Search results for: pain assessment

Authors: Muhammad Saad Aslam

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In 2021, our organization has launched our proprietary mobile App i.e. Farm Intelligence platform, an industrial-first precision agriculture solution, to Pakistan. It was piloted at 47 locations (spanning around 1,200 hectares of land), addressing growers’ pain points by bringing the benefits of precision agriculture to their doorsteps. This year, we have extended its reach by more than 10 times (nearly 130,000 hectares of land) in almost 600 locations across the country. The project team selected highly infested areas to set up traps, which then enabled the sales team to initiate evidence-based conversations with the grower community about preventive crop protection products that includes pesticides and insecticides. Mega farmer meeting field visits and demonstrations plots coupled with extensive marketing activities, were setup to include farmer community. With the help of App real-time pest monitoring (using heat maps and infestation prediction through predictive analytics) we have equipped our growers with on spot insights that will help them optimize pesticide applications. Heat maps allow growers to identify infestation hot spots to fine-tune pesticide delivery, while predictive analytics enable preventive application of pesticides before the situation escalates. Ultimately, they empower growers to keep their crops safe for a healthy harvest.

Keywords: precision pest management, precision agriculture, real time pest tracking, pest forecasting

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Authors: Payal Maheshwari, Maheaswari Brindavan

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The present study aimed at studying the level of perceived self-efficacy of children with learning disability and their mother’s perception about the efficacy of the child and the relationship between the two. The study further aimed at finding out the relationship between the level of perceived self-efficacy of children with learning disability and their academic achievement and their mother’s perception about the Efficacy of the child and child’s Academic Achievement. The sample comprised of 80 respondents (40 children with learning disability and their mothers). Children with learning disability as their primary condition, belonging to middle or upper middle class, living with both the parents, residing in Mumbai and their mothers were selected. Purposive or judgmental and snowball sampling technique was used to select the sample for the present study. Proformas in the form of questionnaires were used to obtain the background information of the children with learning disability and their mother’s. A self-constructed Mother’s Perceived Efficacy of their Child Assessment Scale was used to measure mothers perceived level of efficacy of their child with learning disability. Self-constructed Child’s Perceived Self-Efficacy Assessment Scale was used to measure the level of child’s perceived self-efficacy. Academic scores of the child were collected from the child’s parents or teachers and were converted into percentage. The data were analyzed quantitatively using frequencies, mean and standard deviation. Correlations were computed to ascertain the relationships between the different variables. The findings revealed that majority of the mother’s perceived efficacy about their child with learning disability was above average as well as majority of the children with learning disability also perceived themselves as having above average level of self-efficacy. Further in the domains of self-regulated learning and emotional self-efficacy majority of the mothers perceived their child as having average or below average efficacy, 50% of the children also perceived their self-efficacy in the two domains at average or below average level. A significant (r=.322, p < .05) weak correlation (Spearman’s rho) was found between mother’s perceived efficacy about their child, and child’s perceived self-efficacy and a significant (r=.377, p < .01) weak correlation (Pearson Correlation) was also found between mother’s perceived efficacy about their child and child’s academic achievement. Significant weak positive correlation was found between child’s perceived self-efficacy and academic achievement (r=.332, p < .05). Based on the findings, the study discussed the need for intervention program for children in non-academic skills like self-regulation and emotional competence.

Keywords: learning disability, perceived self efficacy, academic achievement, mothers, children

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Authors: Zdravko Trivic, John Chye Fung, Ruzica Bozovic-Stamenovic

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Within the context of rapidly ageing population in Singapore and the pressing demands on both caregivers and care providers, an integrated approach to ageing-friendly and ability-sensitive enabling environment becomes an imperative. This particularly applies to nursing home environments and their immediate surroundings, as they are becoming one of the main available options of long-term care for many senior adults who are unable to age at home. Yet, despite the considerable efforts to break the still predominant clinical approach to eldercare and to introduce more home-like design and person-centric care model, nursing homes keep being stigmatised and perceived as not so desirable environments to grow old in. The challenges are further emphasised by the associated physical, sensorial, psychological and cognitive declines that are the common consequences of ageing. Such declines have an immense impact on almost all aspects of older adults’ daily functioning, including problems with mobility and spatial orientation, difficulties in communication, withdrawal from social interaction, higher level of depression and decreased sense of independence and autonomy. However, typical nursing home designs tend to neglect the full capacities of balanced and carefully integrated multisensory stimuli as active component of care and ability building. This paper outlines part of a larger multi-disciplinary study of six nursing homes in Singapore, with overarching objectives to create new models of supportive nursing home environments that go beyond the clinical care model and encourage community integration with the nursing home settings. The paper focuses on the largely neglected aspects of sensorial comfort and multi-sensorial properties of nursing homes, including both indoor and immediate outdoor spaces (boundaries). The objective was to investigate the sensory rhythms and explore their role in nursing home users’ daily routine and therapeutic capacities. Socio-sensory rhythms were captured and analysed through a combination of on-site sensory recordings of “objective” quantitative sensory data (air temperature and humidity, sound level and luminance) using multi-function environment meter, perceived experienced data, spatial mapping, first-person observations of nursing home users’ activity patterns, and interviews. This was done in addition to employment of available assessment tools, such as Wisconsin Person Directed Care assessment tool, Dementia Quality of Life [DQoL] instrument, and Resident Environment Impact Scale [REIS], as these tools address the issues of sensorial experience insufficiently and selectively. Key findings indicate varied levels of sensory comfort, as well as diversity, intensity, and customisation of multi-sensory conditions within different nursing home spaces. Sensory stimulation is typically concentrated in communal living areas of the nursing homes or in the areas that often provide controlled or limited access, including specifically designed sensory rooms and outdoor green spaces (gardens and terraces). Opportunities for sensory stimulation are particularly limited for bed-bound senior residents and within more functional areas, such as corridors. This suggests that the capacities of nursing home designs to provide more diverse and better integrated pleasant sensory conditions as integrated “therapeutic devices” to build nursing home residents’ physical and mental abilities, encourage activity and improve wellbeing are far from exhausted.

