Search results for: decision of return migration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5685

Search results for: decision of return migration

3495 Challenging Airway Management for Tracheal Compression Due to a Rhabdomyosarcoma

Authors: Elena Parmentier, Henrik Endeman

Abstract:

Introduction: Large mediastinal masses often present with diagnostic and clinical challenges due to compression of the respiratory and hemodynamic system. We present a case of a mediastinal mass with symptomatic mechanical compression of the trachea, resulting in challenging airway management. Methods: We present a case of 66-year-old male, complaining of progressive dysphagia. Initial esophagogastroscopy revealed a stenosis secondary to external compression, biopsies were inconclusive. Additional CT scan showed a large mediastinal mass of unknown origin, situated between the vertebrae and esophagus. Symptoms progressed and patient developed dyspnea and stridor. A new CT showed quick growth of the mass with compression of the trachea, subglottic to just above the carina. A tracheal covered stent was successfully placed. Endobronchial ultrasound revealed a large irregular mass without tracheal invasion, biopsies were taken. 4 days after stent placement, the patients’ condition deteriorated with worsening of stridor, dyspnea and desaturation. Migration of the tracheal stent into the right main bronchus was seen on chest X ray, with obstruction of the left main bronchus and secondary atelectasis. Different methods have been described in the literature for tracheobronchial stent removal (surgical, endoscopic, fluoroscopyguided), our first choice in this case was flexible bronchoscopy. However, this revealed tracheal compression above the migrated stent and passage of the scope occurred impossible. Patient was admitted to the ICU, high-flow nasal oxygen therapy was started and the situation stabilized, giving time for extensive assessment and preparation of the airway management approach. Close cooperation between the intensivist, pulmonologist, anesthesiologist and otorhinolaryngologist was essential. Results: In case of sudden deterioration, a protocol for emergency situations was made. Given the increased risk of additional tracheal compression after administration of neuromuscular blocking agents, an approach with awake fiberoptic intubation maintaining spontaneous ventilation was proposed. However, intubation without retrieval of the tracheal stent was found undesirable due to expected massive shunting over the left atelectatic lung. As rescue option, assistance of extracorporeal circulation was considered and perfusionist was kept on standby. The patient stayed stable and was transferred to the operating theatre. High frequency jet ventilation under general anesthesia resulted in desaturations up to 50%, making rigid bronchoscopy impossible. Subsequently an endotracheal tube size 8 could be placed successfully and the stent could be retrieved via bronchoscopy over (and with) the tube, after which the patient was reintubated. Finally, a tracheostomy (Shiley™ Tracheostomy Tube With Cuff, size 8) was placed, fiberoptic control showed a patent airway. Patient was readmitted to the ICU and could be quickly weaned of the ventilator. Pathology was positive for rhabdomyosarcoma, without indication for systemic therapy. Extensive surgery (laryngectomy, esophagectomy) was suggested, but patient refused and palliative care was started. Conclusion: Due to meticulous planning in an interdisciplinary team, we showed a successful airway management approach in this complicated case of critical airway compression secondary to a rare rhabdomyosarcoma, complicated by tracheal stent migration. Besides presenting our thoughts and considerations, we support exploring other possible approaches of this specific clinical problem.

Keywords: airway management, rhabdomyosarcoma, stent displacement, tracheal stenosis

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3494 A Comprehensive Review of Electronic Health Records Implementation in Healthcare

Authors: Lateefat Amao, Misagh Faezipour

Abstract:

Implementing electronic health records (EHR) in healthcare is a pivotal transition aimed at digitizing and optimizing patient health information management. The expectations associated with this transition are high, even towards other health information systems (HIS) and health technology. This multifaceted process involves careful planning and execution to improve the quality and efficiency of patient care, especially as healthcare technology is a sensitive niche. Key considerations include a thorough needs assessment, judicious vendor selection, robust infrastructure development, and training and adaptation of healthcare professionals. Comprehensive training programs, data migration from legacy systems and models, interoperability, as well as security and regulatory compliance are imperative for healthcare staff to navigate EHR systems adeptly. The purpose of this work is to offer a comprehensive review of the literature on EHR implementation. It explores the impact of this health technology on health practices, highlights challenges and barriers to its successful utility, and offers practical strategies that can impact its success in healthcare. This paper provides a thorough review of studies on the adoption of EHRs, emphasizing the wide range of experiences and results connected to EHR use in the medical field, especially across different types of healthcare organizations.

Keywords: healthcare, electronic health records, EHR implementation, patient care, interoperability

Procedia PDF Downloads 71
3493 Ethical Investment Instruments for Financial Sustainability

Authors: Sarkar Humayun Kabir

Abstract:

This paper aims to investigate whether ethical investment instruments could contribute to stability in financial markets. In order to address the main issue, the study investigates the stability of return in seven conventional and Islamic equity markets of Asia, Europe and North America and in five major commodity markets starting from 1996 to June 2012. In addition, the study examines the unconditional correlation between returns of the assets under review to investigate portfolio diversification benefits of investors. Applying relevant methods, the study finds that investors may enjoy sustainable returns from their portfolios by investing in ethical financial instruments such as Islamic equities. In addition, it should be noted that most of the commodities, gold in particular, are either low or negatively correlated with equity returns. These results suggest that investors would be better off by investing in portfolios combining Islamic equities and commodities in general. The sustainable returns of ethical investments has important implications for the investors and markets since these investments can provide stable returns while the investors can avoid production of goods and services which believes to be harmful for human and the society as a whole.

