Search results for: post WWII period
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9352

Search results for: post WWII period

7342 One-Stage Conversion of Adjustable Gastric Band to One-Anastomosis Gastric Bypass Versus Sleeve Gastrectomy : A Single-Center Experience With a Short and Mid-term Follow-up

Authors: Basma Hussein Abdelaziz Hassan, Kareem Kamel, Philobater Bahgat Adly Awad, Karim Fahmy

Abstract:

Background: Laparoscopic adjustable gastric band was one of the most applied and common bariatric procedures in the last 8 years. However; the failure rate was very high, reaching approximately 60% of the patients not achieving the desired weight loss. Most patients sought another revisional surgery. In which, we compared two of the most common weight loss surgeries performed nowadays: the laparoscopic sleeve gastrectomy and laparoscopic one- anastomosis gastric bypass. Objective: To compare the weight loss and postoperative outcomes among patients undergoing conversion laparoscopic one-anastomosis gastric bypass (cOAGB) and laparoscopic sleeve gastrectomy (cSG) after a failed laparoscopic adjustable gastric band (LAGB). Patients and Methods: A prospective cohort study was conducted from June 2020 to June 2022 at a single medical center, which included 77 patients undergoing single-stage conversion to (cOAGB) vs (cSG). Patients were reassessed for weight loss, comorbidities remission, and post-operative complications at 6, 12, and 18 months. Results: There were 77 patients with failed LAGB in our study. Group (I) was 43 patients who underwent cOAGB and Group (II) was 34 patients who underwent cSG. The mean age of the cOAGB group was 38.58. While in the cSG group, the mean age was 39.47 (p=0.389). Of the 77 patients, 10 (12.99%) were males and 67 (87.01%) were females. Regarding Body mass index (BMI), in the cOAGB group the mean BMI was 41.06 and in the cSG group the mean BMI was 40.5 (p=0.042). The two groups were compared postoperative in relation to EBWL%, BMI, and the co-morbidities remission within 18 months follow-up. The BMI was calculated post-operative at three visits. After 6 months of follow-up, the mean BMI in the cOAGB group was 34.34, and the cSG group was 35.47 (p=0.229). In 12-month follow-up, the mean BMI in the cOAGB group was 32.69 and the cSG group was 33.79 (p=0.2). Finally, the mean BMI after 18 months of follow-up in the cOAGB group was 30.02, and in the cSG group was 31.79 (p=0.001). Both groups had no statistically significant values at 6 and 12 months follow-up with p-values of 0.229, and 0.2 respectively. However, patients who underwent cOAGB after 18 months of follow-up achieved lower BMI than those who underwent cSG with a statistically significant p-value of 0.005. Regarding EBWL% there was a statistically significant difference between the two groups. After 6 months of follow-up, the mean EBWL% in the cOAGB group was 35.9% and the cSG group was 33.14%. In the 12-month follow-up, the EBWL % mean in the cOAGB group was 52.35 and the cSG group was 48.76 (p=0.045). Finally, the mean EBWL % after 18 months of follow-up in the cOAGB group was 62.06 ±8.68 and in the cSG group was 55.58 ±10.87 (p=0.005). Regarding comorbidities remission; Diabetes mellitus remission was found in 22 (88%) patients in the cOAGB group and 10 (71.4%) patients in the cSG group with (p= 0.225). Hypertension remission was found in 20 (80%) patients in the cOAGB group and 14 (82.4%) patients in the cSG group with (p=1). In addition, dyslipidemia remission was found in 27(87%) patients in cOAGB group and 17(70%) patients in the cSG group with (p=0.18). Finally, GERD remission was found in about 15 (88.2%) patients in the cOAGB group and 6 (60%) patients in the cSG group with (p=0.47). There are no statistically significant differences between the two groups in the post-operative data outcomes. Conclusion: This study suggests that the conversion of LAGB to either cOAGB or cSG could be feasibly performed in a single-stage operation. cOAGB had a significant difference as regards the weight loss results than cSG among the mid-term follow-up. However, there is no significant difference in the postoperative complications and the resolution of the co-morbidities. Therefore, cOAGB could provide a reliable alternative but needs to be substantiated in future long-term studies.

Keywords: laparoscopic, gastric banding, one-anastomosis gastric bypass, Sleeve gastrectomy, revisional surgery, weight loss

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7341 The Greek Revolution Through the Foreign Press. The Case of the Newspaper "The London Times" In the Period 1821-1828

Authors: Euripides Antoniades

Abstract:

In 1821 the Greek Revolution movement, under the political influence that arose from the French revolution, and the corresponding movements in Italy, Germany and America, requested the liberation of the nation and the establishment of an independent national state. Published topics in the British press regarding the Greek Revolution, focused on : a) the right of the Greeks to claim their freedom from Turkish domination in order to establish an independent state based on the principle of national autonomy, b) criticism regarding Turkish rule as illegal and the power of the Ottoman Sultan as arbitrary, c) the recognition of the Greek identity and its distinction from the Turkish one and d) the endorsement Greeks as the descendants of ancient Greeks. The advantage of newspaper as a media is sharing information and ideas and dealing with issues in greater depth and detail, unlike other media, such as radio or television. The London Times is a print publication that presents, in chronological or thematic order, the news, opinions or announcements about the most important events that have occurred in a place during a specified period of time. This paper employs the rich archive of The London Times archive by quoting extracts from publications of that period, to convey the British public perspective regarding the Greek Revolution from its beginning until the London Protocol of 1828. Furthermore, analyses the publications of the British newspaper in terms of the number of references to the Greek revolution, front page and editorial references as well as the size of publications on the revolution during the period 1821-1828. A combination of qualitative and quantitative content analysis was applied. An attempt was made to record Greek Revolution references along with the usage of specific words and expressions that contribute to the representation of the historical events and their exposure to the reading public. Key finds of this research reveal that a) there was a frequency of passionate daily articles concerning the events in Greece, their length, and context in The London Times, b) the British public opinion was influenced by this particular newspaper and c) the newspaper published various news about the revolution by adopting the role of animator of the Greek struggle. For instance, war events and the battles of Wallachin and Moldavia, Hydra, Crete, Psara, Mesollogi, Peloponnese were presented not only for informing the readers but for promoting the essential need for freedom and the establishment of an independent Greek state. In fact, this type of news was the main substance of the The London Times’ structure, establishing a positive image about the Greek Revolution contributing to the European diplomatic development such as the standpoint of France, - that did not wish to be detached from the conclusions regarding the English loans and the death of Alexander I of Russia and his succession by the ambitious Nicholas. These factors offered a change in the attitude of the British and Russians respectively assuming a positive approach towards Greece. The Great Powers maintained a neutral position in the Greek-Ottoman conflict, same time they engaged in Greek power increasement by offering aid.