Keywords: ageing-supportive environment, enabling design, multi-sensory assessment, nursing home environment

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Authors: Symbat Moldabekova

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This research explores the practice of decision-making in commercial banks in Kazakhstan. It focuses on recent technologies, such as contactless payments and QR code, and uses interviews with bank executives and industry practitioners to gain an understanding of how decisions are made and the role of financial assessment methods. The aim of the research is (1) to study the importance of financial techniques to evaluate IT investments; (2) to understand the role of different expert groups; (3) to explore how market trends and industry features affect decisions on IT; (4) to build a model that defines the real practice of decision-making on IT in commercial banks in Kazakhstan. The theoretical framework suggests that decision-making on IT is a socially constructed process, where actor groups with different background interact and negotiate with each other to develop a shared understanding of IT and to make more effective decisions. Theory and observations suggest that the more parties involved in the process of decision-making, the higher the possibility of disagreements between them. As each actor group has their views on the rational decision on an IT project, it is worth exploring how the final decision is made in practice. Initial findings show that the financial assessment methods are used as a guideline and do not play a big role in the final decision. The commercial banks of Kazakhstan tend to study experience of neighboring countries before adopting innovation. Implementing contactless payments is widely regarded as pinnacle success factor due to increasing competition in the market. First-to-market innovations are considered as priorities therefore, such decisions can be made with exemption of some certain actor groups from the process. Customers play significant role and they participate in testing demo versions of the products before bringing innovation to the market. The study will identify the viewpoints of actors in the banking sector on a rational decision, and the ways decision-makers from a variety of disciplines interact with each other in order to make a decision on IT in retail banks.

Keywords: actor groups, decision making, technology investment, retail banks

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Authors: D. Kokt, T. F. Dreyer

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The main objective of the study was to design a mentoring programme aimed at developing the soft skills of mentors. The mentors are all employed by a multinational corporation. The company had a mentoring plan in place that did not yield the required results, especially related to the development of soft skills. This prompted the researchers to conduct an extensive literature review followed by a mixed methods approach to ascertain the best practices in developing the soft skills of mentors. The outcomes of the study led to the development of a structured mentoring programme using 25 modules to be completed by mentors. The design incorporated a blended modular approach using both face-to-face teaching and teaching supported by Information Communication Technology (ICT). Blended learning was ideal as the ICT component helped to minimise instructor-mentor physical contact as part of the health measures during the Covid-19 pandemic. The blended learning approach also allowed instructors and mentors an online or offline mode, so that mentors could have more time for creative and cooperative exercises. A range of delivery methodologies were spread out across the different modules to ensure mentor engagement and accelerate mentor development. This included concept development through in-person instructor-led training sessions, concept development through virtual instructor-led training sessions, simulations, case studies, e-learning, role plays, interactive learning using mentoring toolkits, and experiential learning through application. The mentor development journey included formal modular competency assessments. All modules contained post-competency assessment consisting of 10 questions (comprising of a combination of explanatory questions and multiple-choice questions) to ensure understanding and deal with identified competency gaps. The minimum pass mark for all modular competency assessments was 80%. Mentors were allowed to retake the assessment if they scored less than 80% until they demonstrated understanding at the required level.

Keywords: mentor, mentee, soft skills, mentor development, blended learning, modular approach

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Authors: Pratik Dhabal Deo, Manoj P.

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With the increasing number of social media users, the amount of video content available has also significantly increased. Currently, the number of smartphone users is at its peak, and many are increasingly using their smartphones as their main photography and recording devices. There have been a lot of developments in the field of Video Quality Assessment (VQA) and metrics like VMAF, SSIM etc. are said to be some of the best performing metrics, but the evaluation of these metrics is dominantly done on professionally taken video contents using professional tools, lighting conditions etc. No study particularly pinpointing the performance of the metrics on the contents taken by users on very commonly available devices has been done. Datasets that contain a huge number of videos from different high-end devices make it difficult to analyze the performance of the metrics on the content from most used devices even if they contain contents taken in poor lighting conditions using lower-end devices. These devices face a lot of distortions due to various factors since the spectrum of contents recorded on these devices is huge. In this paper, we have presented an analysis of the objective VQA metrics on contents taken only from most used devices and their performance on them, focusing on full-reference metrics. To carry out this research, we created a custom dataset containing a total of 90 videos that have been taken from three most commonly used devices, and android smartphone, an IOS smartphone and a DSLR. On the videos taken on each of these devices, the six most common types of distortions that users face have been applied on addition to already existing H.264 compression based on four reference videos. These six applied distortions have three levels of degradation each. A total of the five most popular VQA metrics have been evaluated on this dataset and the highest values and the lowest values of each of the metrics on the distortions have been recorded. Finally, it is found that blur is the artifact on which most of the metrics didn’t perform well. Thus, in order to understand the results better the amount of blur in the data set has been calculated and an additional evaluation of the metrics was done using HEVC codec, which is the next version of H.264 compression, on the camera that proved to be the sharpest among the devices. The results have shown that as the resolution increases, the performance of the metrics tends to become more accurate and the best performing metric among them is VQM with very few inconsistencies and inaccurate results when the compression applied is H.264, but when the compression is applied is HEVC, SSIM and VMAF have performed significantly better.

