, play an increasingly vital role in shaping the design characteristic of an international fashion week. Through researching the organizational systems and design preferences of organizers of London and Shanghai fashion weeks, this paper demonstrates the embeddedness of design systems in the forming of design ideologies under various cultural and institutional contexts. The core methodology utilized in this research is ethnography. As a crucial part of a Ph.D. project on innovations in fashion shows under a cross-cultural context run by Edinburgh College of Art, School of Design, the fashion week’s organizational culture in various cultural contexts is investigated in London and Shanghai for approximately six months respectively. Two IBC designers, Angel Chen and Xuzhi Chen were followed during their participation of London and Shanghai Fashion Weeks from September 2016 to June 2017, during which two consecutive seasons were researched in order to verify the consistency of design ideologies’ associations with organizational system and culture.

Keywords: institutional ideologies, international fashion weeks, IBC independent designers; fashion show

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8716 Historical Analysis of Nigeria Politics, 1960–2010

Authors: Abdulsalami Muyideen Deji

Abstract:

Nigeria as nation got independence in 1960 from British government which allowed indigenous people to form self-government and rule themselves base on the acceptable laws and orders provided by indigenes. All citizens saw it as a welcome development that gave them opportunity to develop at their own pace. Certainly, this occurred at the first instance up to the first republic of 1963. But things became worse for the country when the first military coup of January 15, 1966 sowed apple of discord between the three major tribes in Nigeria Hausa, Yoruba and Igbo as a result of miscarriage of well-conceived plan of master-minder of that coup Major Chukwuma Kaduna Nzeogwu. Although, the argument had emanated from different quarters that if Nigeria was given opportunity to develop at the pace it was going at that time probably the Nigeria would have been among developed nation today, but that ill-fated coup was a clog in the wheel of nation’s progress. The base of this argument is that Nigeria achievements after independence still depend on the work of leaders who secure independence and also directed the affairs of nation within that short period of time up till today. Since then Nigeria has been grasping with different system of government, yet, the nation is still far from the solution. This paper will analyze Nigeria politics from independence, offer suggestion on the way forward. The source is strictly base on secondary source from textbook, newspapers, internet and journals.

Keywords: politics, government, independence, development

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8715 Machine Learning Techniques for Estimating Ground Motion Parameters

Authors: Farid Khosravikia, Patricia Clayton

Abstract:

The main objective of this study is to evaluate the advantages and disadvantages of various machine learning techniques in forecasting ground-motion intensity measures given source characteristics, source-to-site distance, and local site condition. Intensity measures such as peak ground acceleration and velocity (PGA and PGV, respectively) as well as 5% damped elastic pseudospectral accelerations at different periods (PSA), are indicators of the strength of shaking at the ground surface. Estimating these variables for future earthquake events is a key step in seismic hazard assessment and potentially subsequent risk assessment of different types of structures. Typically, linear regression-based models, with pre-defined equations and coefficients, are used in ground motion prediction. However, due to the restrictions of the linear regression methods, such models may not capture more complex nonlinear behaviors that exist in the data. Thus, this study comparatively investigates potential benefits from employing other machine learning techniques as a statistical method in ground motion prediction such as Artificial Neural Network, Random Forest, and Support Vector Machine. The algorithms are adjusted to quantify event-to-event and site-to-site variability of the ground motions by implementing them as random effects in the proposed models to reduce the aleatory uncertainty. All the algorithms are trained using a selected database of 4,528 ground-motions, including 376 seismic events with magnitude 3 to 5.8, recorded over the hypocentral distance range of 4 to 500 km in Oklahoma, Kansas, and Texas since 2005. The main reason of the considered database stems from the recent increase in the seismicity rate of these states attributed to petroleum production and wastewater disposal activities, which necessities further investigation in the ground motion models developed for these states. Accuracy of the models in predicting intensity measures, generalization capability of the models for future data, as well as usability of the models are discussed in the evaluation process. The results indicate the algorithms satisfy some physically sound characteristics such as magnitude scaling distance dependency without requiring pre-defined equations or coefficients. Moreover, it is shown that, when sufficient data is available, all the alternative algorithms tend to provide more accurate estimates compared to the conventional linear regression-based method, and particularly, Random Forest outperforms the other algorithms. However, the conventional method is a better tool when limited data is available.