Keywords: Greece, revolution, newspaper, the London times, London, great britain, mass media

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7340 Phenomenology of Child Labour in Estates, Farms and Plantations in Zimbabwe: A Comparative Analysis of Tanganda and Eastern Highlands Tea Estates

Authors: Chupicai Manuel

Abstract:

The global efforts to end child labour have been increasingly challenged by adages of global capitalism, inequalities and poverty affecting the global south. In the face the of rising inequalities whose origin can be explained from historical and political economy analysis between the poor and the rich countries, child labour is also on the rise particularly on the global south. The socio-economic and political context of Zimbabwe has undergone serious transition from colonial times through the post-independence normally referred to as the transition period up to the present day. These transitions have aided companies and entities in the business and agriculture sector to exploit child labour while country provided conditions that enhance child labour due to vulnerability of children and anomic child welfare system that plagued the country. Children from marginalised communities dominated by plantations and farms are affected most. This paper explores the experiences and perceptions of children working in tea estates, plantations and farms, and the adults who formerly worked in these plantations during their childhood to share their experiences and perceptions on child labour in Zimbabwe. Childhood theories that view children as apprentices and a human rights perspectives were employed to interrogate the concept of childhood, child labour and poverty alleviation strategies. Phenomenological research design was adopted to describe the experiences of children working in plantations and interpret the meanings they have on their work and livelihoods. The paper drew form 30 children from two plantations through semi-structured interviews and 15 key informant interviews from civil society organisations, international labour organisation, adults who formerly worked in the plantations and the personnel of the plantations. The findings of the study revealed that children work on the farms as an alternative model for survival against economic challenges while the majority cited that poverty compel them to work and get their fees and food paid for. Civil society organisations were of the view that child rights are violated and the welfare system of the country is malfunctional. The perceptions of the majority of the children interviewed are that the system on the plantations is better and this confirmed the socio-constructivist theory that views children as apprentices. The study recommended child sensitive policies and welfare regime that protects children from exploitation together with policing and legal measures that secure child rights.

Keywords: child labour, child rights, phenomenology, poverty reduction

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7339 The Global Relationship between the Prevalence of Diabetes Mellitus and Incidence of Tuberculosis: 2000-2012

Authors: Alaa Badawi, Suzan Sayegh, Mohamed Sallam, Eman Sadoun, Mohamed Al-Thani, Muhammad W. Alam, Paul Arora

Abstract:

Background: The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has increased over the past decade with DM prevalence increasing in countries already afflicted with a high burden of TB. The coexistence of the two conditions presents a serious threat to global public health. Objective: The present study examines the global relationship between the prevalence of DM and the incidence of TB to evaluate their coexistence worldwide and their contribution to one another. Methods: This is an ecological longitudinal study covering the period between years 2000 to 2012. We utilized data from the WHO and World Bank sources and International Diabetes Federation to estimate prevalence of DM (%) and the incidence of TB (per 100,000). Measures of central tendency and dispersion as well as the harmonic mean and linear regression were used for different WHO regions. The association between DM prevalence and TB incidence was examined by quartile of DM prevalence. Results: The worldwide average (±S.D.) prevalence of DM within the study period was 6.6±3.8% whereas TB incidence was 135.0±190.5 per 100,000. DM prevalence was highest in the Eastern Mediterranean (8.3±4.1) and West Pacific (8.2±5.6) regions and lowest in the Africa (3.5±2.6). TB incidence was highest in Africa (313.1±275.9 per 100,000) and South-East Asia (216.7±124.9) and lowest in the European (46.5±68.6) and American (47.2±52.9) regions. Only countries with high DM prevalence (>7.6%) showed a significant positive association with TB incidence (r=0.17, p=0.013). Conclusion: A positive association between DM and TB may exist in some – but not all – world regions, a dual burden that necessitates identifying the nature of this coexistence to assist in developing public health approaches that curb their rising burden.

Keywords: diabetes mellitus, tuberculosis, disease burden, global association

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7338 Artificial Neural Network Model Based Setup Period Estimation for Polymer Cutting

Authors: Zsolt János Viharos, Krisztián Balázs Kis, Imre Paniti, Gábor Belső, Péter Németh, János Farkas

Abstract:

The paper presents the results and industrial applications in the production setup period estimation based on industrial data inherited from the field of polymer cutting. The literature of polymer cutting is very limited considering the number of publications. The first polymer cutting machine is known since the second half of the 20th century; however, the production of polymer parts with this kind of technology is still a challenging research topic. The products of the applying industrial partner must met high technical requirements, as they are used in medical, measurement instrumentation and painting industry branches. Typically, 20% of these parts are new work, which means every five years almost the entire product portfolio is replaced in their low series manufacturing environment. Consequently, it requires a flexible production system, where the estimation of the frequent setup periods' lengths is one of the key success factors. In the investigation, several (input) parameters have been studied and grouped to create an adequate training information set for an artificial neural network as a base for the estimation of the individual setup periods. In the first group, product information is collected such as the product name and number of items. The second group contains material data like material type and colour. In the third group, surface quality and tolerance information are collected including the finest surface and tightest (or narrowest) tolerance. The fourth group contains the setup data like machine type and work shift. One source of these parameters is the Manufacturing Execution System (MES) but some data were also collected from Computer Aided Design (CAD) drawings. The number of the applied tools is one of the key factors on which the industrial partners’ estimations were based previously. The artificial neural network model was trained on several thousands of real industrial data. The mean estimation accuracy of the setup periods' lengths was improved by 30%, and in the same time the deviation of the prognosis was also improved by 50%. Furthermore, an investigation on the mentioned parameter groups considering the manufacturing order was also researched. The paper also highlights the manufacturing introduction experiences and further improvements of the proposed methods, both on the shop floor and on the quotation preparation fields. Every week more than 100 real industrial setup events are given and the related data are collected.

Keywords: artificial neural network, low series manufacturing, polymer cutting, setup period estimation

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7337 Stability of Pump Station Cavern in Chagrin Shale with Time

Authors: Mohammad Moridzadeh, Mohammad Djavid, Barry Doyle

Abstract:

An assessment of the long-term stability of a cavern in Chagrin shale excavated by the sequential excavation method was performed during and after construction. During the excavation of the cavern, deformations of rock mass were measured at the surface of excavation and within the rock mass by surface and deep measurement instruments. Rock deformations were measured during construction which appeared to result from the as-built excavation sequence that had potentially disturbed the rock and its behavior. Also some additional time dependent rock deformations were observed during and post excavation. Several opinions have been expressed to explain this time dependent deformation including stress changes induced by excavation, strain softening (or creep) in the beddings with and without clay and creep of the shaley rock under compressive stresses. In order to analyze and replicate rock behavior observed during excavation, including current and post excavation elastic, plastic, and time dependent deformation, Finite Element Analysis (FEA) was performed. The analysis was also intended to estimate long term deformation of the rock mass around the excavation. Rock mass behavior including time dependent deformation was measured by means of rock surface convergence points, MPBXs, extended creep testing on the long anchors, and load history data from load cells attached to several long anchors. Direct creep testing of Chagrin Shale was performed on core samples from the wall of the Pump Room. Results of these measurements were used to calibrate the FEA of the excavation. These analyses incorporate time dependent constitutive modeling for the rock to evaluate the potential long term movement in the roof, walls, and invert of the cavern. The modeling was performed due to the concerns regarding the unanticipated behavior of the rock mass as well as the forecast of long term deformation and stability of rock around the excavation.

Keywords: Cavern, Chagrin shale, creep, finite element.

