Search results for: internal and international migration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6892

Search results for: internal and international migration

4792 High Viscous Oil–Water Flow: Experiments and CFD Simulations

Authors: A. Archibong-Eso, J. Shi, Y Baba, S. Alagbe, W. Yan, H. Yeung

Abstract:

This study presents over 100 experiments conducted in a 25.4 mm internal diameter (ID) horizontal pipeline. Oil viscosity ranging from 3.5 Pa.s–5.0 Pa.s are used with superficial velocities of oil and water ranging from 0.06 to 0.55 m/s and 0.01 m/s to 1.0 m/s, respectively. Pressure gradient measurements and flow pattern observations are discussed. Numerical simulation of some flow conditions is performed using the commercial CFD code ANSYS Fluent® and the simulation results are compared with experimental results. Results indicate that CFD numerical simulation performed moderately well in predicting the flow configurations observed in this study while discrepancies were observed in the pressure gradient predictions.

Keywords: flow patterns, plug, pressure gradient, rivulet

Procedia PDF Downloads 426
4791 Strategies for a Sustainable Future of Forest and Tribal Peoples on This Planet

Authors: Dharmpal Singh

Abstract:

The objective of this proposed project is to relocation and resettlement of carnivores tribal communities who are currently residing in the protected forest land in all over the world just like resettlement project of the carnivores tribal families of Mongia who at past were residing in Ranthambhore Tiger Reserve (RTR) and had caused excess damage of endangered species of wildlife including Tigers. At present several tribal communities are residing in the another national parks and they not only consuming the wild animals but also involved in illegal trading of vital organs, skin and bones with National and international traders. Tribal are ideally suited for the job because they are highly skilled game trackers and due to having had a definite source of income over the years, they easily drawn in to the illegal wildlife trade and slaughter of wild animals. Their income is increasing but wild animals are on the brink of extinction. For the conservation of flora and fauna the rehabilitation process should be thought out according to the RTR project (which not only totally change the quality of life of mongia tribal community but also increased the conopy cover of forest and grass due to reduced the biotic pressure on protected land of forest in Rajasthan state) with appropriate understanding of the sociology of the people involved, their culture, education standard and the need of different skills to be acquired by them for sustenance such as agriculture, dairy, poultry, social forestry, job as forest guard and others eco-development programmes. Perhaps, the dimensions presented by me may generate discussion among the international wild life lovers and conservationists and remedies may be result oriented in the field of management of forest and conservation of wildlife on this planet.

Keywords: strategies, rehablety of tribals, conservation of forest, eco-development Programmes, wildlife

Procedia PDF Downloads 436
4790 In vitro and in vivo Antiangiogenic Activity of Girinimbine Isolated from Murraya koenigii

Authors: Venoos Iman, Suzita Mohd Noor, Syam Mohan, Mohamad Ibrahim Noordin

Abstract:

Girinimbine, a carbazole alkaloid was isolated from the stem bark and root of Murraya koenigii and its structure and purity was identified by HPLC and LC-MS. Here we report that Girinimbine strongly inhibit angiogenesis activity both in vitro and in vivo. MTT result showed that girinimbine inhibits cell proliferation of the HUVECS cell line in vitro. Result of endothelial cell invasion, migration, tube formation and wound healing assays also demonstrated significant time and does dependent inhibition by girinimbine. Moreover, girinibine mediates its anti-angiogenic activity through up- and down-regulation of angiogenic and anti-aniogenic proteins. Furthermore, anti-angiogenic potential of girinimbine was evidenced in vivo on zebrafish model. Girinimbine inhibited neo-vessels formation in zebrafish embryos during 24 hours exposure time. Together, these results demonstrated for the first time that girinimbine could effectively suppress angiogenesis and strongly suggest that it might be a novel angiogenesis inhibitor.

Keywords: anti-angiogenic, carbazole alkaloid, girinimbine, zebrafish

Procedia PDF Downloads 376
4789 Study the Behavior of Different Composite Short Columns (DST) with Prismatic Sections under Bending Load

Authors: V. Sadeghi Balkanlou, M. Reza Bagerzadeh Karimi, A. Hasanbakloo, B. Bagheri Azar

Abstract:

In this paper, the behavior of different types of DST columns has been studied under bending load. Briefly, composite columns consist of an internal carbon steel tube and an external stainless steel wall that the between the walls are filled with concrete. Composite columns are expected to combine the advantages of all three materials and have the advantage of high flexural stiffness of CFDST columns. In this research, ABAQUS software is used for finite element analysis then the results of ultimate strength of the composite sections are illustrated.

Keywords: DST, stainless steel, carbon steel, ABAQUS, straigh columns, tapered columns

Procedia PDF Downloads 388
4788 Promoting Gender Diversity in the UN Peacekeeping Operations: An Analysis of Factors Influencing Female Military Troops Deployment

Authors: Rahab Kisio

Abstract:

The persistent underrepresentation of female miltary in United Nations (UN) peacekeeping missions remains a critical concern for addressing the multifaceted challenges in conflict-affected regions. This research explores the factors influencing countries’ decisions to deploy female military troops to UN peacekeeping operations, examining data ranging from 2010 to 2020. The study highlights the urgent need for policymakers and international organizations to recognize gender equality as key instrument in dealing with sexual exploitation and abuse within these missions. The study suggests three reasons for the low female military troops deployment. Firstly, countries actively breaking down barriers for women in the workforce are more likely to send female military troops. Secondly, nations supporting women in politics are more likely to deploy female military troops, showing their value for gender equality. Lastly, countries with a history of conflict may send more female military troops to align with the UN's call and potentially gain international support in future conflicts. Theoretical approaches are presented to explore these motivations further, and the study uses negative binomial regression with country-year as the unit of analysis to test various explanations for a country's contribution of female military troops to UN peacekeeping missions. Findings shows that there is a connection between troop contributing countries’ gender equality and the participation of female military troops in peacekeeping operations. Nations that prioritize gender equality and empower women have a higher likelihood of deploying more female military personnel. The study emphasizes the significance of women in political leadership, indicating that countries actively addressing barriers to women's political representation are more willing to contribute higher numbers of female military troops to peacekeeping missions. While the research supports hypotheses related to gender equality and political representation, it finds no significant evidence that a country's history of conflict directly influences the deployment of female military troops in other conflict-ridden nations. This research contributes valuable insights into gender equality within peacekeeping forces, shedding light on factors influencing the deployment of female military personnel. The implications underscore the importance of actively addressing discrimination, promoting women's political participation, and understanding the influence of a nation's conflict history. The interdisciplinary nature of this work calls for collaborative efforts from policymakers, international organization, and researchers to formulate strategies for effectively increasing female military troops participation in UN peacekeeping