Keywords: financial sustainability, ethical investment instruments, islamic equity, dynamic conditional correlation, conditional volatility

Procedia PDF Downloads 299
3492 Lecturers’ Need to Alter Their Identity in Remote Learning Environments: Case Study of Experiences from Uk and USA Universities

Authors: Richard Nelson

Abstract:

The knowledge, skills, and identity of the Higher Education professional are constantly challenged with a demanding environment of teaching, research, administration, and pastoral care. It is more important than ever for professors and lecturers to maintain their professional development in a constantly changing environment. The importance of professional development has become more focused as new skills are needed to meet the demands of remote teaching and learning during a pandemic. Uncertainty and performance pressures influence teachers to try to return to physical spaces or recreate lecture and seminar rooms despite more effective online spaces being available. This case study uses the Boys’ spatial triad as a framework for qualitative interviews to capture the Lecturers’ experiences in Universities in the UK and the USA of moving to online learning spaces. The study finds that without effective professional development and time to reflect critically on remote learning innovation in their teaching practices, lecturers attempt to defer to lecture theatres and seminar rooms, or similes of, as their preferred space for teaching and learning. Professional Development is needed to encourage teachers to reflect on their professional identity and relationship to the teaching space.

Keywords: professional identity, learning, online, remote

Procedia PDF Downloads 149
3491 Strategies Used by the Saffron Producers of Taliouine (Morocco) to Adapt to Climate Change

Authors: Aziz Larbi, Widad Sadok

Abstract:

In Morocco, the mountainous regions extend over about 26% of the national territory where 30% of the total population live. They contain opportunities for agriculture, forestry, pastureland and mining. The production systems in these zones are characterised by crop diversification. However, these areas have become vulnerable to the effects of climate change. To understand these effects in relation to the population living in these areas, a study was carried out in the zone of Taliouine, in the Anti-Atlas. The vulnerability of crop productions to climate change was analysed and the different ways of adaptation adopted by farmers were identified. The work was done on saffron, the most profitable crop in the target area even though it requires much water. Our results show that the majority of the farmers surveyed had noticed variations in the climate of the region: irregularity of precipitation leading to a decrease in quantity and an uneven distribution throughout the year; rise in temperature; reduction in the cold period and less snow. These variations had impacts on the cropping system of saffron and its productivity. To cope with these effects, the farmers adopted various strategies: better management and use of water; diversification of agricultural activities; increase in the contribution of non-agricultural activities to their gross income; and seasonal migration.

Keywords: climate change, Taliouine, saffron, perceptions, adaptation strategies

Procedia PDF Downloads 55
3490 Research on Emotional Healing Street Furniture under the Background of Urban Micro-Renewal

Authors: Tanhao Gao, Hongtao Zhou

Abstract:

With the COVID-19 pandemic spreading worldwide, people are facing more significant mental pressure. The government and social groups are sparing no effort to find ways to heal people's emotions and return to normal life. Therefore, research on emotional healing has urgency and practical significance. From the perspective of urban planning, street furniture has the potential to become "emotional healing touchpoints." This study first analyzed the suitable places for adding emotional healing street furniture in the background of urban micro-renewal and combined the fifteen-minute living circle, the leftover space, and urban acupuncture theories, then used the 5W analysis method to show the main characteristics of emotionally healing street furniture. Finally, the research discovers four design strategies, which can be summarized as: A. Exploring the renewal potential of the leftover space; B. Integrating with local culture and the surrounding environment; C. Discovering quick and straightforward ways of interaction; D. Finding a delicate balance between artistry and functionality. Then, the author takes one emotional healing street furniture located on Chifeng Road as an example to show the design strategies vividly.

Keywords: emotional healing, street furniture, urban micro-renewal, urban acupuncture

Procedia PDF Downloads 189
3489 Effect of Financing Sources on Firm Performance: A Study of Indian Private Limited Small and Medium Enterprises

Authors: Denila Jinny Arulraj, Thillai Rajan Annamalai

Abstract:

This paper aims to study the relationship between funding sources and firm performance of Indian private limited SMEs using cross-sectional data obtained from a nation-wide census. A unique feature of the study is that it analyses firms that use only one form of external funding. Employing Propensity Score Matching, we find that obtaining any form of external finance has a negative influence on equivalents of profit margin and return on assets and a negative influence on asset turnover of small firms. But, the impact of institutional sources of funding on small enterprises is found to be lesser than that of non-institutional sources of funding. External/institutional sources of funding have a less negative impact on the profit margin for medium enterprises and have no significant influence on other measures of performance. The contribution of this research is the discovery of institutional sources wielding a lesser influence on performance measures considered. It is also found that institutional sources can benefit small enterprises more than medium enterprises.