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7336 The ‘Fun, Move, Play’ Project: Qualitative and Quantitative Findings from Irish Primary School Children (6-8 Years), Parents and Teachers

Authors: Jemma McGourty, Brid Delahunt, Fiona Hackett, Sharon Courtney, Richard English, Graham Russell, Sinéad O’Connor

Abstract:

Fundamental Movement Skills (FMS) mastery is considered essential for children’s ongoing, meaningful engagement in Physical Activity (PA). There has been a dearth of Irish research on baseline FMS and their development by means of intervention in young primary school children. In addition, as children’s participation in PA is heavily influenced by both parents and teachers, it is imperative to understand their attitudes and perceptions towards PA participation and its’ promotion in children. The ‘Fun, Move, Play’ Project investigated the effect of a 6-week play based PA intervention on primary school children’s (aged 6-8 years) FMS while also exploring the attitudes and perceptions of their parents and teachers towards PA participation. The FMS intervention utilised a pre-post quasi-experimental design to determine the effect of a 6-week play based PA intervention (devised from the iCoach Kids Programme) on 176 primary school children’s FMS (N = 176: 90 girls and 86 boys; M = 7.2 years; SD = 0.48). Objective measures of 7 FMS (run, skip, vertical jump, static balance, stationary dribble, catch, kick) were made using a combination of the TGMD2 and Get Skilled, Get Active resources. One hundred parents (87 mothers; 13 fathers; M=36 years; SD=5.45) and 90 teachers (67 females; 23 males) completed surveys investigating their attitudes and perceptions towards PA participation. In addition, 19 of these parents and 9 of these teachers participated in semi-structured qualitative interviews to explore, in more depth, their views and perceptions of PA participation. Both the FMS data set and survey responses were analysed using SPSS version 23, using appropriate statistical analysis. A thematic analysis framework was used to analyse the qualitative findings. A significant improvement was observed in the children’s overall FMS score pre-post intervention (t = 16.67; df = 175; p < 0.001), while there were also significant improvements in each of the seven individual FMS measured in the children, pre-post intervention. Findings from the parent surveys and interviews indicated that parents had positive attitudes towards PA, viewed it as important and supported their child’s PA participation. However, a lack of knowledge regarding the amount and intensity of PA that children should participate in emerged as a recurrent finding. Also, there was a significant positive correlation between the PA levels of parents’ and their children (r = .41; n = 100; p < .001). Arising from the teachers’ surveys and interviews was a positive attitude towards PA and the impact that it has on a child’s health and well-being. They also reported feeling more confident teaching certain aspects of the PE curriculum (games and sports) compared to others (gymnastics, dance), where they appreciate working with specialist practitioners. Conclusion: A short-term PA intervention has a positive effect on children’s FMS. While parents are supportive of their child’s PA participation, there is a knowledge gap regarding National PA guidelines for children. Teachers appreciate the importance of PA in children, but face a number of challenges in its implementation and promotion.

Keywords: fundamental movement skills, parents attitudes to physical activity, short-term intervention, teachers attitudes to physical activity

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7335 Development and Validation of a Semi-Quantitative Food Frequency Questionnaire for Use in Urban and Rural Communities of Rwanda

Authors: Phenias Nsabimana, Jérôme W. Some, Hilda Vasanthakaalam, Stefaan De Henauw, Souheila Abbeddou

Abstract:

Tools for the dietary assessment in adults are limited in low- and middle-income settings. The objective of this study was to develop and validate a semi-quantitative food frequency questionnaire (FFQ) against the multiple pass-24 h recall tool for use in urban and rural Rwanda. A total of 212 adults (154 females and 58 males), 18-49 aged, including 105 urban and 107 rural residents, from the four regions of Rwanda, were recruited in the present study. A multiple-pass 24- H recall technique was used to collect dietary data in both urban and rural areas in four different rounds, on different days (one weekday and one weekend day), separated by a period of three months, from November 2020 to October 2021. The details of all the foods and beverages consumed over the 24h period of the day prior to the interview day were collected during face-to-face interviews. A list of foods, beverages, and commonly consumed recipes was developed by the study researchers and ten research assistants from the different regions of Rwanda. Non-standard recipes were collected when the information was available. A single semi-quantitative FFQ was also developed in the same group discussion prior to the beginning of the data collection. The FFQ was collected at the beginning and the end of the data collection period. Data were collected digitally. The amount of energy and macro-nutrients contributed by each food, recipe, and beverage will be computed based on nutrient composition reported in food composition tables and weight consumed. Median energy and nutrient contents of different food intakes from FFQ and 24-hour recalls and median differences (24-hour recall –FFQ) will be calculated. Kappa, Spearman, Wilcoxon, and Bland-Altman plot statistics will be conducted to evaluate the correlation between estimated nutrient and energy intake found by the two methods. Differences will be tested for their significance and all analyses will be done with STATA 11. Data collection was completed in November 2021. Data cleaning is ongoing and the data analysis is expected to be completed by July 2022. A developed and validated semi-quantitative FFQ will be available for use in dietary assessment. The developed FFQ will help researchers to collect reliable data that will support policy makers to plan for proper dietary change intervention in Rwanda.

Keywords: food frequency questionnaire, reproducibility, 24-H recall questionnaire, validation

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7334 Analysis of the Level of Production Failures by Implementing New Assembly Line

Authors: Joanna Kochanska, Dagmara Gornicka, Anna Burduk

Abstract:

The article examines the process of implementing a new assembly line in a manufacturing enterprise of the household appliances industry area. At the initial stages of the project, a decision was made that one of its foundations should be the concept of lean management. Because of that, eliminating as many errors as possible in the first phases of its functioning was emphasized. During the start-up of the line, there were identified and documented all production losses (from serious machine failures, through any unplanned downtime, to micro-stops and quality defects). During 6 weeks (line start-up period), all errors resulting from problems in various areas were analyzed. These areas were, among the others, production, logistics, quality, and organization. The aim of the work was to analyze the occurrence of production failures during the initial phase of starting up the line and to propose a method for determining their critical level during its full functionality. There was examined the repeatability of the production losses in various areas and at different levels at such an early stage of implementation, by using the methods of statistical process control. Based on the Pareto analysis, there were identified the weakest points in order to focus improvement actions on them. The next step was to examine the effectiveness of the actions undertaken to reduce the level of recorded losses. Based on the obtained results, there was proposed a method for determining the critical failures level in the studied areas. The developed coefficient can be used as an alarm in case of imbalance of the production, which is caused by the increased failures level in production and production support processes in the period of the standardized functioning of the line.