Keywords: UN peacekeeping, gender diversity, female military troops, discrimination

Procedia PDF Downloads 51
4787 Rival Conceptions of Sovereignty in Modern South Asian Political Thought: An Analysis Through the Writings of Maulana Syed Abul Ala Maududi and Maulana Hifzurrahman Seoharvi

Authors: Mohammad Saif

Abstract:

In the post-Westphalianworld order, the concept of sovereignty has been a fundamental area of inquiry in Political Science, International Relations, and International Law. Modern Islamic political thought has also dedicated a fair share of debate on the subject. The debate fundamentally revolves around the ‘ontological differentiation’ between western and Islamic political thought. While the centrality of the individual in western political thought regards the individual as the center of universe, Islamic Political thought provides that space to God. The modern liberal democratic principles suggest sovereignty as one of the major attributes of modern nation state; Islamists regard sovereignty as an attribute of God. However, the position regarding God’ssovereignty in Islamic political thought is not coherent in conception. Some scholars regard such a position as ‘the political interpretation of Islam’. This paper is an attempt to first analyze the fundamental discord between two rival political ideologies (western and Islamic), and then forward a debate on the subject of sovereignty in South Asian Islamic Political thought, particularly between Syed Abul Ala Maududi (ideological father of modern islamist movements) andHifzurrahmanSeoharvi (lesser known in Academia but highly influential in shaping Deobandi position of principles related to political nature of Islamic theology). Maududi regardssovereignty as an attribute of God and the rulers as subservient to Gods will, Seoharvi suggests that God's sovereignty does not entail that the caliph or amir cannot be a ruler or hakim, nor can his command or hukum be an order. Certain references have also been made to contemporary scholars like Sayidd Qutub, Rashid al Ghanouchi, who in one way or the other have contributed to the debate on ‘sovereignty in Islamic thought’.

Keywords: nation state, sovereigty, sovereignty of God (Hakimmiyah), deoband

Procedia PDF Downloads 178
4786 The International Classification of Functioning, Disability and Health (ICF) as a Problem-Solving Tool in Disability Rehabilitation and Education Alliance in Metabolic Disorders (DREAM) at Sultan Bin Abdul Aziz Humanitarian City:A Prototype for Reh

Authors: Hamzeh Awad

Abstract:

Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

Procedia PDF Downloads 351
4785 The Communication of Audit Report: Key Audit Matters in United Kingdom

Authors: L. Sierra, N. Gambetta, M. A. Garcia-Benau, M. Orta

Abstract:

Financial scandals and financial crisis have led to an international debate on the value of auditing. In recent years there have been significant legislative reforms aiming to increase markets’ confidence in audit services. In particular, there has been a significant debate on the need to improve the communication of auditors with audit reports users as a way to improve its informative value and thus, to improve audit quality. The International Auditing and Assurance Standards Board (IAASB) has proposed changes to the audit report standards. The International Standard on Auditing 701, Communicating Key Audit Matters (KAM) in the Independent Auditor's Report, has introduced new concepts that go beyond the auditor's opinion and requires to disclose the risks that, from the auditor's point of view, are more significant in the audited company information. Focusing on the companies included in the Financial Times Stock Exchange 100 index, this study aims to focus on the analysis of the determinants of the number of KAM disclosed by the auditor in the audit report and moreover, the analysis of the determinants of the different type of KAM reported during the period 2013-2015. To test the hypotheses in the empirical research, two different models have been used. The first one is a linear regression model to identify the client’s characteristics, industry sector and auditor’s characteristics that are related to the number of KAM disclosed in the audit report. Secondly, a logistic regression model is used to identify the determinants of the number of each KAM type disclosed in the audit report; in line with the risk-based approach to auditing financial statements, we categorized the KAM in 2 groups: Entity-level KAM and Accounting-level KAM. Regarding the auditor’s characteristics impact on the KAM disclosure, the results show that PwC tends to report a larger number of KAM while KPMG tends to report less KAM in the audit report. Further, PwC reports a larger number of entity-level risk KAM while KPMG reports less account-level risk KAM. The results also show that companies paying higher fees tend to have more entity-level risk KAM and less account-level risk KAM. The materiality level is positively related to the number of account-level risk KAM. Additionally, these study results show that the relationship between client’s characteristics and number of KAM is more evident in account-level risk KAM than in entity-level risk KAM. A highly leveraged company carries a great deal of risk, but due to this, they are usually subject to strong capital providers monitoring resulting in less account-level risk KAM. The results reveal that the number of account-level risk KAM is strongly related to the industry sector in which the company operates assets. This study helps to understand the UK audit market, provides information to auditors and finally, it opens new research avenues in the academia.

Keywords: FTSE 100, IAS 701, key audit matters, auditor’s characteristics, client’s characteristics

Procedia PDF Downloads 231
4784 Causes of Nigeria Unrest and Conflict Situation

Authors: Victor Osaghae

Abstract:

In 2005, the CIA published a report warning that Nigeria, the seventh most populous country in the world, could disintegrate within 15 years. Nigeria experiences civil unrest, violence and strikes. Nigeria has one of the highest rates of internal violence in the world, only unlike others with similar levels of bloodshed such as Colombia or Chechnya, there is not a civil war going on. The types of unrest observed in Nigeria from literatures consulted can be categorized into five namely: religious, social, political, labour, and communal or ethnic unrests. The cuases of the unrests are as follows: injustice, unemployment, religious intolerance, illiteracy and government not filling agreements reached with unions. The cost due to these unrests cannot be quantified because it affects human, material/properties and money.