Keywords: external finance, institutional finance, non-institutional finance, performance, India, SME

Procedia PDF Downloads 270
3488 Loop Heat Pipe Two-Phase Heat Transports: Guidelines for Technology Utilization

Authors: Triem T. Hoang

Abstract:

Loop heat pipes (LHPs) are two-phase capillary-pumped heat transports. An appropriate working fluid is selected for the intended application temperature range. A closed-loop is evacuated to a high vacuum, back-filled partially with the working fluid, and then hermetically sealed under the fluid own pressure. Heat from a heat source conducts through the evaporator casing to vaporize liquid on the outer surface of the wick structure inside the evaporator. The generated vapor is compelled to vent out of the evaporator and into the vapor line for transport to the condenser assembly. There, heat is removed and rejected to a heat sink to condensed vapor back to liquid. The liquid exits the condenser and travels in the liquid line to return to the evaporator to complete the cycle. The circulation of fluid, and thus the heat transport in the LHP, is accomplished entirely by capillary action. The LHP contains no mechanical moving part to wear out or break down and, therefore possesses, reliability and a long life even without maintenance. In this paper, the author not only attempts to introduce the LHP technology in simplistic terms to those who are not familiar with it but also provides necessary technical information to potential users for the proper design and analysis of the LHP system.

Keywords: two-phase heat transfer, loop heat pipe, capillary pumped technology, thermal-fluid modeling

Procedia PDF Downloads 132
3487 'Refugee Crisis' and Global Labour Relations: Syrian Labour in Turkish Textile Factories

Authors: Katarzyna Czarnota, Inga Hajdarowicz

Abstract:

Political mechanisms of legal, social and economic segregation of refugees and migrants have reproduced and deepened existing hierarchies and inequalities in global labour relations. The consequences of these processes strengthened by current, so called, ‘refugee crisis’, tightening of border regimes, militarisation and closing of Balkan Route, will have a significant impact on future integration policies. One of the fields that require further research is limited access to labour rights of migrants and refugees. Although this phenomenon is experienced by a significant proportion of migrant population, these are the poorest who are also exposed to economic racism. The presentation will tackle the influence of current migration policies on increasing social and class inequalities between migrants, refugees, on the example of Syrian labours in Turkish textile factories. The authors will critically analyse examples of integration policies, especially planned changes in labour law as well as examples of violation of labour rights and exploitation of refugees and migrants in textile factories and industry. The presentation will be based on interviews with Syrian workers, conducted in Turkey and Greece in 2016.

Keywords: refugee crisis, economic racism, global labour relations, exploatation

Procedia PDF Downloads 318
3486 Autophagy Suppresses Tumorigenesis through Upregulation of MiR-449a in Colorectal Cancer

Authors: Sheng-Hui Lan, Shan-Ying Wu, Shu-Ching Lin, Wei-Chen Wang, Hsiao-Sheng Liu

Abstract:

Autophagy is an essential mechanism to maintain cellular homeostasis through its degradation function, and the autophagy deficiency is related various diseases including tumorigenesis in several cancers. MicroRNAs (miRNAs) are small none coding RNAs, which regulate gene expression through degradation of mRNA or inhibition of translation. However, the relationship between autophagy deficiency and dysregulated miRNAs is still unclear. We revealed a mechanism that autophagy up-regulates miR-449a expression at the transcriptional level through activation of forkhead transcription factor family member FoxO1 and then suppresses tumorigenesis in CRC. Our data showed that the autophagic activity and miR-449a expression were lower in colorectal cancer (CRC) and has a positive correlation. We further reveal that autophagy degrades p300 expression and then suppresses acetylation of FoxO1. Under autophagic induction conditions, FoxO1 is transported from the cytoplasm to the nucleus and binds to the miR-449a promoter and then promotes miR-449a expression. In addition, either miR-449a overexpression or amiodarone-induced autophagy inhibits cell cycle progression, proliferation, colony formation migration, invasion, and tumor formation of SW480 cells. Our findings indicate that autophagy inducers may have the potential to be used for prevention and treatment of CRC through upregulation of miR-449a expression.

Keywords: autophagy, MiR-449a, FoxO1, colorectal cancer

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3485 Traditional Values and Their Adaptation in Social Housing Design: Towards a New Typology and Establishment of 'Airhouse' Standard in Malaysia

Authors: Mohd Firrdhaus Mohd Sahabuddin, Cristina Gonzalez-Longo

Abstract:

Large migration from rural areas to urban areas like Kuala Lumpur has led to some implications for economic, social and cultural development. This high population has placed enormous demand on the existing housing stocks, especially for low-income groups. However, some issues arise, one of which is overheated indoor air temperature. This problem contributes to the high-energy usage that forces huge sums of money to be spent on cooling the house by using mechanical equipment. Therefore, this study focuses on thermal comfort in social housing, and incorporates traditional values into its design to achieve a certain measurement of natural ventilation in a house. From the study, the carbon emission and energy consumption for an air-conditioned house is 67%, 66% higher than a naturally ventilated house. Therefore, this research has come up with a new typology design, which has a large exposed wall area and full-length openings on the opposite walls to increase cross ventilation. At the end of this research, the measurement of thermal comfort for a naturally ventilated building called ‘AirHouse’ has been identified.