Keywords: distortion, metrics, performance, resolution, video quality assessment

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Authors: Alessandro Suardi, Rodolfo Picchio, Domenico Coaloa, Maria Bonaventura Forleo, Nadia Palmieri, Luigi Pari

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The reconversion process of the Italian sugar supply chain to bio-energy supply chains, as a result of the 2006 Sugar CMO reform, have involved research to define the best logistics, the most adapted energy crops for the Italian territory and their sustainability. Rapeseed (Brassica napus L.), Giant reed (Arundo donax L.) and Poplar (Poplar ssp.) are energy crops considered strategic for the development of Italian energy supply-chains. This study analyzed the environmental and the economic impacts on the farm level of these three energy crops. The environmental assessment included six farming units, two per crop, which were extracted from a sample of 251 rapeseed farm units (2751 ha), 7 giant reed farm units (7.8 ha), and 91 poplar farm units (440 ha) using a statistical multivariate analysis. Life Cycle Assessment (LCA) research method has been used to evaluate and compare the sustainability of the agricultural phases of the crops studied. The impact analyses have been performed at mid-point and end-point levels. The results of the analysis shown that the fertilization, is the major source of environmental impact of the agricultural phase due to the production of the fertilizers and the soil emissions of GHG following the treatment. The perennial energy crops studied (Arundo donax L., Poplar ssp.) were environmentally more sustainable if compared with the annual crop (Brassica napus L.) for all the impact categories at mid-point and end-point levels analyzed. The most relevant impact category influenced by the agricultural process result the fossil depletion, mainly due to the fossil fuels consumed during the mineral fertilizers production (urea). Human health was the most affected damage category at the end point level. Poplar result the energy crop with the best environmental performance for the Italian territory, in the distribution areas most suitable for its cultivation.

Keywords: LCA, energy crops, rapeseed, giant reed, poplar

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Authors: Sonia Mahajan Dinesh, Anant Dinesh, Madhavi Tripathi, Vinod Kumar Ramteke, Rajnish Sharma, Anupam Mondal

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Background: Neo-adjuvant chemotherapy plays an important role in treatment of breast cancer by decreasing the tumour load and it offers an opportunity to evaluate response of primary tumour to chemotherapy. Standard anatomical imaging modalities are unable to accurately reflect the response to chemotherapy until several cycles of drug treatment have been completed. Metabolic imaging using tracers like 18F-fluorodeoxyglucose (FDG) as a marker of glucose metabolism or amino acid tracers like L-methyl-11C methionine (MET) have potential role for the measurement of treatment response. In this study, our objective was to compare these two PET tracers for assessment of response to neoadjuvant chemotherapy, in locally advanced breast carcinoma. Methods: In our prospective study, 20 female patients with histology proven locally advanced breast carcinoma underwent PET-CT imaging using FDG and MET before and after three cycles of neoadjuvant chemotherapy (CAF regimen). Thereafter, all patients were taken for MRM and the resected specimen was sent for histo-pathological analysis. Tumour response to the neoadjuvant chemotherapy was evaluated by PET-CT imaging using PERCIST criteria and correlated with histological results. Responses calculated were compared for statistical significance using paired t- test. Results: Mean SUVmax for primary lesion in FDG PET and MET PET was 15.88±11.12 and 5.01±2.14 respectively (p<0.001) and for axillary lymph nodes was 7.61±7.31 and 2.75±2.27 respectively (p=0.001). Statistically significant response in primary tumour and axilla was noted on both FDG and MET PET after three cycles of NAC. Complete response in primary tumour was seen in only 1 patient in FDG and 7 patients in MET PET (p=0.001) whereas there was no histological complete resolution of tumor in any patient. Response to therapy in axillary nodes noted on both PET scans were similar (p=0.45) and correlated well with histological findings. Conclusions: For the primary breast tumour, FDG PET has a higher sensitivity and accuracy than MET PET and for axilla both have comparable sensitivity and specificity. FDG PET shows higher target to background ratios so response is better predicted for primary breast tumour and axilla. Also, FDG-PET is widely available and has the advantage of a whole body evaluation in one study.

Keywords: 11C-methionine, 18F-FDG, breast carcinoma, neoadjuvant chemotherapy

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Authors: Yanqing Yi, Maria Cristina Lavagnolo, Alessandro Manzardo