Keywords: artificial neural network, ground-motion models, machine learning, random forest, support vector machine

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8714 Act Local, Think Global: Superior Institute of Engineering of Porto Campaign for a Sustainable Campus

Authors: R. F. Mesquita Brandão

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Act Local, Think Global is the name of a campaign implemented at Superior Institute of Engineering of Porto (ISEP), one of schools of Polytechnic of Porto, with the main objective of increase the sustainability of the campus. ISEP has a campus with 52.000 m2 and more than 7.000 students. The campaign started in 2019 and the results are very clear. In 2019 only 16% of the waste created in the campus was correctly separate for recycling and now almost 50% of waste goes to the correct waste container. Actions to reduce the energy consumption were implemented with significantly results. One of the major problems in the campus are the water leaks. To solve this problem was implemented a methodology for water monitoring during the night, a period of time where consumptions are normally low. If water consumption in the period is higher than a determinate value it may mean a water leak and an alarm is created to the maintenance teams. In terms of energy savings, some measurements were implemented to create savings in energy consumption and in equivalent CO₂ produced. In order to reduce the use of plastics in the campus, was implemented the prohibition of selling 33 cl plastic water bottles and in collaboration with the students association all meals served in the restaurants changed the water plastic bottle for a glass that can be refilled with water in the water dispensers. This measures created a reduction of use of more than 75.000 plastic bottles per year. In parallel was implemented the ISEP water glass bottle to be used in all scientific meetings and events. Has a way of involving all community in sustainability issues was developed and implemented a vertical garden in aquaponic system. In 2019, the first vertical garden without soil was installed inside a large campus building. The system occupies the entire exterior façade (3 floors) of the entrance to ISEP's G building. On each of these floors there is a planter with 42 positions available for plants. Lettuces, strawberries, peppers are examples of some vegetable produced that can be collected by the entire community. Associated to the vertical garden was developed a monitoring system were some parameters of the system are monitored. This project is under development because it will work in a stand-alone energy feeding, with the use of photovoltaic panels for production of energy necessities. All the system was, and still is, developed by students and teachers and is used in class projects of some ISEP courses. These and others measures implemented in the campus, will be more developed in the full paper, as well as all the results obtained, allowed ISEP to be the first Portuguese high school to obtain the certification “Coração Verde” (Green Heart), awarded by LIPOR, a Portuguese company with the mission of transform waste into new resources through the implementation of innovative and circular practices, generating and sharing value.

Keywords: aquaponics, energy efficiency, recycling, sustainability, waste separation

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8713 Short-Term Effects of Environmentally Relevant Concentrations of Organic UV Filters on Signal Crayfish Pacifastacus Leniusculus

Authors: Viktoriia Malinovska, Iryna Kuklina, Katerina Grabicova, Milos Buric, Pavel Kozak

Abstract:

Personal care products, including organic UV filters, are considered emerging contaminants and their toxic effects have been a concern for the last decades. Sunscreen compounds continually enter the surface waters via sewage water treatment due to incomplete removal and during human recreational and laundry activities. Despite the environmental occurrence of organic UV filters in the freshwater environment, little is known about their impacts on aquatic biota. In this study, environmentally relevant concentrations of 5-Benzoyl-4-hydroxy-2-methoxybenzenesulfonic acid (BP-4, 2.5 µg/L) and 2-Phenylbenzimidazole-5-sulfonic acid (PBSA, 3 µg/L) were used to evaluate the cardiac and locomotor responses of signal crayfish Pacifastacus leniusculus during a short time period. The effects of these compounds were evident in experimental animals. Specimens exposed to both tested compounds exhibited significantly bigger changes in distance moved and time movement than controls. Significant differences in changes in mean heart rate were detected in both PBSA and BP-4 experimental groups compared to control groups. Such behavioral and physiological alterations demonstrate the ecological effects of selected sunscreen compounds during a short time period. Since the evidence of the impacts of sunscreen compounds is scarce, the knowledge of how organic UV filters influence aquatic organisms is of key importance for future research.