Keywords: unrest, conflicts, Boko Haram, disturbance

Procedia PDF Downloads 388
4783 Artificial Law: Legal AI Systems and the Need to Satisfy Principles of Justice, Equality and the Protection of Human Rights

Authors: Begum Koru, Isik Aybay, Demet Celik Ulusoy

Abstract:

The discipline of law is quite complex and has its own terminology. Apart from written legal rules, there is also living law, which refers to legal practice. Basic legal rules aim at the happiness of individuals in social life and have different characteristics in different branches such as public or private law. On the other hand, law is a national phenomenon. The law of one nation and the legal system applied on the territory of another nation may be completely different. People who are experts in a particular field of law in one country may have insufficient expertise in the law of another country. Today, in addition to the local nature of law, international and even supranational law rules are applied in order to protect basic human values and ensure the protection of human rights around the world. Systems that offer algorithmic solutions to legal problems using artificial intelligence (AI) tools will perhaps serve to produce very meaningful results in terms of human rights. However, algorithms to be used should not be developed by only computer experts, but also need the contribution of people who are familiar with law, values, judicial decisions, and even the social and political culture of the society to which it will provide solutions. Otherwise, even if the algorithm works perfectly, it may not be compatible with the values of the society in which it is applied. The latest developments involving the use of AI techniques in legal systems indicate that artificial law will emerge as a new field in the discipline of law. More AI systems are already being applied in the field of law, with examples such as predicting judicial decisions, text summarization, decision support systems, and classification of documents. Algorithms for legal systems employing AI tools, especially in the field of prediction of judicial decisions and decision support systems, have the capacity to create automatic decisions instead of judges. When the judge is removed from this equation, artificial intelligence-made law created by an intelligent algorithm on its own emerges, whether the domain is national or international law. In this work, the aim is to make a general analysis of this new topic. Such an analysis needs both a literature survey and a perspective from computer experts' and lawyers' point of view. In some societies, the use of prediction or decision support systems may be useful to integrate international human rights safeguards. In this case, artificial law can serve to produce more comprehensive and human rights-protective results than written or living law. In non-democratic countries, it may even be thought that direct decisions and artificial intelligence-made law would be more protective instead of a decision "support" system. Since the values of law are directed towards "human happiness or well-being", it requires that the AI algorithms should always be capable of serving this purpose and based on the rule of law, the principle of justice and equality, and the protection of human rights.

Keywords: AI and law, artificial law, protection of human rights, AI tools for legal systems

Procedia PDF Downloads 74
4782 The Convention of Culture: A Comprehensive Study on Dispute Resolution Pertaining to Heritage and Related Issues

Authors: Bhargavi G. Iyer, Ojaswi Bhagat

Abstract:

In recent years, there has been a lot of discussion about ethnic imbalance and diversity in the international context. Arbitration is now subject to the hegemony of a small number of people who are constantly reappointed. When a court system becomes exclusionary, the quality of adjudication suffers significantly. In such a framework, there is a misalignment between adjudicators' preconceived views and the interests of the parties, resulting in a biased view of the proceedings. The world is currently witnessing a slew of intellectual property battles around cultural appropriation. The term "cultural appropriation" refers to the industrial west's theft of indigenous culture, usually for fashion, aesthetic, or dramatic purposes. Selena Gomez exemplifies cultural appropriation by commercially using the “bindi,” which is sacred to Hinduism, as a fashion symbol. In another case, Victoria's Secret insulted indigenous peoples' genocide by stealing native Indian headdresses. In the case of yoga, a similar process can be witnessed, with Vedic philosophy being reduced to a type of physical practice. Such a viewpoint is problematic since indigenous groups have worked hard for generations to ensure the survival of their culture, and its appropriation by the western world for purely aesthetic and theatrical purposes is upsetting to those who practise such cultures. Because such conflicts involve numerous jurisdictions, they must be resolved through international arbitration. However, these conflicts are already being litigated, and the aggrieved parties, namely developing nations, do not believe it prudent to use the World Intellectual Property Organization's (WIPO) already established arbitration procedure. This practise, it is suggested in this study, is the outcome of Europe's exclusionary arbitral system, which fails to recognise the non-legal and non-commercial nature of indigenous culture issues. This research paper proposes a more comprehensive, inclusive approach that recognises the non-legal and non-commercial aspects of IP disputes involving cultural appropriation, which can only be achieved through an ethnically balanced arbitration structure. This paper also aspires to expound upon the benefits of arbitration and other means of alternative dispute resolution (ADR) in the context of disputes pertaining to cultural issues; positing that inclusivity is a solution to the existing discord between international practices and localised cultural points of dispute. This paper also hopes to explicate measures that will facilitate ensuring inclusion and ideal practices in the domain of arbitration law, particularly pertaining to cultural heritage and indigenous expression.

Keywords: arbitration law, cultural appropriation, dispute resolution, heritage, intellectual property

Procedia PDF Downloads 144
4781 Detection of Powdery Mildew Disease in Strawberry Using Image Texture and Supervised Classifiers

Authors: Sultan Mahmud, Qamar Zaman, Travis Esau, Young Chang

Abstract:

Strawberry powdery mildew (PM) is a serious disease that has a significant impact on strawberry production. Field scouting is still a major way to find PM disease, which is not only labor intensive but also almost impossible to monitor disease severity. To reduce the loss caused by PM disease and achieve faster automatic detection of the disease, this paper proposes an approach for detection of the disease, based on image texture and classified with support vector machines (SVMs) and k-nearest neighbors (kNNs). The methodology of the proposed study is based on image processing which is composed of five main steps including image acquisition, pre-processing, segmentation, features extraction and classification. Two strawberry fields were used in this study. Images of healthy leaves and leaves infected with PM (Sphaerotheca macularis) disease under artificial cloud lighting condition. Colour thresholding was utilized to segment all images before textural analysis. Colour co-occurrence matrix (CCM) was introduced for extraction of textural features. Forty textural features, related to a physiological parameter of leaves were extracted from CCM of National television system committee (NTSC) luminance, hue, saturation and intensity (HSI) images. The normalized feature data were utilized for training and validation, respectively, using developed classifiers. The classifiers have experimented with internal, external and cross-validations. The best classifier was selected based on their performance and accuracy. Experimental results suggested that SVMs classifier showed 98.33%, 85.33%, 87.33%, 93.33% and 95.0% of accuracy on internal, external-I, external-II, 4-fold cross and 5-fold cross-validation, respectively. Whereas, kNNs results represented 90.0%, 72.00%, 74.66%, 89.33% and 90.3% of classification accuracy, respectively. The outcome of this study demonstrated that SVMs classified PM disease with a highest overall accuracy of 91.86% and 1.1211 seconds of processing time. Therefore, overall results concluded that the proposed study can significantly support an accurate and automatic identification and recognition of strawberry PM disease with SVMs classifier.

Keywords: powdery mildew, image processing, textural analysis, color co-occurrence matrix, support vector machines, k-nearest neighbors

Procedia PDF Downloads 120
4780 Understanding the Social Movements around the ‘Rohingya Crisis’ within the Political Process Model

Authors: Aklima Jesmin, Ubaidur Rob, M. Ashrafur Rahman

Abstract:

Rohingya population of Arakan state in Myanmar are one the most persecuted ethnic minorities in this 21st century. According to the Universal Declaration of Human Rights (UDHR), all human beings are born free, equal in dignity and rights. However, these populations are systematically excluded from this universal proclamation of human rights as they are Rohingya, which signify ‘other’. Based on the accessible and available literatures about Rohingya issue, this study firstly found there are chronological pattern of human rights violations against the ethnic Rohingya which follows the pathology of the Holocaust in this 21st century of human civilization. These violations have been possible due to modern technology, bureaucracy which has been performed through authorization, routinization and dehumanization; not only in formal institutions but in the society as a whole. This kind of apparently never-ending situation poses any author with the problem of available many scientific articles. The most important sources are, therefore the international daily newspapers, social media and official webpage of the non-state actors for nitty-gritty day to day update. Although it challenges the validity and objectivity of the information, but to address the critical ongoing human rights violations against Rohingya population can become a base for further work on this issue. One of the aspects of this paper is to accommodate all the social movements since August 2017 to date. The findings of this paper is that even though it seemed only human rights violations occurred against Rohingya historically but, simultaneously the process of social movements had also started, can be traced more after the military campaign in 2017. Therefore, the Rohingya crisis can be conceptualized within one ‘campaign’ movement for justice, not as episodic events, especially within the Political Process Model than any other social movement theories. This model identifies that the role of international political movements as well as the role of non-state actors are more powerful than any other episodes of violence conducted against Rohinyga in reframing issue, blaming and shaming to Myanmar government and creating the strategic opportunities for social changes. The lack of empowerment of the affected Rohingya population has been found as the loop to utilize this strategic opportunity. Their lack of empowerment can also affect their capacity to reframe their rights and to manage the campaign for their justice. Therefore, this should be placed at the heart of the international policy agenda within the broader socio-political movement for the justice of Rohingya population. Without ensuring human rights of Rohingya population, achieving the promise of the united nation’s sustainable development goals - no one would be excluded – will be impossible.

Keywords: civilization, holocaust, human rights violation, military campaign, political process model, Rohingya population, sustainable development goal, social justice, social movement, strategic opportunity

Procedia PDF Downloads 283
4779 Thermal Analysis of a Composite of Coco Fiber and Látex

Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale

Abstract:

Given the unquestionable need of environmental preservation, the natural fibers have been seen as a salutary alternative for production of composites in substitution to the synthetic fibers, vitreous and metallic. In this work, the behavior of a composite was analyzed done with fiber of the peel of the coconut as reinforcement and latex as head office, when submitted the source of heat. The temperature profiles were verified in the internal surfaces and it expresses of the composite as well as the temperature gradient in the same. It was also analyzed the behavior of this composite when submitted to a cold source. As consequence, in function of the answers of the system, conclusions were reached.

Keywords: natural fiber, composite, temperature, latex, gradient

Procedia PDF Downloads 817
4778 The Applications of Toyota Production System to Reduce Wastes in Agricultural Products Packing Process: A Study of Onion Packing Plant

Authors: P. Larpsomboonchai

Abstract:

Agro-industry is one of major industries that has strong impacts on national economic incomes, growth, stability, and sustainable development. Moreover, this industry also has strong influences on social, cultural and political issues. Furthermore, this industry, as producing primary and secondary products, is facing challenges from such diverse factors such as demand inconsistency, intense international competition, technological advancements and new competitors. In order to maintain and to improve industry’s competitiveness in both domestics and international markets, science and technology are key factors. Besides hard sciences and technologies, modern industrial engineering concepts such as Just in Time (JIT) Total Quality Management (TQM), Quick Response (QR), Supply Chain Management (SCM) and Lean can be very effective to supportant to increase efficiency and effectiveness of these agricultural products on world stage. Onion is one of Thailand’s major export products which brings back national incomes. But, it also facing challenges in many ways. This paper focused its interests in onion packing process and its related activities such as storage and shipment from one of major packing plant and storage in Mae Wang District, Chiang Mai, Thailand, by applying Toyota Production System (TPS) or Lean concepts, to improve process capability throughout the entire packing and distribution process which will be profitable for the whole onion supply chain. And it will be beneficial to other related agricultural products in Thailand and other ASEAN countries.