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Construction and demolition waste (C&DW) is a major challenge in the European Union, emphasizing the urgent need for appropriate waste management processes. Selecting these solutions is challenging, as it requires identifying efficient C&DW management techniques that balance acceptable practices, regulatory compliance, resource conservation, economic viability, and environmental concerns. Techniques for analyzing many kinds of criteria allow for the use of multi-criteria analysis in life cycle assessment (LCA). Although LCA is commonly used to analyze environmental effects, the economic factor has not been fully integrated into the LCA approach in C&DW management. The life cycle costing (LCC) approach was designed to assess economic performance in the C&DW management process. The choice of an effective multi-criteria decision-making (MCDM) technique is critical for the C&DW system. This study seeks to propose a model that employs MCDM by considering LCA and LCC results, thereby augmenting both environmental and economic sustainability. A widely used compensatory MCDM technique, TOPSIS, has been chosen to identify the most effective C&DW management scheme by comparing and ranking various scenarios. Four waste management alternatives were examined in the Lombardy region of Italy, namely, (i) landfill; (ii) recycling for concrete production and road construction, incineration with energy recovery; (iii) recycling for road construction; (iv) recycling for concrete production and road construction. We determine that, with the implementation of various scenarios, the most suitable scenario emerges to be recycled for concrete production and road construction, with a score of 0.711/1; recycling for road construction, with a final score of 0.291/1, ranks second; recycling for concrete production and road construction, incineration with energy recovery scores 0.002/1, ranks third; and landfill (scores: 0/1) is the worst choice, indicating it has the highest environmental impact. Finally, suggestions were developed to improve the system's environmental performance.

Keywords: life cycle assessment, life cycle costing, construction and demolition waste, multi-criteria decision making

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Authors: Manal Elgallal, Louise Fletcher, Barbara Evans

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Water scarcity is a growing concern in many arid and semi-arid countries. The increase of water scarcity threatens economic development and sustainability of human livelihoods as well as environment especially in developing countries. Globally, agriculture is the largest water consumption sector, accounting for approximately 70% of all freshwater extraction. Growing competition between the agricultural and higher economic value in urban and industrial uses of high-quality freshwater supplies, especially in regions where water scarcity major problems, will increase the pressure on this precious resource. In this circumstance, wastewater may provide reliable source of water for agriculture and enable freshwater to be exchanged for more economically valuable purposes. Concern regarding the risks from microbial and toxic components to human health and environment quality is a serious obstacle for wastewater reuse particularly in agriculture. Although powerful approaches and tools for microbial risk assessment and management for safe use of wastewater are now available, few studies have attempted to provide any mechanism to quantitatively assess and manage the environmental risks resulting from reusing wastewater. In seeking pragmatic solutions to sustainable wastewater reuse, there remains a lack of research incorporating both health and environmental risk assessment and management with economic analysis in order to quantitatively combine cost, benefits and risks to rank alternative reuse options. This study seeks to enhance effective reuse of wastewater for irrigation in arid and semi-arid areas, the outcome of the study is an evaluation approach that can be used to assess different reuse strategies and to determine the suitable scale at which treatment alternatives and interventions are possible, feasible and cost effective in order to optimise the trade-offs between risks to protect public health and the environment and preserving the substantial benefits.

Keywords: environmental risks, management, life cycle costs, waste water irrigation

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Authors: Stefano Sorace, Gloria Terenzi, Giulia Mazzieri, Iacopo Costoli

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The prolonged earthquake sequence that struck several urban agglomerations and villages in Central Italy, starting from 24 August 2016 through January 2017, highlighted once again the seismic vulnerability of pre-normative reinforced concrete (R/C) structures. At the same time, considerable damages were surveyed in recently retrofitted R/C buildings too, one of which also by means of a dissipative bracing system. The solution adopted for the latter did not expressly take into account the performance of non-structural elements, and namely of infills and partitions, confirming the importance of their dynamic interaction with the structural skeleton. Based on this consideration, an alternative supplemental damping-based retrofit solution for this representative building, i.e., a school with an R/C structure situated in the municipality of Norcia, is examined in this paper. It consists of the incorporation of dissipative braces equipped with pressurized silicone fluid viscous (FV) dampers, instead of the BRAD system installed in the building, the delayed activation of which -caused by the high stiffness of the constituting metallic dampers- determined the observed non-structural damages. Indeed, the alternative solution proposed herein, characterized by dissipaters with mainly damping mechanical properties, guarantees an earlier activation of the protective system. A careful assessment analysis, preliminarily carried out to simulate and check the case study building performance in originally BRAD-retrofitted conditions, confirms that the interstorey drift demand related to the Norcia earthquake's mainshock and aftershocks is beyond the response capacity of infills. The verification analyses developed on the R/C structure, including the FV-damped braces, highlight their higher performance, giving rise to a completely undamaged response both of structural and non-structural elements up to the basic design earthquake normative level of seismic action.

Keywords: dissipative technologies, performance assessment analysis, concrete structures, seismic retrofit

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Authors: Talita Cavaignac

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Adorno's critique of totality, especially in a split society marked by reification, also rests on the impossibility of generalizing normative principles. Given the unfeasibility of normative universalizations, which conditions can justify the possibility of criticism and normativity in Adorno's thought? If reason itself is still entangled in alienation from the model of the domination of nature, how could be possible a critical theory? In political terms, if the notion of totality is challenged by the critique of identity, how can Adorno maintain the ideal of liberation and reconciliation between private interests and the possibility of some sort of ethics without giving up a materialist theory of society and without betting in a necessary link between redemption and history? Faced with this complex of questions, it is intended to reflect on the sense in which the notion of ‘suffering’ could throw help to the epistemological problem of the foundations of criticism in Adorno's work. The idea is that, in contrast to a universalizable model of justice, Adorno mobilizes in the notion of ‘suffering’ a gateway to the critical reflection of society. He would thus develop an approach to moral problems through the sensual-bodily perspective, fear, pain, and somatic factors. Nevertheless, due to the attention to the damaged experience and to the constitution of subjectivity -a sense in which the concept of mimesis continues to stand out- we understand suffering as an expression of an objective reification. Following the statement of other authors, the intention is to think how the resources linked to the idea of ‘suffering’ in Adorno's writings are engaged in the reflection of the problem of morality and of the contradictions between universal and particular (articulated in Hegel's tradition).