Keywords: production failures, level of production losses, new production line implementation, assembly line, statistical process control

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7333 Analysis of Rainfall and Malaria Trends in Limpopo Province, South Africa

Authors: Abiodun M. Adeola, Hannes Rautenbach, Gbenga J. Abiodun, Thabo E. Makgoale, Joel O. Botai, Omolola M. Adisa, Christina M. Botai

Abstract:

There was a surge in malaria morbidity as well as mortality in 2016/2017 malaria season in malaria-endemic regions of South Africa. Rainfall is a major climatic driver of malaria transmission and has potential use for predicting malaria. Annual and seasonal trends and cross-correlation analyses were performed on time series of monthly total rainfall (derived from interpolated weather station data) and monthly malaria cases in five districts of Limpopo Province for the period of 1998 to 2017. The time series analysis indicated that an average of 629.5mm of rainfall was received over the period of study. The rainfall has an annual variation of about 0.46%. Rainfall amount varies among the five districts, with the north-eastern part receiving more rainfall. Spearman’s correlation analysis indicated that total monthly rainfall with one to two months lagged effect is significant in malaria transmission in all the five districts. The strongest correlation is noticed in Mopani (r=0.54; p-value = < 0.001), Vhembe (r=0.53; p-value = < 0.001), Waterberg (r=0.40; p-value = < 0.001), Capricorn (r=0.37; p-value = < 0.001) and lowest in Sekhukhune (r=0.36; p-value = < 0.001). More particularly, malaria morbidity showed a strong relationship with an episode of rainfall above 5-year running means of rainfall of 400 mm. Both annual and seasonal analyses showed that the effect of rainfall on malaria varied across the districts and it is seasonally dependent. Adequate understanding of climatic variables dynamics annually and seasonally is imperative in seeking answers to malaria morbidity among other factors, particularly in the wake of the sudden spike of the disease in the province.

Keywords: correlation, malaria, rainfall, seasonal, trends

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7332 Hagios Spyridon Church in Selymbria and Its Particular Standing in Middle Byzantine Architecture

Authors: Görkem Günay, Bilge Ar

Abstract:

Selymbria is an ancient maritime city, approximately 60 km west to Constantinople. Although it was a particularly important settlement during the Byzantine period, our knowledge about its Byzantine layer is rather sketchy. On the other hand, one of the Byzantine churches of Selymbria, namely Hagios Spyridon which had been survived until the beginning of 20th century, deserves special attention. The church is mainly known via textual and visual data from the end of 19th and the beginning of 20th century. These documents, together with some architectural pieces which most probably were belonging to the church, indicate that Hagios Spyridon Church was built in ‘simple domed octagon’ plan-scheme. Nothing from the building is preserved in-situ today. However, this small church helps to fill a very important gap in the history of Middle Byzantine architecture and occupies a notable place in the on-going discussion of the origins of ‘domed octagon’ churches of Helladic paradigm and their link with the capital. This study aims to reexamine the now lost church of Hagios Spyridon in the context of architectural developments of Middle Byzantine period. In the presentation, the exact location and the architecture of the church will be tried to be clarified using the existing documents and the publications of previous scholars. Some new architectural pieces which possibly belonged to the church, will be introduced and interpretations on existing restitution drawings will be made. The church will be architecturally compared with the oldest known example of the plan-scheme, Nea Moni on Chios and its later local copies. The study of Hagios Spyridon Church of Selymbria, hopefully, will contribute to the discussion of the possible influence of the capital on the plan-scheme and will help us to ask further questions about the close relations between Constantinopolitan and provincial architecture.

Keywords: Hagios Spyridon church, insular domed octagon, middle Byzantine architecture, silymarin

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7331 Extensions to Chen's Minimizing Equal Mass Paralellogram Solutions

Authors: Abdalla Manur, Daniel Offin, Alessandro Arsie

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In this paper, we study the extension of the minimizing equal mass parallelogram solutions which was derived by Chen in 2001. Chen’s solution was minimizing for one quarter of the period [0; T], where numerical integration had been used in his proof. This paper focuses on extending the minimization property to intervals of time [0; 2T] and [0; 4T].

Keywords: action, Hamiltoian, N-body, symmetry

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7330 Teenage Pregnancy: The Unmet Needs of Female Adolescents in Uganda

Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan

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Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.

Keywords: adolescents, attitudes, teenage pregnancy, Uganda

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7329 Conceptualizing of Priorities in the Dynamics of Public Administration Contemporary Reforms

Authors: Larysa Novak-Kalyayeva, Aleksander Kuczabski, Orystlava Sydorchuk, Nataliia Fersman, Tatyana Zemlinskaia

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The article presents the results of the creative analysis and comparison of trends in the development of the theory of public administration during the period from the second half of the 20th to the beginning of the 21st century. The process of conceptualization of the priorities of public administration in the dynamics of reforming was held under the influence of such factors as globalization, integration, information and technological changes and human rights is examined. The priorities of the social state in the concepts of the second half of the 20th century are studied. Peculiar approaches to determining the priorities of public administration in the countries of "Soviet dictatorship" in Central and Eastern Europe in the same period are outlined. Particular attention is paid to the priorities of public administration regarding the interaction between public power and society and the development of conceptual foundations for the modern managerial process. There is a thought that the dynamics of the formation of concepts of the European governance is characterized by the sequence of priorities: from socio-economic and moral-ethical to organizational-procedural and non-hierarchical ones. The priorities of the "welfare state" were focused on the decent level of material wellbeing of population. At the same time, the conception of "minimal state" emphasized priorities of human responsibility for their own fate under the conditions of minimal state protection. Later on, the emphasis was placed on horizontal ties and redistribution of powers and competences of "effective state" with its developed procedures and limits of responsibility at all levels of government and in close cooperation with the civil society. The priorities of the contemporary period are concentrated on human rights in the concepts of "good governance" and all the following ones, which recognize the absolute priority of public administration with compliance, provision and protection of human rights. There is a proved point of view that civilizational changes taking place under the influence of information and technological imperatives also stipulate changes in priorities, redistribution of emphases and update principles of managerial concepts on the basis of publicity, transparency, departure from traditional forms of hierarchy and control in favor of interactivity and inter-sectoral interaction, decentralization and humanization of managerial processes. The necessity to permanently carry out the reorganization, by establishing the interaction between different participants of public power and social relations, to establish a balance between political forces and social interests on the basis of mutual trust and mutual understanding determines changes of social, political, economic and humanitarian paradigms of public administration and their theoretical comprehension. The further studies of theoretical foundations of modern public administration in interdisciplinary discourse in the context of ambiguous consequences of the globalizational and integrational processes of modern European state-building would be advisable. This is especially true during the period of political transformations and economic crises which are the characteristic of the contemporary Europe, especially for democratic transition countries.