Keywords: tropical architecture, natural ventilation, passive design, AirHouse, social housing design

Procedia PDF Downloads 672
3484 Regional Flood-Duration-Frequency Models for Norway

Authors: Danielle M. Barna, Kolbjørn Engeland, Thordis Thorarinsdottir, Chong-Yu Xu

Abstract:

Design flood values give estimates of flood magnitude within a given return period and are essential to making adaptive decisions around land use planning, infrastructure design, and disaster mitigation. Often design flood values are needed at locations with insufficient data. Additionally, in hydrologic applications where flood retention is important (e.g., floodplain management and reservoir design), design flood values are required at different flood durations. A statistical approach to this problem is a development of a regression model for extremes where some of the parameters are dependent on flood duration in addition to being covariate-dependent. In hydrology, this is called a regional flood-duration-frequency (regional-QDF) model. Typically, the underlying statistical distribution is chosen to be the Generalized Extreme Value (GEV) distribution. However, as the support of the GEV distribution depends on both its parameters and the range of the data, special care must be taken with the development of the regional model. In particular, we find that the GEV is problematic when developing a GAMLSS-type analysis due to the difficulty of proposing a link function that is independent of the unknown parameters and the observed data. We discuss these challenges in the context of developing a regional QDF model for Norway.

Keywords: design flood values, bayesian statistics, regression modeling of extremes, extreme value analysis, GEV

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3483 Efficiency and Performance of Legal Institutions in the Middle East in the 21st Century

Authors: Marco Khalaf Ayad Milhaail

Abstract:

In thinking about the role of legal rules and their impact on social ethics and social structures, scholars have explored many issues related to gender, power, and ideology. First, it provides a framework for defining feminist legal studies through an overview of the field's evolution in terms of equality, rights, and justice. Secondly, it encourages those interested in equality, rights, and justice regarding women's issues to participate in international comparative law research. Third, we must emphasize that those seeking solutions to disability and discrimination must be aware of the need to confront the so-called undermining of culture. Therefore, an effective way for women to solve this problem is to rely heavily on international law, which establishes basic legal principles such as gender equality, rights, and justice and can help create a domestic environment. Woman has gained many advantages by adopting the law of Divorce in the Islamic Sharea. Any Egyptian woman can get divorce by letting her rightful rights and wealth to her husband in return for her freedom.

Keywords: stability, harsh environments, techniques, thermal, properties, materials, applications, brittleness, fragility, disadvantages, bank, branches, profitability, setting prediction, effective target, measurement, evaluation, performance, commercial, business, profitability, sustainability, financial, system, banks

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3482 Corporate Governance and Performance of Islamic Banks in GCC Countries

Authors: Samir Srairi

Abstract:

This paper investigates the impact of the internal corporate governance on bank performance by constructing a corporate governance index (CGI) for 27 Islamic banks operating in five Arab Gulf countries. Using content analysis on the banks’ annual reports for 3 years (2011-2013), the index construction uses information on six important corporate governance mechanisms, namely board structure, risk management, transparency and disclosure, audit committee, Sharia supervisory board and investment account holders. The results demonstrate that Islamic banks adhere to 54% of the attributes addressed in the CGI. The most frequently reported and disclosed elements are Sharia supervisory board followed by board structure and risk management. The findings related to countries revealed that only two countries, the United Arab Emirates and Bahrain, possess a higher level of CGI. Our regression results provide evidence that Islamic banks with higher levels of corporate governance report high operating performance measured by return on assets and net interest margin. Finally, as of the effect of internal and external factors, we identified four variables that were associated with bank performance, namely size, equity, risk and concentration.

Keywords: governance mechanisms, corporate governance index, bank performance, Islamic banks, GCC countries

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3481 Post-Disaster Recovery and Impacts on Construction Resources: Case Studies of Queensland Catastrophic Events

Authors: Scott A. Abbott

Abstract:

This paper examines the increase in the occurrence of natural disasters worldwide and the need to support vulnerable communities in post-disaster recovery. Preparation and implementation of post-disaster recovery projects need to be improved to allow communities to recover infrastructure, housing, economically and socially following a catastrophe. With the continual rise in catastrophic events worldwide due to climate change, impacts on construction resources affect the ability for post-disaster recovery to be undertaken. This research focuses on case studies of catastrophic events in Queensland, Australia, to contribute to the body of knowledge and gain valuable insights on lessons learned from past events and how they have been managed. The aim of this research is to adopt qualitative data using semi-structured interviews from participants predominantly from the insurance sector to understand barriers that have previously and currently exist in post-disaster recovery. Existing literature was reviewed to reveal gaps in knowledge that needed to be tested. Qualitative data was collected and summarised from field research with the results analysed and discussed. Barriers that impacted post-disaster recovery included time, cost, and resource capability and capacity. Causal themes that impacted time and cost were identified as decision making, pre-planning, and preparedness, as well as effective communication across stakeholders. The research study applied a qualitative approach to the existing literature and case studies across Queensland, Australia, to identify existing and new barriers that impact post-disaster recovery. It was recommended to implement effective procurement strategies to assist in cost control; implement pre-planning and preparedness strategies across funder, contractor, and local governments; more effective and timely decision making to reduce time and cost impacts.

Keywords: construction recovery, cost, disaster recovery, resources, time

Procedia PDF Downloads 122
3480 Characteristics of Phytophthora infestans: The Causal Fungus of Potato Late Blight Disease

Authors: A. E. Elkorany, Eman Elsrgawy

Abstract:

Eighty six isolates of Phytophthora infestans dating back to 2006 were recovered from potato tubers that were on sale in Alexandria markets, Egypt. The isolates were characterized for mating type and colony morphology. Both A1 and A2 mating types were detected in the isolate collection, however, the A2 constituted 5.8% of the total isolates made while the A1 mating type isolates constituted 91.9%. The self-fertile phenotype was also detected but at a lower percentage of 2.3% of the total isolates. This indicated that Mexico, the probable origin of the disease, is no longer the only place where A2 mating type ever exists. The lumpy phenotype was the only trait observed linked to the A2 mating type isolates on rye A agar medium. The self-fertile isolates, however, exhibited colonies of a waxy appearance with little aerial hyphae and the culture were backed full with oospores. The A1 mating colonies were of smooth white abundant aerial hyphae. The metalaxyl resistant isolates were also detected among the analyzed isolates and constituted 4.6% of the total (86) isolates investigated. The appearance of the A2 mating type outside Mexico and the variation revealed in the population of Phytophthora infestans investigated supported the hypothesis of a second worldwide migration of the fungus from its origin which could constitute a threat to potato cultivation around the world.

Keywords: Phytophthora infestans, potato, Egypt, fungus

Procedia PDF Downloads 378
3479 Navigating Rough Seas: A Qualitative Exploration of National Sociotechnical Imaginaries of Myanmar’s Future Marine Fisheries

Authors: Hannes Groeneweg

Abstract:

Myanmar is considered one of the largest fishing nations in the world. The country’s rapid economic and political reform process since 2011 entails both challenges and opportunities for its marine fishing sector. The development pathway of the sector remains unclear. Which future will eventually materialize is shaped and determined by the various visions and actions of the stakeholders engaging in political debates and decision-making. These visions can be conceptualized through the Science and Technology Studies (STS) concept of sociotechnical imaginaries. The research of this article is guided by the question of which imaginaries are currently relevant, who is propagating these imaginaries, and how are these imaginaries produced and contested. Using qualitative documentary analysis of policy documents, reports, and media articles as well as in-depth interviews with key stakeholders, three archetypical national sociotechnical imaginaries of Myanmar’s future marine fisheries were identified: The industrial scale extractivism imaginary views marine fishing sector as a driver for national economic growth and focuses on the industrial and technological development of the production chain, increasing yield and exports. Sustainable fishing management encompasses the vulnerability of marine ecosystems and views increasing efficient sustainability governance, planning, and management into existing fishing practices. In the traditional sufficiency fishing imaginary, small-scale fishing practices are viewed as an important livelihood practice for millions of coastal dwellers. The need to conserve them through strengthening the self-reliance, autonomy, and resilience of these communities is stressed. In national debates, the first two imaginaries are currently dominant. The imaginaries, as well as their contestations, are also linked to other critical political issues. The paper suggests that participatory decision-making processes are needed to create an inclusive imaginary of the future marine fishing sector.

Keywords: science and technology studies, sociotechnical imaginaries, marine fishing, knowledge coproduction, Myanmar

Procedia PDF Downloads 176
3478 Fish Check-List and Their Characteristics in Bayeku Water, Lagos, Nigeria

Authors: A. W. Kashimawo

Abstract:

Fish check list of Bayeku water, Lagos, Nigeria was investigated between February 2012 and January 2013. Fish specimens were caught with gill and cast-nets, and non-return valve basket trap. Services of artisanal fishermen were employed for the setting of gears and collections of fish. Species not captured after sampling were assumed to be absent or so rare as to be of minimal ecological importance. The 632 specimens were preserved in 10 % formaldehyde in the field prior to their identification. Physicochemical parameters such as temperature, salinity, dissolved oxygen and pH were determined from the lagoon water samples following standard methods. A total of 632 fish were encountered, belonging to 23 families, 27 genera and 29 species. The most abundant species were Chrysichthys nigrodigitatus (9.65 %), Macrobrachium vollenhoveni (7.94 %), Ethmalosa fimbriata (7.12 %), Elops lacerta (6.96 %), Cynoglossus browni (6.17 %), Gobioides broussonnetii (5.69 %), Sphyraena piscatorum (5.39 %), Polydactylus quadrifilis (5.06 %), and Mugil cephalus (4.91 %). There were seasonal variations in species occurrence and abundance. Marine fishes were found in dry season.. Freshwater fishes were more during the wet season. There are marine and freshwater fishes that have euryhaline characteristics and have adapted to the lagoon environment such that they were encountered both in dry and wet seasons.