Keywords: ethics, morality, sensitive, Theodor Adorno

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Authors: Mengdan Guo, Zongmin Wang, Haibo Yang

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Drought is one of the most complex and destructive natural disasters, with a huge impact on both nature and society. In recent years, adverse climate conditions and uncontrolled human activities have exacerbated the occurrence of global droughts, among which socio-economic droughts are closely related to human survival. The study of socio-economic drought risk assessment is crucial for sustainable social development. Therefore, this study comprehensively considered the risk of disaster causing factors, the exposure level of the disaster-prone environment, and the vulnerability of the disaster bearing body to construct a socio-economic drought risk assessment model for Chuxiong Prefecture in Yunnan Province. Firstly, a threedimensional frequency analysis of intensity area duration drought was conducted, followed by a statistical analysis of the drought risk of the socio-economic system. Secondly, a grid analysis model was constructed to assess the exposure levels of different agents and study the effects of drought on regional crop growth, industrial economic growth, and human consumption thresholds. Thirdly, an agricultural vulnerability model for different irrigation levels was established by using the DSSAT crop model. Industrial economic vulnerability and domestic water vulnerability under the impact of drought were investigated by constructing a standardized socio-economic drought index and coupling water loss. Finally, the socio-economic drought risk was assessed by combining hazard, exposure, and vulnerability. The results show that the frequency of drought occurrence in Chuxiong Prefecture, Yunnan Province is relatively high, with high population and economic exposure concentrated in urban areas of various counties and districts, and high agricultural exposure concentrated in mountainous and rural areas. Irrigation can effectively reduce agricultural vulnerability in Chuxiong, and the yield loss rate under the 20mm winter irrigation scenario decreased by 10.7% compared to the rain fed scenario. From the perspective of comprehensive risk, the distribution of long-term socio-economic drought risk in Chuxiong Prefecture is relatively consistent, with the more severe areas mainly concentrated in Chuxiong City and Lufeng County, followed by counties such as Yao'an, Mouding and Yuanmou. Shuangbai County has the lowest socio-economic drought risk, which is basically consistent with the economic distribution trend of Chuxiong Prefecture. And in June, July, and August, the drought risk in Chuxiong Prefecture is generally high. These results can provide constructive suggestions for the allocation of water resources and the construction of water conservancy facilities in Chuxiong Prefecture, and provide scientific basis for more effective drought prevention and control. Future research is in the areas of data quality and availability, climate change impacts, human activity impacts, and countermeasures for a more comprehensive understanding and effective response to drought risk in Chuxiong Prefecture.

Keywords: DSSAT model, risk assessment, socio-economic drought, standardized socio-economic drought index

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Authors: Xiaobin Liang, Wei Liang, Laibin Zhang, Xiaoyan Guo

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Pipelines pass through coal mined gobs inevitably in the mining area, the stability of which has great influence on the safety of pipelines. After extensive literature study and field research, it was found that there are a few risk assessment methods for coal mined gob pipelines, and there is a lack of data on the gob sites. Therefore, the fuzzy comprehensive evaluation method is widely used based on expert opinions. However, the subjective opinions or lack of experience of individual experts may lead to inaccurate evaluation results. Hence the accuracy of the results needs to be further improved. This paper presents a comprehensive approach to achieve this purpose by combining bow-tie model and cloud inference. The specific evaluation process is as follows: First, a bow-tie model composed of a fault tree and an event tree is established to graphically illustrate the probability and consequence indicators of pipeline failure. Second, the interval estimation method can be scored in the form of intervals to improve the accuracy of the results, and the censored mean algorithm is used to remove the maximum and minimum values of the score to improve the stability of the results. The golden section method is used to determine the weight of the indicators and reduce the subjectivity of index weights. Third, the failure probability and failure consequence scores of the pipeline are converted into three numerical features by using cloud inference. The cloud inference can better describe the ambiguity and volatility of the results which can better describe the volatility of the risk level. Finally, the cloud drop graphs of failure probability and failure consequences can be expressed, which intuitively and accurately illustrate the ambiguity and randomness of the results. A case study of a coal mine gob pipeline carrying natural gas has been investigated to validate the utility of the proposed method. The evaluation results of this case show that the probability of failure of the pipeline is very low, the consequences of failure are more serious, which is consistent with the reality.

Keywords: bow-tie model, natural gas pipeline, coal mine gob, cloud inference

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Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

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Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

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Authors: Vathanachannbo Veth, Ilan Ich, Sophea Rom Phy, Ty Sok, Layheang Song, Sophal Try, Chantha Oeurng