Keywords: concepts of public administration, democratic transition countries, human rights, the priorities of public administration, theory of public administration

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7328 In vivo Alterations in Ruminal Parameters by Megasphaera Elsdenii Inoculation on Subacute Ruminal Acidosis (SARA)

Authors: M. S. Alatas, H. D. Umucalilar

Abstract:

SARA is a common and serious metabolic disorder in early lactation in dairy cattle and in finishing beef cattle, caused by diets with high inclusion of cereal grain. This experiment was performed to determine the efficacy of Megasphaera elsdenii, a major lactate-utilizing bacterium in prevention/treatment of SARA in vivo. In vivo experimentation, it was used eight ruminally cannulated rams and it was applied the rapid adaptation with the mixture of grain based on wheat (%80 wheat, %20 barley) and barley (%80 barley, %20 wheat). During the systematic adaptation, it was followed the probability of SARA formation by being measured the rumen pH with two hours intervals after and before feeding. After being evaluated the data, it was determined the ruminal pH ranged from 5,2-5,6 on the condition of feeding with 60 percentage of grain mixture based on barley and wheat, that assured the definite form of subacute acidosis. In four days SARA period, M. elsdenii (1010 cfu ml-1) was inoculated during the first two days. During the SARA period, it was observed the decrease of feed intake with M. elsdenii inoculation. Inoculation of M. elsdenii was caused to differentiation of rumen pH (P < 0,0001), while it was found the pH level approximately 5,55 in animals applied the inoculation, it was 5,63 pH in other animals. It was observed that total VFA with the bacterium inoculation tended to change in terms of grain feed (P < 0,07). It increased with the effect of total VFA inoculation in barley based diet, but it was more stabilized in wheat based diet. Bacterium inoculation increased the ratio of propionic acid (18,33%-21,38%) but it caused to decrease the butyric acid, and acetic/propionic acid. During the rapid adaptation, the concentration of lactic acid in the rumen liquid increased depending upon grain level (P<0,0001). On the other hand bacterium inoculation did not have an effect on concentration of lactic acid. M. elsdenii inoculation did not affect ruminal ammonia concentration. In the group that did not apply inoculation, the level of ruminal ammonia concentration was higher than the others applied inoculation. M. elsdenii inoculation did not changed protozoa count in barley-based diet whereas it decreased in wheat-based diet. In the period of SARA, it was observed that the level of blood glucose, lactate and hematocrit increased greatly after inoculation (P < 0,0001). When it is generally evaluated, it is seen that M. elsdenii inoculation has not a positive impact on rumen parameters. Therefore, to reveal the full impact of the inoculation with different strains, feedstuffs and animal groups, further research is required.

Keywords: In vivo, Subactute ruminal acidosis, Megasphaera elsdenii, Rumen fermentation

Procedia PDF Downloads 645
7327 Crack Propagation in Concrete Gravity Dam

Authors: Faramarz Khoshnoudian

Abstract:

A seismic stability assessment of the concrete gravity dam was performed. Initially (Phase 1), a linear response spectrum analysis was performed to verify the potential for crack formation. The result shows the possibility of developing cracks in the upstream face of the dam close to the lowest gallery, which were sufficiently long that the dam would not be stable following the earthquake. The results show the dam has potentially inadequate seismic and post-earthquake resistance and recommended an update of the stability analysis.

Keywords: crack propgation, concrete gravity dam, seismic, assesment

Procedia PDF Downloads 71
7326 Lumbar Punctures: Re-Audit of Procedure Documentation Following the Introduction of a Standardised Procedure Checklist

Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

Abstract:

Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

Procedia PDF Downloads 103
7325 The Effect of Soil-Structure Interaction on the Post-Earthquake Fire Performance of Structures

Authors: A. T. Al-Isawi, P. E. F. Collins

Abstract:

The behaviour of structures exposed to fire after an earthquake is not a new area of engineering research, but there remain a number of areas where further work is required. Such areas relate to the way in which seismic excitation is applied to a structure, taking into account the effect of soil-structure interaction (SSI) and the method of analysis, in addition to identifying the excitation load properties. The selection of earthquake data input for use in nonlinear analysis and the method of analysis are still challenging issues. Thus, realistic artificial ground motion input data must be developed to certify that site properties parameters adequately describe the effects of the nonlinear inelastic behaviour of the system and that the characteristics of these parameters are coherent with the characteristics of the target parameters. Conversely, ignoring the significance of some attributes, such as frequency content, soil site properties and earthquake parameters may lead to misleading results, due to the misinterpretation of required input data and the incorrect synthesise of analysis hypothesis. This paper presents a study of the post-earthquake fire (PEF) performance of a multi-storey steel-framed building resting on soft clay, taking into account the effects of the nonlinear inelastic behaviour of the structure and soil, and the soil-structure interaction (SSI). Structures subjected to an earthquake may experience various levels of damage; the geometrical damage, which indicates the change in the initial structure’s geometry due to the residual deformation as a result of plastic behaviour, and the mechanical damage which identifies the degradation of the mechanical properties of the structural elements involved in the plastic range of deformation. Consequently, the structure presumably experiences partial structural damage but is then exposed to fire under its new residual material properties, which may result in building failure caused by a decrease in fire resistance. This scenario would be more complicated if SSI was also considered. Indeed, most earthquake design codes ignore the probability of PEF as well as the effect that SSI has on the behaviour of structures, in order to simplify the analysis procedure. Therefore, the design of structures based on existing codes which neglect the importance of PEF and SSI can create a significant risk of structural failure. In order to examine the criteria for the behaviour of a structure under PEF conditions, a two-dimensional nonlinear elasto-plastic model is developed using ABAQUS software; the effects of SSI are included. Both geometrical and mechanical damages have been taken into account after the earthquake analysis step. For comparison, an identical model is also created, which does not include the effects of soil-structure interaction. It is shown that damage to structural elements is underestimated if SSI is not included in the analysis, and the maximum percentage reduction in fire resistance is detected in the case when SSI is included in the scenario. The results are validated using the literature.

Keywords: Abaqus Software, Finite Element Analysis, post-earthquake fire, seismic analysis, soil-structure interaction

Procedia PDF Downloads 121
7324 A General Framework to Successfully Operate the Digital Transformation Process in the Post-COVID Era

Authors: Driss Kettani

Abstract:

In this paper, we shed light on “Digital Divide 2.0,” which we see as COVID-19’s Version of the Digital Divide! We believe that “Fighting” against Digital Divide 2.0 necessitates for a Country to be seriously advanced in the Global Digital Transformation that is, naturally, a complex, delicate, costly and long-term Process. We build an argument supporting our assumption and, from there, we present the foundations of a computational framework to guide and streamline Digital Transformation at all levels.

Keywords: digital divide 2.0, digital transformation, ICTs for development, computational outcomes assessment

Procedia PDF Downloads 177
7323 Study on the Addition of Solar Generating and Energy Storage Units to a Power Distribution System

Authors: T. Costa, D. Narvaez, K. Melo, M. Villalva

Abstract:

Installation of micro-generators based on renewable energy in power distribution system has increased in recent years, with the main renewable sources being solar and wind. Due to the intermittent nature of renewable energy sources, such micro-generators produce time-varying energy which does not correspond at certain times of the day to the peak energy consumption of end users. For this reason, the use of energy storage units next to the grid contributes to the proper leveling of the buses’ voltage level according to Brazilian energy quality standards. In this work, the effect of the addition of a photovoltaic solar generator and a store of energy in the busbar voltages of an electric system is analyzed. The consumption profile is defined as the average hourly use of appliances in a common residence, and the generation profile is defined as a function of the solar irradiation available in a locality. The power summation method is validated with analytical calculation and is used to calculate the modules and angles of the voltages in the buses of an electrical system based on the IEEE standard, at each hour of the day and with defined load and generation profiles. The results show that bus 5 presents the worst voltage level at the power consumption peaks and stabilizes at the appropriate range with the inclusion of the energy storage during the night time period. Solar generator maintains improvement of the voltage level during the period when it receives solar irradiation, having peaks of production during the 12 pm (without exceeding the appropriate maximum levels of tension).