Keywords: packing process, Toyota Production System (TPS), lean concepts, waste reduction, lean in agro-industries activities

Procedia PDF Downloads 275
4777 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study

Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

Abstract:

Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

Procedia PDF Downloads 60
4776 Unsteady Reactive Hydromagnetic Fluid Flow of a Two-Step Exothermic Chemical Reaction through a Channel

Authors: J. A. Gbadeyan, R. A. Kareem

Abstract:

In this paper, we investigated the effects of unsteady internal heat generation of a two-step exothermic reactive hydromagnetic fluid flow under different chemical kinetics namely: Sensitized, Arrhenius and Bimolecular kinetics through an isothermal wall temperature channel. The resultant modeled nonlinear partial differential equations were simplified and solved using a combined Laplace-Differential Transform Method (LDTM). The solutions obtained were discussed and presented graphically to show the salient features of the fluid flow and heat transfer characteristics.

Keywords: unsteady, reactive, hydromagnetic, couette ow, exothermi creactio

Procedia PDF Downloads 448
4775 Rare Internal Organ Trauma in Adolescent Athletes: Insights from a Pancreatic Injury Case Study

Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka

Abstract:

Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.

Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman

Procedia PDF Downloads 73
4774 CybeRisk Management in Banks: An Italian Case Study

Authors: E. Cenderelli, E. Bruno, G. Iacoviello, A. Lazzini

Abstract:

The financial sector is exposed to the risk of cyber-attacks like any other industrial sector. Furthermore, the topic of CybeRisk (cyber risk) has become particularly relevant given that Information Technology (IT) attacks have increased drastically in recent years, and cannot be stopped by single organizations requiring a response at international and national level. IT risk is never a matter purely for the IT manager, although he clearly plays a key role. A bank's risk management function requires a thorough understanding of the evolving risks as well as the tools and practical techniques available to address them. Upon the request of European and national legislation regarding CybeRisk in the financial system, banks are therefore called upon to strengthen the operational model for CybeRisk management. This will require an important change with a more intense collaboration with the structures that deal with information security for the development of an ad hoc system for the evaluation and control of this type of risk. The aim of the work is to propose a framework for the management and control of CybeRisk that will bridge the gap in the literature regarding the understanding and consideration of CybeRisk as an integral part of business management. The IT function has a strong relevance in the management of CybeRisk, which is perceived mainly as operational risk, but with a positive tendency on the part of risk management to the identification of CybeRisk assessment methods that are increasingly complete, quantitative and able to better describe the possible impacts on the business. The paper provides answers to the research questions: Is it possible to define a CybeRisk governance structure able to support the comparison between risk and security? How can the relationships between IT assets be integrated into a cyberisk assessment framework to guarantee a system of protection and risks control? From a methodological point of view, this research uses a case study approach. The choice of “Monte dei Paschi di Siena” was determined by the specific features of one of Italy’s biggest lenders. It is chosen to use an intensive research strategy: an in-depth study of reality. The case study methodology is an empirical approach to explore a complex and current phenomenon that develops over time. The use of cases has also the advantage of allowing the deepening of aspects concerning the "how" and "why" of contemporary events, on which the scholar has little control. The research bases on quantitative data and qualitative information obtained through semi-structured interviews of an open-ended nature and questionnaires to directors, members of the audit committee, risk, IT and compliance managers, and those responsible for internal audit function and anti-money laundering. The added value of the paper can be seen in the development of a framework based on a mapping of IT assets from which it is possible to identify their relationships for purposes of a more effective management and control of cyber risk.

Keywords: bank, CybeRisk, information technology, risk management

Procedia PDF Downloads 232
4773 The Effect of the Construction Contract System by Simulating the Comparative Costs of Capital to the Financial Feasibility of the Construction of Toll Bali Mandara

Authors: Mas Pertiwi I. G. AG Istri, Sri Kristinayanti Wayan, Oka Aryawan I. Gede Made

Abstract:

Ability of government to meet the needs of infrastructure investment constrained by the size of the budget commitments for other sectors. Another barrier is the complexity of the process of land acquisition. Public Private Partnership can help bridge the investment gap by including the amount of funding from the private sector, shifted the responsibility of financing, construction of the asset, and the operation and post-project design and care to them. In principle, a construction project implementation always requires the investor as a party to provide resources in the form of funding which it must be contained in a successor agreement in the form of a contract. In general, construction contracts consist of contracts which passed in Indonesia and contract International. One source of funding used in the implementation of construction projects comes from funding that comes from the collaboration between the government and the private sector, for example with the system: BLT (Build Lease Transfer), BOT (Build Operate Transfer), BTO (Build Transfer Operate) and BOO (Build Operate Own). And form of payment under a construction contract can be distinguished several ways: monthly payment, payments based on progress and payment after completed projects (Turn Key). One of the tools used to analyze the feasibility of the investment is to use financial models. The financial model describes the relationship between different variables and assumptions used. From a financial model will be known how the cash flow structure of the project, which includes revenues, expenses, liabilities to creditors and the payment of taxes to the government. Net cash flow generated from the project will be used as a basis for analyzing the feasibility of investment source of project financing Public Private Partnership could come from equity or debt. The proportion of funding according to its source is a comparison of a number of investment funds originating from each source of financing for a total investment cost during the construction period by selected the contract system and several alternative financing percentage ratio determined according to sources will generate cash flow structure that is different. Of the various possibilities for the structure of the cash flow generated will be analyzed by software is to test T Paired to compared the contract system used by various alternatives comparison of financing to determine the effect of the contract system and the comparison of such financing for the feasibility of investment toll road construction project for the economic life of 20 (twenty) years. In this use case studies of toll road contruction project Bali Mandara. And in this analysis only covered two systems contracts, namely Build Operate Transfer and Turn Key. Based on the results obtained by analysis of the variable investment feasibility of the NPV, BCR and IRR between the contract system Build Operate Transfer and contract system Turn Key on the interest rate of 9%, 12% and 15%.

