Search results for: surgical history
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3415

Search results for: surgical history

1075 Natural Law in the Mu’Tazilite Theology

Authors: Samaneh Khalili

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Natural law theory, in moral philosophy, refers to a system of unchanging values held to be mutual to all humans and can be discovered through reason. The natural law theory is commonly associated with western Philosophers. In contrast, discussions on notions of natural law in Islamic intellectual history were relatively rare. This paper aims to show that the moral theory developed by the Mu'tazilite thinkers can be classified in the ideas of natural law. In doing so, this study will demonstrate that the objective and unchanging values, according to Mu'tazilite theologians, provide the guidelines for assessing the Islamic law rules in the field of human coexistence. The focus of the paper lies on ʿAbd al-Ğabbār, who was the most influential thinker in the late epoch of the Muʿtazila. Although ʿAbd al-Ǧabbār did not leave a text with a systematic discussion of natural law, his teaching of nature, human reason, and the moral values of actions are all scattered throughout his work -'al-Muġnī fī abwāb at-tawḥīd wa-l-'adl'. It is necessary to focus on ʿAbd al-Ǧabbār's theories on reason, nature, and ethics since natural law revolves around the basic concepts of nature, reason, and moral value. While analyzing the concept of the Nature, it will attempt to answer how he explains the world's physical structure and God's relationship to natural events. Moreover, from ʿAbd al-Ǧabbār's point of view, is nature a self-determined system that follows its inner principle in every kind of change, or is nature guided by an external power? Does causality govern natural events? About the concept of reason, an attempt is made to examine how human reason, according to ʿAbd al-Ǧabbār, conceives moral attributes. Finally, the Autor will discuss the concepts of objective values and the place of rights and duties derived from Islamic law in ʿAbd al-Ǧabbār's thought.

Keywords: Islamic law, Mu'tazilite theology, natural law in Islamic theology, objective and unchanging values.

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1074 Analyzing Music Theory in Different Countries: Compare with Greece and China

Authors: Baoshan Wang

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The present study investigates how music theory has developed across different countries due to their diverse histories, religions, and cultural differences. It is unknown how these various factors may contribute to differences in music theory across countries. Therefore, we examine the differences between China and Greece, which have developed unique music theories over time. Specifically, our analysis looks at musical notation and scales. For example, Tonal music originates from Greece, which harbors quite complex notation and scaling. There exist seven notes in each scale within seven modes of scales. Each mode of the diatonic scale has a unique temperament, two of which are most commonly used in modern music. In contrast, we find that Chinese music has only five notes in its scales. Interestingly, a unique feature of Chinese music theory is that there is no half-step, resulting in a highly divergent and culture-specific sound. Fascinatingly, these differences may arise from the contrasting ways that Western and Eastern musicians perceive music. While Western musicians tend to believe in music “without borders,” Eastern musicians generally embrace differing perspectives. Yet, the vast majority of colleges or music conservatories teach the borderless theory of Western music, which renders the music educational system incomplete. This is critically important because learning music is not simply a profession for musicians. Rather, it is an intermediary to facilitate understanding and appreciation for different countries’ cultures and religions. Education is undoubtedly the optimal mode to promote different countries’ music theory so people across the world can learn more about music and, in turn, each other. Even though Western music theory is predominantly taught, it is crucial we also pursue an understanding of other countries’ music because their unique aspects contribute to the systematic completeness of Music Theory in its entirety.

Keywords: culture, development, music theory, music history, religion, western music

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1073 The Invaluable Contributions of Radiography and Radiotherapy in Modern Medicine

Authors: Sahar Heidary

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Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

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1072 The Impact of COVID-19 on the Mental Health of Residents of Saudi Arabia

Authors: Khaleel Alyahya, Faizah Alotaibi

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The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.

Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress

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1071 Servant Leadership for Elder Care in St. Camillus Health Systems, USA

Authors: Anthoni Jeorge

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Throughout the history of the world, servant leadership has been researched, and favourable results such as individual, team, and organizational have been linked to the construct. This research paper designates St. Camillus de Lellis, a practitioner of servant leadership and founder of the Ministers of the Sick as a servant leader in his approach to care for the sick. Service is the visible face of his servant leadership. First of all, despite many challenges, St. Camillus de Lellis practiced leadership by the example of compassionate service to the sick. Second, he made service to the sick the highest priority of his life. Third, Camillus displayed servant leadership such that his manner of leadership gave birth to a New School of Service to the Sick. The paper identifies the distinctive dimensions and essential elements which characterized his service-centered leadership. Furthermore, discuss the six major characteristics of a servant leader as set forth by St. Camillus’s life example. The research illustrates the transformational power of servant leadership infield healthcare in general and, in doing so, provides servant leadership seekers ways servant leadership can transform elder care in one’s own field (St. Camillus Health Systems). Thus, it ascertains that servant leadership is best-fit for humanized elder care. Supported by the review of literature, the paper ascertains that Camillus, by identifying himself with the sick, gained deeper insights concerning the pain and suffering of the population. Uniquely drawn from his true grit, Camillus’ service-centered leadership is value-based, people-oriented, and compassion-filled. His way of service to the sick is the prolongation of gestures of mercy and compassion. It is hoped that the results of this study will help health care workers and servant leadership practitioners to humanize elder care and cultivate servant leadership attitude in their health care services to the sick. By incorporating such service-oriented elements into their leadership orientation, health care workers will be true servant leaders of the sick.