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Climate change is one of the major global challenges inducing disaster risks and threatening livelihoods and communities through adverse impacts on food and water security, ecosystems, and services. Prek Thnot River Basin of Cambodia is one of the largest tributaries in the Lower Mekong that has been exposed to hazards and disasters, particularly floods and is said to be the effect of climate change. Therefore, the assessment of precipitation and streamflow changes under the effect of climate change was proposed in this river basin using Soil Water Assessment Tool (SWAT) model and different flow indices under baseline (1997 to 2011) and climate change scenarios (RCP2.6 and RCP8.5 with three General Circulation Models (GCMs): GFDL, GISS, and IPSL) in two time-horizons: near future (the 2030s: 2021 to 2040) and medium future (2060s: 2051 to 2070). Both intensity and frequency indices compared with the historical extreme rainfall indices significantly change in the GFDL under the RCP8.5 for both 2030s and 2060s. The average rate change of Rx1day, Rx10day, SDII, and R20mm in the 2030s and 2060s of both RCP2.6 and RCP8.5 was found to increase in GFDL and decrease in both GISS and IPSL. The mean percentage change of the flow analyzed in the IHA tool (Group1) indicated that the flow in the Prek Thnot River increased in GFDL for both RCP2.6 and RCP8.5 in both 2030s and 2060s, oppositely in GISS, the flow decreases. Moreover, the IPSL affected the flow by increasing in five months (January, February, October, November, and December), and in the other seven months, the flow decreased accordingly. This study provides water resources managers and policymakers with a wide range of precipitation and water flow projections within the Prek Thnot River Basin in the context of plausible climate change scenarios.

Keywords: IHA, climate change, disaster risk, Prek Thnot River Basin, Cambodia

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Authors: Manu Manu, Pardha J. Saradhi, Ramana M. V. Murthy

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Wind Energy is accepted as one of the most developed, cost effective and proven renewable energy technologies to meet increasing electricity demands in a sustainable manner. Preliminary assessment studies along Indian Coastline by Ministry of New and Renewable Energy have indicated prospects for development of offshore wind power along Tamil Nadu Coast, India. The commercial viability of a wind project mainly depends on wind characteristics on site. Hence, it is internationally recommended to perform site-specific wind resource assessment based on two years’ wind profile as a part of the feasibility study. Conventionally, guy wire met mast are used onshore for the collection of wind profile. Installation of similar structure in offshore requires complex marine spread and are very expensive. In the present study, an attempt is made to develop 120 m long lattice tower supported on the jacket, piled to the seabed at Rameshwaram, Tamil Nadu, India. Offshore met-masts are subjected to combined wind and hydrodynamic loads, and these lateral loads should be safely transferred to soil. The wind loads are estimated based on gust factor method, and the hydrodynamic loads are estimated by Morison’s equation along with suitable wave theory. The soil is modeled as three nonlinear orthogonal springs based on API standards. The structure configuration and optimum member sizes are obtained for extreme cyclone events. The dynamic behavior of mast under coupled wind and wave loads is also studied. The static responses of a mast with jacket type offshore platform have been studied using a frame model in SESAM. It is found from the study that the maximum displacement at the top of the mast for the random wave is 0.003 m and that of the tower for wind is 0.08 m during the steady state. The dynamic analysis results indicate that the structure is safe against coupled wind and wave loading.

Keywords: offshore wind, mast, static, aerodynamic load, hydrodynamic load

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Authors: Leena-Maria Alyedreessy

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Self-esteem is thought to be determined by ones’ own feeling of being included, liked and accepted by others. This research explores whether this concept may also be applied in the virtual world and assesses whether there is any relationship between Twitter users' self-esteem and the amount of interactions they receive. 20 female Arab participants were given a survey asking them about their Twitter interactions and their feelings of having an imagined audience to fill out and a Rosenberg Self-Esteem Assessment to complete. After completion and statistical analysis, results showed a significant correlation between the feeling of being Twitter elite, the feeling of having a lot of people listening to your tweets and having a lot of interactions with high self-esteem. However, no correlations were detected for low-self-esteem and low interactions.

Keywords: twitter, social media, self-esteem, narcissism, interactions

Procedia PDF Downloads 407

Authors: Nathan Garcia

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The polarizing dialogue of contemporary political America results from core philosophical differences. But these differences are beyond ideological and reach metaphysical distinction. Good intellectual historians have theorized that fundamental concepts such as freedom, God, and nature have been sterilized of their intellectual vigor. They are partially correct. 19th-century pragmatist Charles Sanders Peirce offers a penetrating philosophy which can yield greater insight into the contemporary political divide. Peirce argues that metaphysical and ethical issues are derivative of operational logic. His triadic logical structure and ensuing metaphysical principles constructed therefrom is contemporaneously applicable for three reasons. First, Peirce’s logic aptly scrutinizes the logical processes of liberal and conservative mindsets. Each group arrives at a cosmological root metaphor (abduction), resulting in a contemporary assessment (deduction), ultimately prompting attempts to verify the original abduction (induction). Peirce’s system demonstrates that liberal citizens develop a cosmological root metaphor in the concept of fairness (abduction), resulting in a contemporary assessment of, for example, underrepresented communities being unfairly preyed upon (deduction), thereby inciting anger toward traditional socio-political structures suspected of purposefully destabilizing minority communities (induction). Similarly, conservative citizens develop a cosmological root metaphor in the concept of freedom (abduction), resulting in a contemporary assessment of, for example, liberal citizens advocating an expansion of governmental powers (deduction), thereby inciting anger towards liberal communities suspected of attacking freedoms of ordinary Americans in a bid to empower their interests through the government (induction). The value of this triadic assessment is the categorization of distinct types of inferential logic by their purpose and boundaries. Only deductive claims can be concretely proven, while abductive claims are merely preliminary hypotheses, and inductive claims are accountable to interdisciplinary oversight. Liberals and conservative logical processes preclude constructive dialogue because of (a) an unshared abductive framework, and (b) misunderstanding the rules and responsibilities of their types of claims. Second, Peircean metaphysical principles offer a greater summary of the contemporaneously divisive political climate. His insights can weed through the partisan theorizing to unravel the underlying philosophical problems. Corrosive nominalistic and essentialistic presuppositions weaken the ability to share experiences and communicate effectively, both requisite for any promising constructive dialogue. Peirce’s pragmatist system can expose and evade fallacious thinking in pursuit of a refreshing alternative framework. Finally, Peirce’s metaphysical foundation enables a logically coherent, scientifically informed orthopraxis well-suited for American dialogue. His logical structure necessitates radically different anthropology conducive to shared experiences and dialogue within a dynamic, cultural continuum. Pierce’s fallibilism and sensitivity to religious sentiment successfully navigate between liberal and conservative values. In sum, he provides a normative paradigm for intranational dialogue that privileges individual experience and values morally defensible notions of freedom, God, and nature. Utilizing Peirce’s thought will yield fruitful analysis and offers a promising philosophical alternative for framing and engaging in contemporary American political discourse.