Keywords: contract system, financing, internal rate of return, net present value

Procedia PDF Downloads 227
4772 Enhancing Emotional Intelligence through Non-Verbal Communication Training in Higher Education Exchange Programs: A Longitudinal Study

Authors: Maciej Buczowski

Abstract:

This study investigates the impact of non-verbal communication training on enhancing the emotional intelligence (EI) of participants in higher education exchange programs. Recognizing the vital role EI plays in academic and professional success, particularly in multicultural environments, this research aims to explore the interplay between non-verbal cues and EI. Utilizing a longitudinal mixed-methods approach, the study will assess EI development over time among international students and faculty members. Participants will undergo a comprehensive non-verbal communication training program, covering modules on recognizing and interpreting emotional expressions, understanding cultural variations, and using non-verbal cues to manage interpersonal dynamics. EI levels will be measured using established instruments such as the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the Emotional Quotient Inventory (EQ-i), supplemented by qualitative data from interviews and focus groups. A control group will be included to validate the intervention's effectiveness. Data collection at multiple time points (pre-training, mid-training, post-training, and follow-up) will enable tracking of EI changes. The study hypothesizes significant improvements in participants' EI, particularly in emotional awareness, empathy, and relationship management, leading to better academic performance and increased satisfaction with the exchange experience. This research aims to provide insights into the relationship between non-verbal communication and EI, potentially influencing the design of exchange programs to include EI development components and enhancing the effectiveness of international education initiatives.

Keywords: emotional intelligence, higher education exchange program, non-verbal communication, intercultural communication, cognitive linguistics

Procedia PDF Downloads 24
4771 Tourism Policy Challenges in Post-Soviet Georgia

Authors: Merab Khokhobaia

Abstract:

The research of Georgian tourism policy challenges is important, as the tourism can play an increasing role for the economic growth and improvement of standard of living of the country even with scanty resources, at the expense of improved creative approaches. It is also important to make correct decisions at macroeconomic level, which will be accordingly reflected in the successful functioning of the travel companies and finally, in the improvement of economic indicators of the country. In order to correctly orient sectoral policy, it is important to precisely determine its role in the economy. Development of travel industry has been considered as one of the priorities in Georgia; the country has unique cultural heritage and traditions, as well as plenty of natural resources, which are a significant precondition for the development of tourism. Despite the factors mentioned above, the existing resources are not completely utilized and exploited. This work represents a study of subjective, as well as objective reasons of ineffective functioning of the sector. During the years of transformation experienced by Georgia, the role of travel industry in economic development of the country represented the subject of continual discussions. Such assessments were often biased and they did not rest on specific calculations. This topic became especially popular on the ground of market economy, because reliable statistical data have a particular significance in the designing of tourism policy. In order to deeply study the aforementioned issue, this paper analyzes monetary, as well as non-monetary indicators. The research widely included the tourism indicators system; we analyzed the flaws in reporting of the results of tourism sector in Georgia. Existing defects are identified and recommendations for their improvement are offered. For stable development tourism, similarly to other economic sectors, needs a well-designed policy from the perspective of national, as well as local, regional development. The tourism policy must be drawn up in order to efficiently achieve our goals, which were established in short-term and long-term dynamics on the national or regional scale of specific country. The article focuses on the role and responsibility of the state institutes in planning and implementation of the tourism policy. The government has various tools and levers, which may positively influence the processes. These levers are especially important in terms of international, as well as internal tourism development. Within the framework of this research, the regulatory documents, which are in force in relation to this industry, were also analyzed. The main attention is turned to their modernization and necessity of their compliance with European standards. It is a current issue to direct the efforts of state policy on support of business by implementing infrastructural projects, as well as by development of human resources, which may be possible by supporting the relevant higher and vocational studying-educational programs.

Keywords: regional development, tourism industry, tourism policy, transition

Procedia PDF Downloads 263
4770 Towards Sustainable Concrete: Maturity Method to Evaluate the Effect of Curing Conditions on the Strength Development in Concrete Structures under Kuwait Environmental Conditions

Authors: F. Al-Fahad, J. Chakkamalayath, A. Al-Aibani

Abstract:

Conventional methods of determination of concrete strength under controlled laboratory conditions will not accurately represent the actual strength of concrete developed under site curing conditions. This difference in strength measurement will be more in the extreme environment in Kuwait as it is characterized by hot marine environment with normal temperature in summer exceeding 50°C accompanied by dry wind in desert areas and salt laden wind on marine and on shore areas. Therefore, it is required to have test methods to measure the in-place properties of concrete for quality assurance and for the development of durable concrete structures. The maturity method, which defines the strength of a given concrete mix as a function of its age and temperature history, is an approach for quality control for the production of sustainable and durable concrete structures. The unique harsh environmental conditions in Kuwait make it impractical to adopt experiences and empirical equations developed from the maturity methods in other countries. Concrete curing, especially in the early age plays an important role in developing and improving the strength of the structure. This paper investigates the use of maturity method to assess the effectiveness of three different types of curing methods on the compressive and flexural strength development of one high strength concrete mix of 60 MPa produced with silica fume. This maturity approach was used to predict accurately, the concrete compressive and flexural strength at later ages under different curing conditions. Maturity curves were developed for compressive and flexure strengths for a commonly used concrete mix in Kuwait, which was cured using three different curing conditions, including water curing, external spray coating and the use of internal curing compound during concrete mixing. It was observed that the maturity curve developed for the same mix depends on the type of curing conditions. It can be used to predict the concrete strength under different exposure and curing conditions. This study showed that concrete curing with external spray curing method cannot be recommended to use as it failed to aid concrete in reaching accepted values of strength, especially for flexural strength. Using internal curing compound lead to accepted levels of strength when compared with water cuing. Utilization of the developed maturity curves will help contactors and engineers to determine the in-place concrete strength at any time, and under different curing conditions. This will help in deciding the appropriate time to remove the formwork. The reduction in construction time and cost has positive impacts towards sustainable construction.