Keywords: leadership, service, healthcare, compassion

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1070 Bio-Inspired Design Approach Analysis: A Case Study of Antoni Gaudi and Santiago Calatrava

Authors: Marzieh Imani

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Antoni Gaudi and Santiago Calatrava have reputation for designing bio-inspired creative and technical buildings. Even though they have followed different independent approaches towards design, the source of bio-inspiration seems to be common. Taking a closer look at their projects reveals that Calatrava has been influenced by Gaudi in terms of interpreting nature and applying natural principles into the design process. This research firstly discusses the dialogue between Biomimicry and architecture. This review also explores human/nature discourse during the history by focusing on how nature revealed itself to the fine arts. This is explained by introducing naturalism and romantic style in architecture as the outcome of designers’ inclination towards nature. Reviewing the literature, theoretical background and practical illustration of nature have been included. The most dominant practical aspects of imitating nature are form and function. Nature has been reflected in architectural science resulted in shaping different architectural styles such as organic, green, sustainable, bionic, and biomorphic. By defining a set of common aspects of Gaudi and Calatrava‘s design approach and by considering biomimetic design categories (organism, ecosystem, and behaviour as the main division and form, function, process, material, and construction as subdivisions), Gaudi’s and Calatrava’s project have been analysed. This analysis explores if their design approaches are equivalent or different. Based on this analysis, Gaudi’s architecture can be recognised as biomorphic while Calatrava’s projects are literally biomimetic. Referring to these architects, this review suggests a new set of principles by which a bio-inspired project can be determined either biomorphic or biomimetic.

Keywords: biomimicry, Calatrava, Gaudi, nature

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1069 Competing Risks Modeling Using within Node Homogeneity Classification Tree

Authors: Kazeem Adesina Dauda, Waheed Babatunde Yahya

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To design a tree that maximizes within-node homogeneity, there is a need for a homogeneity measure that is appropriate for event history data with multiple risks. We consider the use of Deviance and Modified Cox-Snell residuals as a measure of impurity in Classification Regression Tree (CART) and compare our results with the results of Fiona (2008) in which homogeneity measures were based on Martingale Residual. Data structure approach was used to validate the performance of our proposed techniques via simulation and real life data. The results of univariate competing risk revealed that: using Deviance and Cox-Snell residuals as a response in within node homogeneity classification tree perform better than using other residuals irrespective of performance techniques. Bone marrow transplant data and double-blinded randomized clinical trial, conducted in other to compare two treatments for patients with prostate cancer were used to demonstrate the efficiency of our proposed method vis-à-vis the existing ones. Results from empirical studies of the bone marrow transplant data showed that the proposed model with Cox-Snell residual (Deviance=16.6498) performs better than both the Martingale residual (deviance=160.3592) and Deviance residual (Deviance=556.8822) in both event of interest and competing risks. Additionally, results from prostate cancer also reveal the performance of proposed model over the existing one in both causes, interestingly, Cox-Snell residual (MSE=0.01783563) outfit both the Martingale residual (MSE=0.1853148) and Deviance residual (MSE=0.8043366). Moreover, these results validate those obtained from the Monte-Carlo studies.

Keywords: within-node homogeneity, Martingale residual, modified Cox-Snell residual, classification and regression tree

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1068 A Paradigm Shift in the Cost of Illness of Type 2 Diabetes Mellitus over a Decade in South India: A Prevalence Based Study

Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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1067 Correlation Between Diastolic Function and Lower GLS in Hypertensive Patients

Authors: A. Kherraf, S. Ouarrak, L. Azzouzi, R. Habbal

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Introduction: Preserved LVEF heart failure is an important cause of mortality and morbidity in hypertensive patients. A strong correlation between impaired diastolic function and longitudinal systolic dysfunction. could have several explanations, first, the diastole is an energy dependent process, especially during its first phase, it also includes active systolic components during the phase of iso volumetric relaxation, in addition, the impairment of the intrinsic myocytic function is part of hypertensive pathology as evidenced by recent studies. METHODS AND MATERIALS: This work consists of performing in a series of 333 hypertensive patients (aged 25 to 75 years) a complete echocardiographic study, including LVEF by Simpson biplane method, the calculation of the indexed left ventricular mass, the analysis of the diastolic function, and finally, the study of the longitudinal deformation of the LV by the technique of speckletracking (calculation of the GLS). Patients with secondary hypertension, leaky or stenosing valve disease, arrhythmia, and a history of coronary insufficiency were excluded from this study. RESULTS: Of the 333 hypertensive patients, 225 patients (67.5%) had impaired diastolic function, of which 60 patients (18%) had high filling pressures. 49.39% had echocardigraphic HVG, Almost all of these patients (60 patients) had low GLS. There is a statistically very significant relationship between lower GLS and increased left ventricular filling pressures in hypertensive patients. These results suggest that increased filling pressures are closely associated with atrioventricular interaction in patients with hypertension, with a strong correlation with impairment of longitudinal systolic function and diastolic function CONCLUSION: Overall, a linear relationship is established between increased left ventricular mass, diastolic dysfunction, and longitudinal LV systolic dysfunction