Keywords: energy storage, power distribution system, solar generator, voltage level

Procedia PDF Downloads 141
7322 Design and Fabrication of Piezoelectric Tactile Sensor by Deposition of PVDF-TrFE with Spin-Coating Method for Minimally Invasive Surgery

Authors: Saman Namvarrechi, Armin A. Dormeny, Javad Dargahi, Mojtaba Kahrizi

Abstract:

Since last two decades, minimally invasive surgery (MIS) has grown significantly due to its advantages compared to the traditional open surgery like less physical pain, faster recovery time and better healing condition around incision regions; however, one of the important challenges in MIS is getting an effective sensing feedback within the patient’s body during operations. Therefore, surgeons need efficient tactile sensing like determining the hardness of contact tissue for investigating the patient’s health condition. In such a case, MIS tactile sensors are preferred to be able to provide force/pressure sensing, force position, lump detection, and softness sensing. Among different pressure sensor technologies, the piezoelectric operating principle is the fittest for MIS’s instruments, such as catheters. Using PVDF with its copolymer, TrFE, as a piezoelectric material, is a common method of design and fabrication of a tactile sensor due to its ease of implantation and biocompatibility. In this research, PVDF-TrFE polymer is deposited via spin-coating method and treated with various post-deposition processes to investigate its piezoelectricity and amount of electroactive β phase. These processes include different post thermal annealing, the effect of spin-coating speed, different layer of deposition, and the presence of additional hydrate salt. According to FTIR spectroscopy and SEM images, the amount of the β phase and porosity of each sample is determined. In addition, the optimum experimental study is established by considering every aspect of the fabrication process. This study clearly shows the effective way of deposition and fabrication of a tactile PVDF-TrFE based sensor and an enhancement methodology to have a higher β phase and piezoelectric constant in order to have a better sense of touch at the end effector of biomedical devices.

Keywords: β phase, minimally invasive surgery, piezoelectricity, PVDF-TrFE, tactile sensor

Procedia PDF Downloads 122
7321 Effect of Two Transactional Instructional Strategies on Primary School Pupils’ Achievement in English Language Vocabulary and Reading Comprehension in Ibadan Metropolis, Nigeria

Authors: Eniola Akande

Abstract:

Introduction: English vocabulary and reading comprehension are core to academic achievement in many school subjects. Deficiency in both accounts for dismal performance in internal and external examinations among primary school pupils in Ibadan Metropolis, Nigeria. Previous studies largely focused on factors influencing pupils’ achievement in English vocabulary and reading comprehension. In spite of what literature has shown, the problem still persists, implying the need for other kinds of intervention. This study was therefore carried out to determine the effect of two transactional strategies Picture Walk (PW) and Know-Want to Learn-Learnt (KWL) on primary four pupils’ achievement in English vocabulary and reading comprehension in Ibadan Metropolis. The moderating effects of gender and learning style were also examined. Methodology: The study was anchored on Rosenblatt’s Transactional Reading and Piaget’s Cognitive Development theories; pretest-posttest control group quasi-experimental design with 3x2x3 factorial matrix was adopted. Six public primary schools were purposively selected based on the availability of qualified English language teachers in Primary Education Studies. Six intact classes (one per school) with a total of 101 primary four pupils (48 males and 53 females) participated. The intact classes were randomly assigned to PW (27), KWL (44) and conventional (30) groups. Instruments used were English Vocabulary (r=0.83), Reading Comprehension (r=0.84) achievement tests, Pupils’ Learning Style Preference Scale (r=0.93) and instructional guides. Treatment lasted six weeks. Data were analysed using the Descriptive statistics, Analysis of Covariance and Bonferroni post-hoc test at 0.05 level of significance. The mean age was 8.86±0.84 years. Result: Treatment had a significant main effect on pupils’ reading comprehension (F(2,82)=3.17), but not on English vocabulary. Participants in KWL obtained the highest post achievement means score in reading comprehension (8.93), followed by PW (8.06) and control (7.21) groups. Pupils’ learning style had a significant main effect on pupils’ achievement in reading comprehension (F(2,82)=4.41), but not on English vocabulary. Pupils with preference for tactile learning style had the highest post achievement mean score in reading comprehension (9.40), followed by the auditory (7.43) and the visual learning style (7.37) groups. Gender had no significant main effect on English vocabulary and reading comprehension. There was no significant two-way interaction effect of treatment and gender on pupils’ achievement in English vocabulary and reading comprehension. The two-way interaction effect of treatment and learning style on pupils’ achievement in reading comprehension was significant (F(4,82)=3.37), in favour of pupils with tactile learning style in PW group. There was no significant two-way interaction effect of gender and learning style on pupils’ achievement in English vocabulary and reading comprehension. The three-way interaction effects were not significant on English vocabulary and reading comprehension. Conclusion: Picture Walk and Know-Want to learn-Learnt instructional strategies were effective in enhancing pupils’ achievement in reading comprehension but not on English vocabulary. Learning style contributed considerably to achievement in reading comprehension but not to English vocabulary. Primary school, English language teachers, should put into consideration pupils’ learning style when adopting both strategies in teaching reading comprehension for improved achievement in the subject.

Keywords: comprehension-based intervention, know-want to learn-learnt, learning style, picture walk, primary school pupils

Procedia PDF Downloads 143
7320 Numerical Investigation of Dynamic Stall over a Wind Turbine Pitching Airfoil by Using OpenFOAM

Authors: Mahbod Seyednia, Shidvash Vakilipour, Mehran Masdari

Abstract:

Computations for two-dimensional flow past a stationary and harmonically pitching wind turbine airfoil at a moderate value of Reynolds number (400000) are carried out by progressively increasing the angle of attack for stationary airfoil and at fixed pitching frequencies for rotary one. The incompressible Navier-Stokes equations in conjunction with Unsteady Reynolds Average Navier-Stokes (URANS) equations for turbulence modeling are solved by OpenFOAM package to investigate the aerodynamic phenomena occurred at stationary and pitching conditions on a NACA 6-series wind turbine airfoil. The aim of this study is to enhance the accuracy of numerical simulation in predicting the aerodynamic behavior of an oscillating airfoil in OpenFOAM. Hence, for turbulence modelling, k-ω-SST with low-Reynolds correction is employed to capture the unsteady phenomena occurred in stationary and oscillating motion of the airfoil. Using aerodynamic and pressure coefficients along with flow patterns, the unsteady aerodynamics at pre-, near-, and post-static stall regions are analyzed in harmonically pitching airfoil, and the results are validated with the corresponding experimental data possessed by the authors. The results indicate that implementing the mentioned turbulence model leads to accurate prediction of the angle of static stall for stationary airfoil and flow separation, dynamic stall phenomenon, and reattachment of the flow on the surface of airfoil for pitching one. Due to the geometry of the studied 6-series airfoil, the vortex on the upper surface of the airfoil during upstrokes is formed at the trailing edge. Therefore, the pattern flow obtained by our numerical simulations represents the formation and change of the trailing-edge vortex at near- and post-stall regions where this process determines the dynamic stall phenomenon.