Keywords: curing, durability, maturity, strength

Procedia PDF Downloads 304
4769 The Potential of Sown Pastures as Feedstock for Biofuels in Brazil

Authors: Danilo G. De Quadros

Abstract:

Biofuels are a priority in the renewable energy agenda. The utilization of tropical grasses to ethanol production is a real opportunity to Brazil reaches the world’s leadership in biofuels production because there are 100 million hectares of sown pastures, which represent 20% of all land and 80% of agricultural areas. Basically, nowadays tropical grasses are used to raise livestock. The results obtained in this research could bring tremendous advance not only to national technology and economy but also to improve social and environmental aspects. Thus, the objective of this work was to estimate, through well-established international models, the potential of biofuels production using sown tropical pastures as feedstocks and to compare the results with sugarcane ethanol, considering state-of-art of conversion technology, advantages and limitations factors. There were used data from national and international literature about forage yield and biochemical conversion yield. Some scenarios were studied to evaluate potential advantages and limitations for cellulosic ethanol production, since non-food feedstock appeal to conversion strategies, passing through harvest, densification, logistics, environmental impacts (carbon and water cycles, nutrient recycling and biodiversity), and social aspects. If Brazil used only 1% of sown pastures to ethanol production by biochemical pathway, with average dry matter yield of 15 metric tons per hectare per year (there are results of 40 tons), resulted annually in 721 billion liters, that represents 10 times more than sugarcane ethanol projected by the Government in 2030. However, more research is necessary to take the results to commercial scale with competitive costs, considering many strategies and methods applied in ethanol production using cellulosic feedstock.

Keywords: biofuels, biochemical pathway, cellulosic ethanol, sustainability

Procedia PDF Downloads 263
4768 International Trade and Regional Inequality in South America: A Study Applied to Brazil and Argentina

Authors: Mónica Arroyo

Abstract:

South America shows increasing decline in regional export values in the last years, after a strong growth of trade flows especially with China up to 2013. This change is due to the end of the commodity price boom, the slowing of the Chinese economy and the effects of the 2008 economic crisis. This paper examines the integration of regional economies in this context, particularly the situation in Brazil and Argentina. Based on transformations over the last two decades, the analysis is focused on the spatial circuits of production linked to foreign markets, contributing to the understanding of the different uses of territory and the within-country inequality. The South American regional exports, consisting basically of raw materials, are concentrated in a few companies. Large areas are intended for the production of agriculture and mining commodities, under the command of major economic groups, both domestic and foreign, relegating the local population to less productive places or, in most cases, forcing them to change their activity and to migrate to other regions in search of some source of income. On the other hand, the dynamics of these commodities’ spatial circuits of production print requirements in territories in terms of infrastructure and regulation. Capturing this movement requires understanding businesses and government’s role in territorial regulation, and consequently how regional systems are changing – for instance, economic specialisation, growing role of services, investment in roads, railways, ports, and airports. This paper aims to highlight topics for discussion on regional economic dynamics and their different degrees of internationalisation. The intention is to contribute to the debate about the relations between trade, globalization, and development.

Keywords: regional inequality, international trade, developing world, South America

Procedia PDF Downloads 260
4767 Exploring Environmental, Social, and Governance (ESG) Standards for Space Exploration

Authors: Rachael Sullivan, Joshua Berman

Abstract:

The number of satellites orbiting earth are in the thousands now. Commercial launches are increasing, and civilians are venturing into the outer reaches of the atmosphere. As the space industry continues to grow and evolve, so too will the demand on resources, the disparities amongst socio-economic groups, and space company governance standards. Outside of just ensuring that space operations are compliant with government regulations, export controls, and international sanctions, companies should also keep in mind the impact their operations will have on society and the environment. Those looking to expand their operations into outer space should remain mindful of both the opportunities and challenges that they could encounter along the way. From commercial launches promoting civilian space travel—like the recent launches from Blue Origin, Virgin Galactic, and Space X—to regulatory and policy shifts, the commercial landscape beyond the Earth's atmosphere is evolving. But practices will also have to become sustainable. Through a review and analysis of space industry trends, international government regulations, and empirical data, this research explores how Environmental, Social, and Governance (ESG) reporting and investing will manifest within a fast-changing space industry.Institutions, regulators, investors, and employees are increasingly relying on ESG. Those working in the space industry will be no exception. Companies (or investors) that are already engaging or plan to engage in space operations should consider 1) environmental standards and objectives when tackling space debris and space mining, 2) social standards and objectives when considering how such practices may impact access and opportunities for different socioeconomic groups to the benefits of space exploration, and 3) how decision-making and governing boards will function ethically, equitably, and sustainably as we chart new paths and encounter novel challenges in outer space.

Keywords: climate, environment, ESG, law, outer space, regulation

Procedia PDF Downloads 152
4766 Case Study of the Impact of Sport Tourism Event on Local Residents in Cameroon: The African Cup of Nations

Authors: Zita Fomukong Andam

Abstract:

The decision on where to host sport events does not depend on the national politicians or specific international sport event bodies but also involves the residents of the hosting country. Sport tourism is one of the fast growing industries in the world. Cameroonians consider sport as a point of unity and growth within the country. It has a huge variety of sporting activities like swimming, canoe racing, tug of war and most especially soccer well known as football. The football national team made an impact in 1990 at the FIFA world cup. They also won the African Nations Cup five times. Being the winner of the 2017 African Cup of Nations, they are to host the 2019 African cup of Nations. The purpose of this research is to analyse the impacts of sport tourism event in Cameroon and specifically examine how this event influences the residents. A deep research discourse conducted with randomly selected 300 inbound residents and 200 Cameroonian residents living abroad. Survey questionnaires, interviews and direct observations were carried out as a method of collecting data. The results showed that sport events brings a lot of prestige and honor to the country; generate revenues to the country’s economy and particularly to the local businesses. On the other hand, the results showed that the local residents lose their intimacy, privacy, and their daily life routine is affected. In addition to this, they face negative social inequalities and environmental impacts. Understanding these results the national government and international bodies might be able to contribute to future studies and propose efficient measures to maximize the positive benefits and minimize the negative benefits.