Keywords: aquatic pollutants, behavior, freshwaters, heart rate, invertebrate

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8712 Harnessing Renewable Energy as a Strategy to Combating Climate Change in Sub Saharan Africa

Authors: Gideon Nyuimbe Gasu

Abstract:

Sub Saharan Africa is at a critical point, experiencing rapid population growth, particularly in urban areas and young growing force. At the same time, the growing risk of catastrophic global climate change threatens to weaken food production system, increase intensity and frequency of drought, flood, and fires and undermine gains on development and poverty reduction. Although the region has the lowest per capital greenhouse gas emission level in the world, it will need to join global efforts to address climate change, including action to avoid significant increases and to encourage a green economy. Thus, there is a need for the concept of 'greening the economy' as was prescribed at Rio Summit of 1992. Renewable energy is one of the criterions to achieve this laudable goal of maintaining a green economy. There is need to address climate change while facilitating continued economic growth and social progress as energy today is critical to economic growth. Fossil fuels remain the major contributor of greenhouse gas emission. Thus, cleaner technologies such as carbon capture storage, renewable energy have emerged to be commercially competitive. This paper sets out to examine how to achieve a low carbon economy with minimal emission of carbon dioxide and other greenhouse gases which is one of the outcomes of implementing a green economy. Also, the paper examines the different renewable energy sources such as nuclear, wind, hydro, biofuel, and solar voltaic as a panacea to the looming climate change menace. Finally, the paper assesses the different renewable energy and energy efficiency as a propeller to generating new sources of income and jobs and in turn reduces carbon emission. The research shall engage qualitative, evaluative and comparative methods. The research will employ both primary and secondary sources of information. The primary sources of information shall be drawn from the sub Saharan African region and the global environmental organizations, energy legislation, policies and related industries and the judicial processes. The secondary sources will be made up of some books, journal articles, commentaries, discussions, observations, explanations, expositions, suggestions, prescriptions and other material sourced from the internet on renewable energy as a panacea to climate change. All information obtained from these sources will be subject to content analysis. The research result will show that the entire planet is warming as a result of the activities of mankind which is clear evidence that the current development is fundamentally unsustainable. Equally, the study will reveal that a low carbon development pathway in the sub Saharan African region should be embraced to minimize emission of greenhouse gases such as using renewable energy rather than coal, oil, and gas. The study concludes that until adequate strategies are devised towards the use of renewable energy the region will continue to add and worsen the current climate change menace and other adverse environmental conditions.

Keywords: carbon dioxide, climate change, legislation/law, renewable energy

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8711 DNA Isolation and Identification of Virulence Factors of Escherichia coli and Salmonella Species Isolated from Fresh Vegetables in Phnom Penh

Authors: Heng Sreyly, Phoeurk Chanrith

Abstract:

Fresh-eaten vegetables have become more popular in the Cambodian diet. However, according to WHO, these vegetables should be one of the main sources of infection if contaminated with pathogenic microorganisms. The outbreaks of foodborne diseases related to fresh fruits and vegetables have been increasingly reported and raised concerns regarding the safety of these products. Therefore, it is very important to conduct the determination of virulence factors Escherichia coli and Salmonella spp. in fresh vegetables. This study aims to identify virulence strains of Escherichia coli and Salmonella species from fresh vegetables, including cucumber (Cucumis sativus), saw-herb (Eryngium foetidum), and lettuce (Lactuca sativa) from different market and supermarket in Phnom Penh. The PCR method was used to detect the virulence strains of each sample. The results indicate that there are ninety five samples containing extracted DNA among one hundred and three samples. Moreover, the virulence strain of E. coli and salmonella have been found in leafy vegetables (lettuce and saw-herb) much more than in fruit vegetables (cucumber). This research is mainly used to raise public awareness of washing fresh vegetables with clean water more carefully to reduce adverse health impacts.

Keywords: DNA, virulence factor, Escherichia coli, Salmonella

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8710 Coping with Climate Change in Agriculture: Perception of Farmers in Oman

Authors: B. S. Choudri

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Introduction: Climate change is a major threat to rural livelihoods and to food security in the developing world, including Oman. The aim of this study is to provide a basis for policymakers and researchers in order to understand the impacts of climate change on agriculture and developing adaptation strategies in Oman. Methodology: The data was collected from different agricultural areas across the country with the help of a questionnaire survey among farmers, discussion with community, and observations at the field level. Results: The analysis of data collected from different areas within the country shows a shift in the sowing period of major crops and increased temperatures over recent years. Farmer community is adopting through diversification of crops, use of heat-tolerant species, and improved measures of soil and water conservation. Agriculture has been the main livelihood for most of the farmer communities in rural areas in the country. Conclusions: In order to reduce the effects of climate change at the local and farmer communities, risk reduction would be important along with an in-depth analysis of the vulnerability. Therefore, capacity building of local farmers and providing them with scientific knowledge, mainstreaming adaptation into development activities would be essential with additional funding and subsidies.