Keywords: CFD, moderate Reynolds number, OpenFOAM, pitching oscillation, unsteady aerodynamics, wind turbine

Procedia PDF Downloads 203
7319 The Potential of Role Models in Enhancing Smokers' Readiness to Change (Decision to Quit Smoking): A Case Study of Saudi National Anti-Smoking Campaign

Authors: Ghada M. AlSwayied, Anas N. AlHumaid

Abstract:

Smoking has been linked to thousands of deaths worldwide. Around three million adults continue to use tobacco each day in Saudi Arabia; a sign that smoking is prevalent among Saudi population and obviously considered as a public health threat. Although the awareness against smoking is continuously running, it can be observed that smoking behavior increases noticeably as common practice especially among young adults across the world. Therefore, it was an essential step to guess what does motivate smokers to think about quit smoking. Can a graphic and emotional ad that is focusing on health consequences do really make a difference? A case study has been conducted on the Annual Anti-Smoking National Campaign, which was provided by Saudi Ministry of Health in the period of May 2017. To assess campaign’s effects on the number of calls, the number of visits and online access to health messages during and after the campaign period from May to August compared with the previous campaign in 2016. The educational video was selected as a primary tool to deliver the smoking health message. The Minister of Health who is acting as a role model for young adults was used to deliver a direct message to smokers with an avoidance of smoking cues usage. Due to serious consequences of smoking, the Minister of Health delivered the news of canceling the media campaign and directing the budget to smoking cessation clinics. It was shown that the positive responses and interactions on the campaign were obviously remarkable; achieving a high rate of recall and recognition. During the campaign, the number of calls to book for a visit reached 45880 phone calls, and the total online views ran to 1,253,879. Whereas, clinic visit raised up to 213 cumulative percent. Interestingly, a total number of 15,192 patients visited the clinics along three months compared with the last year campaign’s period, which was merely 4850 patients. Furthermore, around half of patients who visited the clinics were in the age from 26 to 40-year-old. There was a great progress in enhancing public awareness on: 'where to go' to assist smokers in making a quit attempt. With regard to the stages of change theory, it was predicted that by following direct-message technique; the proportion of patients in the contemplation and preparation stages would be increased. There was no process evaluation obtained to assess implementation of the campaigns’ activities.

Keywords: smoking, health promotion, role model, educational material, intervention, community health

Procedia PDF Downloads 149
7318 Platelet Transfusion Thresholds for Pediatrics; A Retrospective Study

Authors: Hessah Alsulami, Majedah Aldosari

Abstract:

Introduction: Platelet threshold of 10x109 /L is recommended for clinically stable thrombocytopenic pediatric patients. Transfusions at a higher level (given the absence of research evidence, as determined by clinical circumstances, generally at threshold of 40x109 /L) may be required for patients with signs of bleeding, high fever, hyper-leukocytosis, rapid fall in platelet count, concomitant coagulation abnormality, critically ill patients, and those with impaired platelet function (including drug induced). Transfusions at a higher level may be also required for patients undergoing invasive procedures. Method: This study is a retrospective observational analysis of platelet transfusion thresholds in a single secondary pediatric hospital in Riyadh. From the blood bank database, the list of the patients who received platelet transfusions in the second half of 2018 was retrieved. Patients were divided into two groups; group A, those belong to the category of high platelet level for transfusion (such as those with bleeding, high fever, rapid fall in platelet count, impaired platelet function or undergoing invasive procedures) and group B, those who were not. Then we looked at the pre and post transfusion platelet levels for each group. The data was analyzed using GraphPad software and the data expressed as Mean ± SD. Result: A total of 112 of transfusion episodes in 61 patients (38% female) were analyzed. The age ranged from 24 days to 8 years. The distribution of platelet transfusion episodes was 64% (n=72) for group A and 36% (n= 40) for group B. The mean pre-transfusion platelet count was 46x103 ± (11x 103) for group A and 28x103 ± (6x103) for group B. the post-transfusion mean platelet count was 61 x 103 ± (14 x 103) and 60 x103 ± (24 x 103) for group A and B respectively. Among the groups the rise in the mean platelet count after transfusion was significant among stable patients (group B) compared to unstable patients (group A) (P < 0.001). Conclusion: The platelet count threshold for transfusion varied with the clinical condition and is higher among unstable patients’ group which is expected. For stable patients the threshold was higher than what it should be which means that the clinicians don’t follow the guidelines in this regard. The rise of platelet count after transfusion was higher among stable patients.

Keywords: platelet, transfusion, threshold, pediatric

Procedia PDF Downloads 71
7317 The Crisis in Ukraine and the End of the Post Cold War Security Delusions in Europe

Authors: Georgios Siachamis

Abstract:

The main objective of this paper is to examine how the crisis in Ukraine can change our perception and understanding of the strategic challenges in Europe. It will try also to address the main factors behind the beginning of the conflict in Ukraine, the miscalculations and mistakes that lead towards the escalation of the crisis and what constructive initiatives are needed to be taken in order to avoid further instability in the region. Furthermore, measures in order to develop a more stable relation with Russia are also going to be presented. Finally the implementation of a new strategic outlook for the EU is also going to be analysed.

Keywords: crisis management, European grand strategy, crisis in Ukraine, Russian policy

Procedia PDF Downloads 369
7316 Inverted Diameter-Limit Thinning: A Promising Alternative for Mixed Populus tremuloides Stands Management

Authors: Ablo Paul Igor Hounzandji, Benoit Lafleur, Annie DesRochers

Abstract:

Introduction: Populus tremuloides [Michx] regenerates rapidly and abundantly by root suckering after harvest, creating stands with interconnected stems. Pre-commercial thinning can be used to concentrate growth on fewer stems to reach merchantability faster than un-thinned stands. However, conventional thinning methods are typically designed to reach even spacing between residual stems (1,100 stem ha⁻¹, evenly distributed), which can lead to treated stands consisting of weaker/smaller stems compared to the original stands. Considering the nature of P. tremuloides's regeneration, with large underground biomass of interconnected roots, aiming to keep the most vigorous and largest stems, regardless of their spatial distribution, inverted diameter-limit thinning could be more beneficial to post-thinning stand productivity because it would reduce the imbalance between roots and leaf area caused by thinning. Aims: This study aimed to compare stand and stem productivity of P. tremuloides stands thinned with a conventional thinning treatment (CT; 1,100 stem ha⁻¹, evenly distributed), two levels of inverted diameter-limit thinning (DL1 and DL2, keeping the largest 1100 or 2200 stems ha⁻¹, respectively, regardless of their spatial distribution) and a control unthinned treatment. Because DL treatments can create substantial or frequent gaps in the thinned stands, we also aimed to evaluate the potential of this treatment to recreate mixed conifer-broadleaf stands by fill-planting Picea glauca seedlings. Methods: Three replicate 21 year-old sucker-regenerated aspen stands were thinned in 2010 according to four treatments: CT, DL1, DL2, and un-thinned control. Picea glauca seedlings were underplanted in gaps created by the DL1 and DL2 treatments. Stand productivity per hectare, stem quality (diameter and height, volume stem⁻¹) and survival and height growth of fill-planted P. glauca seedlings were measured 8 year post-treatments. Results: Productivity, volume, diameter, and height were better in the treated stands (CT, DL1, and DL2) than in the un-thinned control. Productivity of CT and DL1 stands was similar 4.8 m³ ha⁻¹ year⁻¹. At the tree level, diameter and height of the trees in the DL1 treatment were 5% greater than those in the CT treatment. The average volume of trees in the DL1 treatment was 11% higher than the CT treatment. Survival after 8 years of fill planted P. glauca seedlings was 2% greater in the DL1 than in the DL2 treatment. DL1 treatment also produced taller seedlings (+20 cm). Discussion: Results showed that DL treatments were effective in producing post-thinned stands with larger stems without affecting stand productivity. In addition, we showed that these treatments were suitable to introduce slower growing conifer seedlings such as Picea glauca in order to re-create or maintain mixed stands despite the aggressive nature of P. tremuloides sucker regeneration.