Keywords: fish check list, species occurrence, abundance, ecological importance

Procedia PDF Downloads 481
3477 Grade and Maximum Tumor Dimension as Determinants of Lymphadenectomy in Patients with Endometrioid Endometrial Cancer (EEC)

Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

Abstract:

Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size

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3476 Thermal Stability and Crystallization Behaviour of Modified ABS/PP Nanocomposites

Authors: Marianna I. Triantou, Petroula A. Tarantili

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In this research work, poly (acrylonitrile-butadiene-styrene)/polypropylene (ABS/PP) blends were processed by melt compounding in a twin-screw extruder. Upgrading of the thermal characteristics of the obtained materials was attempted by the incorporation of organically modified montmorillonite (OMMT), as well as, by the addition of two types of compatibilizers; polypropylene grafted with maleic anhydride (PP-g-MAH) and ABS grafted with maleic anhydride (ABS-g-MAH). The effect of the above treatments was investigated separately and in combination. Increasing the PP content in ABS matrix seems to increase the thermal stability of their blend and the glass transition temperature (Tg) of SAN phase of ABS. From the other part, the addition of ABS to PP promotes the formation of its β-phase, which is maximum at 30 wt% ABS concentration, and increases the crystallization temperature (Tc) of PP. In addition, it increases the crystallization rate of PP.The β-phase of PP in ABS/PP blends is reduced by the addition of compatibilizers or/and organoclay reinforcement. The incorporation of compatibilizers increases the thermal stability of PP and reduces its melting (ΔΗm) and crystallization (ΔΗc) enthalpies. Furthermore it decreases slightly the Tgs of PP and SAN phases of ABS/PP blends. Regarding the storage modulus of the ABS/PP blends, it presents a change in their behavior at about 10°C and return to their initial behavior at ~110°C. The incorporation of OMMT to no compatibilized and compatibilized ABS/PP blends enhances their storage modulus.

Keywords: acrylonitrile, butadiene, styrene terpolymer, compatibilizer, organoclay, polypropylene

Procedia PDF Downloads 316
3475 Long Distance Aspirating Smoke Detection for Large Radioactive Areas

Authors: Michael Dole, Pierre Ninin, Denis Raffourt

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Most of the CERN’s facilities hosting particle accelerators are large, underground and radioactive areas. All fire detection systems installed in such areas, shall be carefully studied to cope with the particularities of this stringent environment. The detection equipment usually chosen by CERN to secure these underground facilities are based on air sampling technology. The electronic equipment is located in non-radioactive areas whereas air sampling networks are deployed in radioactive areas where fire detection is required. The air sampling technology provides very good detection performances and prevent the "radiation-to-electronic" effects. In addition, it reduces the exposure to radiations of maintenance workers and is permanently available during accelerator operation. In order to protect the Super Proton Synchrotron and its 7 km tunnels, a specific long distance aspirating smoke detector has been developed to detect smoke at up to 700 meters between electronic equipment and the last air sampling hole. This paper describes the architecture, performances and return of experience of the long distance fire detection system developed and installed to secure the CERN Super Proton Synchrotron tunnels.

Keywords: air sampling, fire detection, long distance, radioactive areas

Procedia PDF Downloads 153
3474 Clinical Advice Services: Using Lean Chassis to Optimize Nurse-Driven Telephonic Triage of After-Hour Calls from Patients

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

Abstract:

It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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3473 Heart Rate Variability Responses Pre-, during, and Post-Exercise among Special Olympics Athletes

Authors: Kearney Dover, Viviene Temple, Lynneth Stuart-Hill

Abstract:

Heart Rate Variability (HRV) is the beat-to-beat variation in adjacent heartbeats. HRV is a non-invasive measure of the autonomic nervous system (ANS) and provides information about the sympathetic (SNS) and parasympathetic (PNS) nervous systems. The HRV of a well-conditioned heart is generally high at rest, whereas low HRV has been associated with adverse outcomes/conditions, including congestive heart failure, diabetic neuropathy, depression, and hospital admissions. HRV has received very little research attention among individuals with intellectual disabilities in general or Special Olympic athletes. Purpose: 1) Having a longer post-exercise rest and recovery time to establish how long it takes for the athletes’ HRV components to return to pre-exercise levels, 2) To determine if greater familiarization with the testing processes influences HRV. Participants: Two separate samples of 10 adult Special Olympics athletes will be recruited for 2 separate studies. Athletes will be between 18 and 50 years of age and will be members of Special Olympics BC. Anticipated Findings: To answer why the Special Olympics athletes display poor cardiac responsiveness to changes in autonomic modulation during exercise. By testing the cortisol levels in the athletes, we can determine their stress levels which will then explain their measured HRV.