Keywords: agriculture, climate change, vulnerability, adaptation

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8709 Long Term Changes of Water Quality in Latvia

Authors: Maris Klavins, Valery Rodinov

Abstract:

The aim of this study was to analyze long term changes of surface water quality in Latvia, spatial variability of water chemical composition, possible impacts of different pollution sources as well as to analyze the measures to protect national water resources - river basin management. Within this study, the concentrations of major water ingredients and microelements in major rivers and lakes of Latvia have been determined. Metal concentrations in river and lake waters were compared with water chemical composition. The mean concentrations of trace metals in inland waters of Latvia are appreciably lower than the estimated world averages for river waters and close to or lower than background values, unless regional impacts determined by local geochemistry. This may be explained by a comparatively lower level of anthropogenic load. In the same time in several places, direct anthropogenic impacts are evident, regarding influences of point sources both transboundary transport impacts. Also, different processes related to pollution of surface waters in Latvia have been analyzed. At first the analysis of changes and composition of pollutant emissions in Latvia has been realized, and the obtained results were compared with actual composition of atmospheric precipitation and their changes in time.

Keywords: water quality, trend analysis, pollution, human impact

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8708 Speciation and Bioavailability of Heavy Metals in Greenhouse Soils

Authors: Bulent Topcuoglu

Abstract:

Repeated amendments of organic matter and intensive use of fertilizers, metal-enriched chemicals and biocides may cause soil and environmental pollution in greenhouses. Specially, the impact of heavy metal pollution of soils on food metal content and underground water quality has become a public concern. Due to potential toxicity of heavy metals to human life and environment, determining the chemical form of heavy metals in greenhouse soils is an important approach of chemical characterization and can provide useful information on its mobility and bioavailability. A sequential extraction procedure was used to estimate the availability of heavy metals (Zn, Cd, Ni, Pb and Cr) in greenhouse soils of Antalya Aksu. Zn was predominantly associated with Fe-Mn oxide fraction, major portion of Cd associated with carbonate and organic matter fraction, a major portion of (>65 %) Ni and Cr were largely associated with Fe-Mn oxide and residual fractions and Pb was largely associated with organic matter and Fe-Mn oxide fractions. Results of the present study suggest that the mobility and bioavailability of metals probably increase in the following order: Cr < Pb < Ni < Cd < Zn. Among the elements studied, Zn and Cd appeared to be the most readily soluble and potentially bioavailable metals and these metals may carry a potential risk for metal transfer in food chain and contamination to ground water.

Keywords: metal speciation, metal mobility, greenhouse soils, biosystems engineering

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8707 Phytochemical Screening, Anticancer, Antibacterial and Antioxidant Activities of the Leaf Extracts of Mabolo (Diospyros philippinensis A. DC.)

Authors: Jarel Elgin Tolentino, Arby Denise Nera, Mary Rose Roco, Angela Vianca Aspa, Nikko Beltran, Else Dapat

Abstract:

Drug resistance by cells has been the problem in the medical field for decades now. The use of medicinal plants as a source of creating powerful drugs has been nowadays recognized worldwide to treat such resistant diseases. In the present study, the potential for Diospyros philippinensis A. DC. to inhibit growth of both bacteria and cancer cell line was conducted. The leaf crude extracts were screened for the presence of phytochemicals and examined for potential bioactivities by employing several assays like Kirby-Bauer disc diffusion method, DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) assay and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium assay for the antibacterial, antioxidant and cytotoxic activities of the extract, respectively. Phytochemical test results of the extracts revealed the presence of alkaloids, flavonoids, saponins, phenols, quinones, cardiac glycosides, phlobatannins, carbohydrate, cardenolides and proteins. The leaf extracts were found to exhibit antibacterial activity against gram-positive bacteria, high antioxidant activity (99.22% ± 0.005) but did not show any sign of cytotoxicity towards HCT116 (ATCC CCL-247). The study therefore concludes that D. philippinensis A. DC. leaf extract can be a source of antibacterial and chemopreventive agents. This claim may be used as basis for future investigation.

Keywords: bioassay, medicinal plants, plant crude extracts, phytochemical screening

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8706 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

Abstract:

Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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