Keywords: sport Tourism, economic impact, resident altitude, african Cup of nations

Procedia PDF Downloads 170
4765 Antimicrobial, Antioxidant and Enzyme Activities of Geosmithia pallida (KU693285): A Fungal Endophyte Associated with Brucea mollis Wall Ex. Kurz, an Endangered and Medicinal Plant of N. E. India

Authors: Deepanwita Deka, Dhruva Kumar Jha

Abstract:

Endophytes are the microbes that colonize living, internal tissues of plants without causing any immediate, overt negative effects. Endophytes are rich source of therapeutic substances like antimicrobial, anticancerous, herbicidal, insecticidal, immunomodulatory compounds. Brucea mollis, commonly known as Quinine in Assam, belonging to the family Simaroubaceae, is a shrub or small tree, recorded as endangered species in North East India by CAMP survey in 2003. It is traditionally being used as antimalarial and antimicrobial agent and has antiplasmodial, cytotoxic, anticancer, diuretic, cardiovascular effect etc. Being endangered and medicinal; this plant may host certain noble endophytes which need to be studied in depth. The aim of the present study was isolation and identification of potent endophytic fungi from Brucea mollis, an endangered medicinal plant, to protect it from extinction due to over use for medicinal purposes. Aseptically collected leaves, barks and roots samples of healthy plants were washed and cut into a total of 648 segments of about 2 cm long and 0.5 cm broad with sterile knife, comprising 216 segments each from leaves, barks and roots. These segments were surface sterilized using ethanol, mercuric chloride (HgCl2) and aqueous solution of sodium hypochlorite (NaClO). Different media viz., Czapeck-Dox-Agar (CDA, Himedia), Potato-Dextrose-Agar (PDA, Himedia), Malt Extract Agar (MEA, Himedia), Sabourad Dextrose Agar (SDA, Himedia), V8 juice agar, nutrient agar and water agar media and media amended with plant extracts were used separately for the isolation of the endophytic fungi. A total of 11 fungal species were recovered from leaf, bark and root tissues of B. mollis. The isolates were screened for antimicrobial, antioxidant and enzymatic activities using certain protocols. Cochliobolus geniculatus was identified as the most dominant species. The mycelia sterilia (creamy white) showing highest inhibitory activity against Candida albicans (MTCC 183) was induced to sporulate using modified PDA media. The isolate was identified as Geosmithia pallida. The internal transcribed spacer of rDNA was sequenced for confirmation of the taxonomic identity of the sterile mycelia (creamy white). The internal transcribed spacer r-DNA sequence was submitted to the NCBI (KU693285) for the first time from India. G. pallida and Penicillium showed highest antioxidant activity among all the isolates. The antioxidant activity of G. pallida and Penicillium didn’t show statistically significant difference (P˃0.05). G. pallida, Cochliobolus geniculatus and P. purpurogenum respectively showed highest cellulase, amylase and protease activities. Thus, endopytic fungal isolates may be used as potential natural resource of pharmaceutical importance. The endophytic fungi, Geosmithia pallida, may be used for synthesis of pharmaceutically important natural products and consequently can replace plants hitherto used for the same purpose. This study suggests that endophytes should be investigated more aggressively to better understand the endophyte biology of B. mollis.

Keywords: Antimicrobial activity, antioxidant activity, Brucea mollis, endophytic fungi, enzyme activity, Geosmithia pallida

Procedia PDF Downloads 187
4764 One Decade Later: The Conundrum of Unrecognized Asherman Syndrome

Authors: Maria Francesca Lavadia-Gumabao, Mary Antoinette Salvamante-Torallo

Abstract:

Introduction: The fibrous intrauterine adhesions forming inside the uterus and/or cervix in Asherman syndrome can obstruct the internal cervical orifice and may present as a case of outflow tract obstruction. Asherman syndrome is often overlooked since it has no specific presentation and is undetectable by routine physical examinations or diagnostic procedures such as an ultrasound. This paper highlights the delay and elusive diagnosis of Asherman syndrome which negatively impacted the patient’s fertility and quality of life. Case presentation: A 33-year-old woman (gravida 3, para 3) who presented with secondary amenorrhea for thirteen years associated with cyclic pelvic pain and secondary infertility sought a consultation at our institution for evaluation and specialty management. The patient had no other well-established risk factors for Asherman syndrome aside from pregnancy. For more than a decade, she delayed seeking medical care. At presentation, history taking, physical examination, and ultrasound were not helpful in identifying the cause of outflow tract obstruction. Diagnostic hysteroscopy was then performed, during which extensive scarring and fibrosis completely obscured the internal cervical orifice were observed, consistent with the diagnosis of Asherman syndrome (Grade 5B). The patient then underwent ultrasound guided hysteroscopy outflow tract dilatation and responded well to the treatment as she had her menstrual period a month after the procedure and no longer had cyclic pelvic pain with a repeat ultrasound finding of an unremarkable uterus. The hispathology result of the tissues retrieved revealed myometrial fragments with associated old hemorrhage benign endometrial stromal tissues, which failed to show endometrial glands. Conclusion: The delay and elusive diagnosis of Asherman syndrome can be brought about by poor health seeking behavior of patients and difficulty in detecting this condition by routine physical examinations or diagnostic procedures such as an ultrasound. It is, therefore, necessary to include Asherman syndrome in the differential diagnosis of secondary amenorrhea and secondary infertility. With expertise in hysteroscopy, early diagnosis, proper classification in the advent of hysteroscopy, and optimal management can improve patient outcomes.

Keywords: Asherman syndrome, outflow tract obstruction, secondary amenorrhea, infertility, hysteroscopy

Procedia PDF Downloads 9
4763 Development and State in Brazil: How Do Some Institutions Think and Influence These Issues

Authors: Alessandro Andre Leme

Abstract:

To analyze three Brazilian think tanks: a) Fernando Henrique Foundation; b) Celso Furtado International Center; c) Millennium Institute and how they dispute interpretations about the type of development and State that should be adopted in Brazil. We will make use of Network and content analysis of the sites. The analyzes show a dispute that goes from a defense of ultraliberalism to developmentalism, going through a hybrid between State and Market voiced in each of the Think Tanks.

Keywords: sociopolitical and economic thinking, development, strategies, intellectuals, state

Procedia PDF Downloads 150