Keywords: Charles s. Peirce, american politics, logic, pragmatism

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Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou

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Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, graft, scalp, partial thickness

Procedia PDF Downloads 84

Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena

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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.

Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure

Procedia PDF Downloads 158

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

Procedia PDF Downloads 109

Authors: Yiqi Sun, Zhiyuan Zhang, Chenkun Ma

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Regeneration of outmoded urban forms and restorative environments are now recognized as major assets towards achieving sustainable development. Shanghai, like many Chinese cities, is now shifting from an agitated industrial past to more livable development schemes. Therefore, a sustainable approach to Shanghai development consists in turning industrial heritage into places with high potential for improving citizen’s daily life as regard to the three pillars of sustainability, namely: environment, economy, and society. As such, this study focuses on the Corniche in Xuhui West Bund district; a former industrial area converted into recreational public spaces in Xuhui West Bund. This area was the birthplace of the aviation industry of China, and many of the industrial features were preserved. Unused areas have been transformed into exhibition halls and green spaces, integrating some of the original industrial, architectural forms. Our case study investigates the effects of this approach associating urban regeneration with restorative design, as well as its impact on the surrounding neighborhood. Information extracted from visitors’ answers to a questionnaire survey; on-site systematic observation, counts, and measurements allowed us to assess the sustainability of this intervention in terms of accessibility, functionality, cultural and restorative qualities. In general, we found that cycling is not highly encouraged by the current design and level of connectivity, while visitors widely acknowledge the enhancement of cultural heritage resulting from the intervention. Moreover, recreational and restorative areas were found to have a very positive effect on local communities. Indeed, such an approach can provide valuable insights on how future interventions in Chinese major cities could take full advantage of existing assets in creating a more environmental, more livable, and culturally richer city.

Keywords: architectural heritage conservation, cultural urban identity, sustainability assessment, restorative environment, urban regeneration

Procedia PDF Downloads 179

Authors: Nilgün Katrancı, Pınar Göv

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With the acceleration and assessment of quality and patient safety works in healthcare services in the 21st century, activities to reduce errors have gained importance. The prevention and reduction of unintended consequences related to healthcare services and errors made during the delivery of healthcare services can be achieved by understanding the causes of the errors. Communication is the basic reason most frequently seen in such cases. Nurses who communicate with patients more closely and for longer time play a more critical role in ensuring patient safety compared to other healthcare professionals. To reduce the risk of medical errors and increase the quality of care, it is important to raise the awareness of nurses about patient safety in training period. This descriptive study was conducted between February 2017 and May 2017 to assess intern students' attitudes towards and knowledge of patient safety and medical errors. The target population of the study consists of intern students at the Faculty of Nursing in Gaziantep University (N=180). The study did not apply any sample selection method, and the research group consisted of 90 female and 37 male senior students who were available and accepted to take part in the study (N=127). The study used personal information form and medical error attitude scale to collect data. The medical error attitude scale consists of 16 items and 3 sub-dimensions. The most frequently seen medical error in the clinics the interns worked at was found as ‘Failure to comply with asepsis rules’ with a rate of 67,7%. The most frequent case among reasons for not disclosing an error is ‘noticing and correcting the error before affecting the patient’ with the rate of 70,9%. The most frequently expressed implications of disclosing a serious error for the intern students participating in the study are ‘harming patient trust (78%)’ and ‘possibility of overreaction by patient (62,2%)’. According to the results of the study, the awareness of the students about the importance of medical errors and error reporting was found high (3,48 ± 0,49). Consequently, it is important to assess and positively improve the attitudes of nurses and other healthcare professionals towards medical errors for the determination of causes of medical errors and their prevention.