Keywords: Aspen, inverted diameter-limit, mixed forest, populus tremuloides, silviculture, thinning

Procedia PDF Downloads 141
7315 Vestibular Dysfunction in Post-Acute Sequelae of SARS-CoV-2 Infection: A Gait Analysis Pilot Study

Authors: Adar Pelah, Avraham Adelman, Amanda Balash, Jake Mitchell, Mattan J. Pelah, Viswadeep Sarangi, Xin Chen Cai, Zadok Storkey, Gregg B. Fields, Ximena Levy, Ali A. Danesh

Abstract:

Introduction: Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 infection (PASC), or Long COVID, while primarily a respiratory disorder, can also include dizziness, lasting weeks to months in individuals who had previously tested positive for COVID-19. This study utilized gait analysis to assess the potential vestibular effects of PASC on the presentation of gait anomalies. Materials and Methods: The study included 11 participants who tested positive for COVID-19, a mean of 2.8 months prior to gait testing (PP=11), and 8 control participants who did not test positive for COVID-19 (NP=8). Participants walked 7.5m at three self-selected speeds: ‘slow,’ ‘normal,’ and ‘fast.’ Mean walking speeds were determined for each speed and overall range from four laps on an instrumented walkway using video capture. Results: A Z-test at 0.05 significance was used for speed range, ‘normal’ and ‘fast’ at the lower tail, and for ‘slow’ at the higher tail. Average speeds (m/s) were: ‘slow’ (PP=0.709, NP=0.678), ‘normal’ (PP=1.141, NP=1.170), ‘fast’ (PP=1.529, NP=1.821), average range (PP=0.846, NP=1.143). Significant speed decreases between PP and NP were observed in ‘fast’ (-17.43%) and average range (-29.86%), while changes in ‘slow’ (+2.44%) and ‘normal’ (-4.39%) speeds were not significant. Conclusions: Long COVID is a recognized disability (Americans with Disabilities Act), and although it presents variably, dizziness, vertigo, and tinnitus are not uncommon in COVID-19 infection. These results suggest that potential inner-ear damage may persist and manifest in gait changes even after recovery from acute illness. Further research with a larger sample size may indicate the need for providers to consider PASC when diagnosing patients with vestibular dysfunction.

Keywords: gait analysis, long-COVID, vestibular dysfunction, walking speed

Procedia PDF Downloads 125
7314 Dietary Anion-Cation Balance of Grass and Net Acid-Base Excretion in Urine of Suckler Cows

Authors: H. Scholz, P. Kuehne, G. Heckenberger

Abstract:

Dietary Anion-Cation Balance (DCAB) in grazing systems under German conditions has a tendency to decrease from May until September and often are measured DCAB lower than 100 meq per kg dry matter. Lower DCAB in grass feeding system can change the metabolic status of suckler cows and often are results in acidotic metabolism. Measurement of acid-base excretion in dairy cows has been proved to a method to evaluate the acid-base status. The hypothesis was that metabolic imbalances could be identified by urine measurement in suckler cows. The farm study was conducted during the grazing seasons 2017 and 2018 and involved 7 suckler cow farms in Germany. Suckler cows were grazing during the whole time of the investigation and had no access to other feeding components. Cows had free access to water and salt block and free access to minerals (loose). The dry matter of the grass was determined at 60 °C and were then analysed for energy and nutrient content and for the Dietary Cation-Anion Balance (DCAB). Urine was collected in 50 ml-glasses and analysed for net acid-base excretion (NSBA) and the concentration of creatinine and urea in the laboratory. Statistical analysis took place with ANOVA with fixed effects of farms (1-7), month (May until September), and number of lactations (1, 2, and ≥ 3 lactations) using SPSS Version 25.0 for windows. An alpha of 0.05 was used for all statistical tests. During the grazing periods of years 2017 and 2018, an average DCAB was observed in the grass of 167 meq per kg DM. A very high mean variation could be determined from -42 meq/kg to +439 meq/kg. Reference values in relation to DCAB were described between 150 meq and 400 meq per kg DM. It was found the high chlorine content with reduced potassium level led to this reduction in DCAB at the end of the grazing period. Between the DCAB of the grass and the NSBA in urine of suckler cows was a correlation according to PEARSON of r = 0.478 (p ≤ 0.001) or after SPEARMAN of r = 0.601 (p ≤ 0.001) observed. For the control of urine values of grazing suckler cows, the wide spread of the values poses a challenge of the interpretation, especially since the DCAB is unknown. The influence of several feeding components such as chlorine, sulfur, potassium, and sodium (ions for the DCAB) and dry matter feed intake during the grazing period of suckler cows should be taken into account in further research. The results obtained show that up a decrease in the DCAB is related to a decrease in NSBA in urine of suckler cows. Monitoring of metabolic disturbances should include analysis of urine, blood, milk, and ruminal fluid.

Keywords: dietary anion-cation balance, DCAB, net acid-base excretion, NSBA, suckler cow, grazing period

Procedia PDF Downloads 151
7313 Rediscovery of Important Elements Contributing to Cultural Interchange Values Made during Restoration of Khanpur Gate

Authors: Poonam A. Trambadia, Ashish V. Trambadia

Abstract:

The architecture of sultanate period of Ahmedabad had evolved just before the establishment of Mughal rule in North India. After shifting the capital of the kingdom from Patan to Ahmedabad, when the buildings and structures were being built, an interesting cultural blend happened in architecture. Many sultanate buildings in Ahmedabad historic city have resemblance with Patan including the names. Outer fortification walls and Gates were built during the rule of the third ruler in the late 15th century. All the gates had sandstone slabs supported by three arched entrance in sandstone with wooden shutter. A restoration project of Khanpur Gate was initiated in 2016. The paper identifies some evidences and some hidden layers of structures as important elements of cultural interchange while some were just forgotten in the process. The recycling of pre-existing elements of structures are examined and compared. There were layers uncovered that were hidden behind later repairs using traditional brick arch, which was taken out in the process. As the gate had partially collapsed, the restoration included piece by piece dismantling and restoring in the same sequence wherever required. The recycled materials found in the process were recorded and provided the basis for this study. The gate after this discovery sets a new example of fortification Gate built in Sultanate era. The comparison excludes Maratha and British Period Gates to avoid further confusion and focuses on 15th – 16th century sultanate architecture of Ahmedabad.

Keywords: Ahmedabad World Heritage, fortification, Indo-Islamic style, Sultanate architecture, cultural interchange

Procedia PDF Downloads 116