Keywords: 6MWT, autonomic modulation, cortisol levels, intellectual disability

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3472 University-home Partnerships for Enhancing Students’ Career Adapting Responses: A Moderated-mediation Model

Authors: Yin Ma, Xun Wang, Kelsey Austin

Abstract:

Purpose – Building upon career construction theory and the conservation of resources theory, we developed a moderated mediation model to examine how the perceived university support impact students’ career adapting responses, namely, crystallization, exploration, decision and preparation, via the mediator career adaptability and moderator perceived parental support. Design/methodology/approach – The multi-stage sampling strategy was employed and survey data were collected. Structural equation modeling was used to perform the analysis. Findings – Perceived university support could directly promote students’ career adaptability, and promote three career adapting responses, namely, exploration, decision and preparation. It could also impact four career adapting responses via mediation effect of career adaptability. Its impact on students’ career adaptability can greatly increase when students’ receive parental related career support. Research limitations/implications – The cross-sectional design limits causal inference. Conducted in China, our findings should be cautiously interpreted in other countries due to cultural differences. Practical implications – University support is vital to students’ career adaptability and supports from parents can enhance this process. University-home collaboration is necessary to promote students’ career adapting responses. For students, seeking and utilizing as much supporting resources as possible is vital for their human resources development. On an organizational level, universities could benefit from our findings by introducing the practices which ask students to rate the career-related courses and encourage them to chat with parents regularly. Originality/ value – Using recently developed scale, current work contributes to the literature by investigating the impact of multiple contextual factors on students’ career adapting response. It also provide the empirical support for the role of human intervention in fostering career adapting responses.

Keywords: career adapability, university and parental support, China studies, sociology of education

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3471 Economic Analysis of Domestic Combined Heat and Power System in the UK

Authors: Thamo Sutharssan, Diogo Montalvao, Wen-Chung Wang, Yong Chen, Claudia Pisac

Abstract:

A combined heat and power (CHP) system is an efficient and clean way to generate power (electricity). Heat produced by the CHP system can be used for water and space heating. The CHP system which uses hydrogen as fuel produces zero carbon emission. Its’ efficiency can reach more than 80% whereas that of a traditional power station can only reach up to 50% because much of the thermal energy is wasted. The other advantages of CHP systems include that they can decentralize energy generation, improve energy security and sustainability, and significantly reduce the energy cost to the users. This paper presents the economic benefits of using a CHP system in the domestic environment. For this analysis, natural gas is considered as potential fuel as the hydrogen fuel cell based CHP systems are rarely used. UK government incentives for CHP systems are also considered as the added benefit. Results show that CHP requires a significant initial investment in return it can reduce the annual energy bill significantly. Results show that an investment may be paid back in 7 years. After the back period, CHP can run for about 3 years as most of the CHP manufacturers provide 10-year warranty.

Keywords: combined heat and power, clean energy, hydrogen fuel cell, economic analysis of CHP, zero emission

Procedia PDF Downloads 378
3470 Analysing Waste Management Options in the Printing Industry: Case of a South African Company

Authors: Stanley Fore

Abstract:

The case study company is one of the leading newsprint companies in South Africa. The company has achieved this status through operational expansion, diversification and investing in cutting-edge technology. They have a reputation for the highest quality and personalised service that transcends borders and industries. The company offers a wide variety of small and large scales printing services. The company is faced with the challenge of significant waste production during normal operations. The company generates 1200 kg of plastic waste and 60 – 70 tonnes of paper waste per month. The company operates a waste management process currently, whereby waste paper is sold, at low cost, to recycling firms for further processing. Having considered the quantity of waste being generated, the company has embarked on a venture to find a more profitable solution to its current waste production. As waste management and recycling is not the company’s core business, the aim of the venture is to implement a secondary profitable waste process business. The venture will be expedited as a strategic project. This research aims to estimate the financial feasibility of a selected solution as well as the impact of non-financial considerations thereof. The financial feasibility is analysed using metrics such as Payback period; internal rate of return and net present value.

Keywords: waste, printing industry, up-cycling, management

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3469 Affective (And Effective) Teaching and Learning: Higher Education Gets Social Again

Authors: Laura Zizka, Gaby Probst

Abstract:

The Covid-19 pandemic has affected the way Higher Education Institutions (HEIs) have given their courses. From emergency remote where all students and faculty were immediately confined to home teaching and learning, the continuing evolving sanitary situation obliged HEIs to adopt other methods of teaching and learning from blended courses that included both synchronous and asynchronous courses and activities to hy-flex models where some students were on campus while others followed the course simultaneously online. Each semester brought new challenges for HEIs and, subsequently, additional emotional reactions. This paper investigates the affective side of teaching and learning in various online modalities and its toll on students and faculty members over the past three semesters. The findings confirm that students and faculty who have more self-efficacy, flexibility, and resilience reported positive emotions and embraced the opportunities that these past semesters have offered. While HEIs have begun a new semester in an attempt to return to ‘normal’ face-to-face courses, this paper posits that there are lessons to be learned from these past three semesters. The opportunities that arose from the challenge of the pandemic should be considered when moving forward by focusing on a greater emphasis on the affective aspect of teaching and learning in HEIs worldwide.