Keywords: healthcare service, intern student, medical error, patient safety

Procedia PDF Downloads 199

Authors: Juhi Sah

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Habitat is characterized by the inter-dependency of environmental elements. Anthropocentric development approach is increasing our vulnerability towards natural hazards. Hence, manmade interventions should have a higher level of sensitivity towards the natural settings. Sensitivity towards the environment can be assessed by the behavior of the stakeholders involved. This led to the establishment of a hypothesis: there exists a legitimate relationship between the behavioral sciences, land use evolution and environment conservation, in the planning process. An attempt has been made to establish this relationship by reviewing the existing set of knowledge and case examples pertaining to the three disciplines under inquiry. Understanding the scarce & deteriorating nature of fresh-water reserves of earth and experimenting the above concept, a case study of a growing urban center's river flood plain is selected, in a developing economy, India. Cases of urban flooding in Chennai, Delhi and other mega cities of India, imposes a high risk on the unauthorized settlement, on the floodplains of the rivers. The issue addressed here is the encroachment of floodplains, through psychological enlightenment and modification through knowledge building. The reaction of an individual or society can be compared to a cognitive process. This study documents all the stakeholders' behavior and perception for their immediate natural environment (water body), and produce various land uses suitable along a river in an urban settlement as per different stakeholder's perceptions. To assess and induce morally responsible behavior in a community (small scale or large scale), tools of psychological inquiry is used for qualitative analysis. The analysis will deal with varied data sets from two sectors namely: River and its geology, Land use planning and regulation. Identification of a distinctive pattern in the built up growth, river ecology degradation, and human behavior, by handling large quantum of data from the diverse sector and comments on the availability of relevant data and its implications, has been done. Along the whole river stretch, condition and usage of its bank vary, hence stakeholder specific survey questionnaires have been prepared to accurately map the responses and habits of the rational inhabitants. A conceptual framework has been designed to move forward with the empirical analysis. The classical principle of virtues says "virtue of a human depends on its character" but another concept defines that the behavior or response is a derivative of situations and to bring about a behavioral change one needs to introduce a disruption in the situation/environment. Owing to the present trends, blindly following the results of data analytics and using it to construct policy, is not proving to be in favor of planned development and natural resource conservation. Thus behavioral assessment of the rational inhabitants of the planet is also required, as their activities and interests have a large impact on the earth's pre-set systems and its sustenance.

Keywords: behavioral assessment, flood plain encroachment, land use planning, river sustenance

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Authors: Ahcene Boucied

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In this paper, a case study is conducted to analyze the effectiveness of web pages designed in Barbados for the tourism and hospitality industry. The assessment is made from two perspectives: to understand how the Barbados’ tourism industry is using the web, and to identify the effect of information technology on economic issues. In return, this is used: (a) to provide interested parties with accurate information and marketing insight necessary for decision making for electronic commerce/e-commerce, and (b) to demonstrate pragmatic difficulties in searching and designing web pages.

Keywords: segmentation, tourism stakeholders, destination marketing, case study

Procedia PDF Downloads 415

Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

Procedia PDF Downloads 91

Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

Procedia PDF Downloads 349

Authors: M. Elder, L. Beech, A. Mackie

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Heterotopic pregnancy is an uncommon and potentially life-threatening condition in which there is simultaneous occurrence of intrauterine and ectopic pregnancies. It has an incidence of approximately 1:3900 pregnancies, occurring in only 1:30000 spontaneous pregnancies. This study presents a rare case of spontaneous heterotopic pregnancy in a 34-year-old primiparous woman who was brought in by ambulance to the emergency department following collapse at 20+1 weeks gestation after normal first trimester screening and morphology scan. She was hemodynamically unstable and fetal heart rate was 60bpm. Initial resuscitation included transfusion of 2 units packed red blood cells and 1g intravenous tranexamic acid. Bedside ultrasound revealed evidence of approximately 1000ml clot in the right upper quadrant. She underwent a diagnostic laparoscopy and washout, which proceeded to a midline exploratory laparotomy. This revealed a 2.6L hemoperitoneum and query right ectopic pregnancy with calcified areas and clot, with no other cause of bleeding identified. Right salpingectomy was performed, and pathology later confirmed ectopic pregnancy. The intrauterine pregnancy had no complications, and she delivered a healthy full-term baby. This case demonstrates that ultrasound confirmation of intrauterine pregnancy does not exclude coexisting ectopic pregnancy. Heterotopic pregnancy should be considered in any pregnant woman presenting with abdominal pain or signs of hemorrhagic shock, as prompt diagnosis and treatment is essential to minimize foetal and maternal morbidity and mortality.

Keywords: ectopic pregnancy, hemorrhagic shock, salpingectomy, spontaneous heterotopic pregnancy

Procedia PDF Downloads 132

Authors: Awais Naeem, Osama Shakeel, Faizan Ullah, Abdul Wahid Anwer

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Introduction: To study the clinic-pathological factors, diagnostic factors and survival of extra-pulmonary small cell carcinoma. Methodology: From 1995 to 2017 all patients with a diagnosis of extra-pulmonary small cell carcinoma were included in the study. Demographic variables and clinic-pathological factors were collected. Management of disease was recorded. Short and long term oncological outcomes were recorded. All data was entered and analyzed in SPSS version 21. Results: A total of 14 patients were included in the study. Median age was 53.42 +/- 16.1 years. There were 5 male and 9 female patients. Most common presentation was dysphagia in 16 patient among esophageal small cell carcinoma and while other patient had pain in abdomen. Mean duration of symptoms was 4.23+/-2.91 months .Most common site is esophagus (n=6) followed by gall bladder(n=3). Almost all of the patients received chemo-radiotherapy. Majority of the patient presented with extensive disease. Five patients (35.7%) died during the follow up period, two (14.3%) were alive and rest of the patients were lost to follow up. Mean follow up period was 22.92 months and median follow up was 15 months. Conclusion: Extra-pulmonary small cell carcinoma is rare and needs to be managed aggressively. All patients should be treated with both systemic and local therapies.

Keywords: small cell carcinoma of esophagus, extrapulmonary small cell carcinoma, small cell carcinoma of gall bladder, small cell carcinoma of rectum, small cell carcinoma of stomach

Procedia PDF Downloads 153