Keywords: effective teaching and learning, higher education, engagement, interaction, motivation

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3468 Identifying a Drug Addict Person Using Artificial Neural Networks

Authors: Mustafa Al Sukar, Azzam Sleit, Abdullatif Abu-Dalhoum, Bassam Al-Kasasbeh

Abstract:

Use and abuse of drugs by teens is very common and can have dangerous consequences. The drugs contribute to physical and sexual aggression such as assault or rape. Some teenagers regularly use drugs to compensate for depression, anxiety or a lack of positive social skills. Teen resort to smoking should not be minimized because it can be "gateway drugs" for other drugs (marijuana, cocaine, hallucinogens, inhalants, and heroin). The combination of teenagers' curiosity, risk taking behavior, and social pressure make it very difficult to say no. This leads most teenagers to the questions: "Will it hurt to try once?" Nowadays, technological advances are changing our lives very rapidly and adding a lot of technologies that help us to track the risk of drug abuse such as smart phones, Wireless Sensor Networks (WSNs), Internet of Things (IoT), etc. This technique may help us to early discovery of drug abuse in order to prevent an aggravation of the influence of drugs on the abuser. In this paper, we have developed a Decision Support System (DSS) for detecting the drug abuse using Artificial Neural Network (ANN); we used a Multilayer Perceptron (MLP) feed-forward neural network in developing the system. The input layer includes 50 variables while the output layer contains one neuron which indicates whether the person is a drug addict. An iterative process is used to determine the number of hidden layers and the number of neurons in each one. We used multiple experiment models that have been completed with Log-Sigmoid transfer function. Particularly, 10-fold cross validation schemes are used to access the generalization of the proposed system. The experiment results have obtained 98.42% classification accuracy for correct diagnosis in our system. The data had been taken from 184 cases in Jordan according to a set of questions compiled from Specialists, and data have been obtained through the families of drug abusers.

Keywords: drug addiction, artificial neural networks, multilayer perceptron (MLP), decision support system

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3467 Six Failure Points Innovators and Entrepreneurs Risk Falling into: An Exploratory Study of Underlying Emotions and Behaviors of Self- Perceived Failure

Authors: Katarzyna Niewiadomska

Abstract:

Many technology startups fail to achieve a worthwhile return on investment for their funders, founders, and employees. Failures in product development, to-market strategy, sales, and delivery are commonly recognized. Founder failures are not as obvious and harder to identify. This paper explores six critical failure points that entrepreneurs and innovators are susceptible to and aims to link their emotional intelligence and behavioral profile to the points at which they experienced self-perceived failure. A model of six failure points from the perspective of the technology entrepreneur ranging from pre-startup to maturity is provided. By analyzing emotional and behavioral profile data from entrepreneurs and recording in-person accounts, certain key emotional and behavioral clusters contributing to each failure point are determined, and several underlying factors are defined and discussed. Recommendations that support entrepreneurs and innovators stalling at each failure point are given. This work can enable stakeholders to evaluate founder emotional and behavioral profiles and to take risk-mitigating action, either through coaching or through more robust team creation, to avoid founder-related company failure. The paper will be of interest to investors funding startups, executives leading them and mentors supporting them.

Keywords: behavior, emotional intelligence, entrepreneur, failure

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3466 A Study Concerning Foreign Worker Migration in Thailand

Authors: Napatsorn Suput-Anyaporn

Abstract:

This paper aimed to investigate multilateral relationships across the factors which included labor shortage, trade union, turnover rate of employee, labor law and regulation, and effectiveness of foreign worker administration in the scope of foreign workers in the industrial manufacturing sector of Thailand. The research employed both quantitative and qualitative approaches, in which foreign workers from Myanmar, Laos and Cambodia in the industrial manufacturing sector in selected areas of Thailand were sampled for the quantitative data collection, and persons in the chief executive management and the supervisor levels, and persons in the academic area in relation with foreign workers were selected as the sample for the qualitative data collection method. Thus, a questionnaire, in-depth interview and focus group were utilized as tools in this research paper. The discussion placed an emphasis on the fact that Thailand should design more effective law and regulations for the foreign workers administration and management in response to preparing for the coming ASEAN Economic Community with the declaration of the free- flow labor movement policy.

Keywords: industrial manufacturing sector, labor law and regulation, labor shortage, migrant worker, trade union, turnover rate of employee

Procedia PDF Downloads 405