Keywords: hypertension, diastolic function, left ventricle, heart failure

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1066 Analyzing Emerging Scientific Domains in Biomedical Discourse: Case Study Comparing Microbiome, Metabolome, and Metagenome Research in Scientific Articles

Authors: Kenneth D. Aiello, M. Simeone, Manfred Laubichler

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It is increasingly difficult to analyze emerging scientific fields as contemporary scientific fields are more dynamic, their boundaries are more porous, and the relational possibilities have increased due to Big Data and new information sources. In biomedicine, where funding, medical categories, and medical jurisdiction are determined by distinct boundaries on biomedical research fields and definitions of concepts, ambiguity persists between the microbiome, metabolome, and metagenome research fields. This ambiguity continues despite efforts by institutions and organizations to establish parameters on the core concepts and research discourses. Further, the explosive growth of microbiome, metabolome, and metagenomic research has led to unknown variation and covariation making application of findings across subfields or coming to a consensus difficult. This study explores the evolution and variation of knowledge within the microbiome, metabolome, and metagenome research fields related to ambiguous scholarly language and commensurable theoretical frameworks via a semantic analysis of key concepts and narratives. A computational historical framework of cultural evolution and large-scale publication data highlight the boundaries and overlaps between the competing scientific discourses surrounding the three research areas. The results of this study highlight how discourse and language distribute power within scholarly and scientific networks, specifically the power to set and define norms, central questions, methods, and knowledge.

Keywords: biomedicine, conceptual change, history of science, philosophy of science, science of science, sociolinguistics, sociology of knowledge

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1065 The Term of Intellectual Property and Artificial Intelligence

Authors: Yusuf Turan

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Definition of Intellectual Property Rights according to the World Intellectual Property Organization: " Intellectual property (IP) refers to creations of the mind, such as inventions; literary and artistic works; designs; and symbols, names and images used in commerce." It states as follows. There are 2 important points in the definition; we can say that it is the result of intellectual activities that occur by one or more than one PERSON and as INNOVATION. When the history and development of the relevant definitions are briefly examined, it is realized that these two points have remained constant and Intellectual Property law and rights have been shaped around these two points. With the expansion of the scope of the term Intellectual Property as a result of the development of technology, especially in the field of artificial intelligence, questions such as "Can "Artificial Intelligence" be an inventor?" need to be resolved within the expanding scope. In the past years, it was ruled that the artificial intelligence named DABUS seen in the USA did not meet the definition of "individual" and therefore would be an inventor/inventor. With the developing technology, it is obvious that we will encounter such situations much more frequently in the field of intellectual property. While expanding the scope, we should definitely determine the boundaries of how we should decide who performs the mental activity or creativity that we call indispensable on the inventor/inventor according to these problems. As a result of all these problems and innovative situations, it is clearly realized that not only Intellectual Property Law and Rights but also their definitions need to be updated and improved. Ignoring the situations that are outside the scope of the current Intellectual Property Term is not enough to solve the problem and brings uncertainty. The fact that laws and definitions that have been operating on the same theories for years exclude today's innovative technologies from the scope contradicts intellectual property, which is expressed as a new and innovative field. Today, as a result of the innovative creation of poetry, painting, animation, music and even theater works with artificial intelligence, it must be recognized that the definition of Intellectual Property must be revised.

Keywords: artificial intelligence, innovation, the term of intellectual property, right

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1064 Finite Element Approach to Evaluate Time Dependent Shear Behavior of Connections in Hybrid Steel-PC Girder under Sustained Loading

Authors: Mohammad Najmol Haque, Takeshi Maki, Jun Sasaki

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Headed stud shear connections are widely used in the junction or embedded zone of hybrid girder to achieve whole composite action with continuity that can sustain steel-concrete interfacial tensile and shear forces. In Japan, Japan Road Association (JRA) specifications are used for hybrid girder design that utilizes very low level of stud capacity than those of American Institute of Steel Construction (AISC) specifications, Japan Society of Civil Engineers (JSCE) specifications and EURO code. As low design shear strength is considered in design of connections, the time dependent shear behavior due to sustained external loading is not considered, even not fully studied. In this study, a finite element approach was used to evaluate the time dependent shear behavior for headed studs used as connections at the junction. This study clarified, how the sustained loading distinctively impacted on changing the interfacial shear of connections with time which was sensitive to lodging history, positions of flanges, neighboring studs, position of prestress bar and reinforcing bar, concrete strength, etc. and also identified a shear influence area. Stud strength was also confirmed through pushout tests. The outcome obtained from the study may provide an important basis and reference data in designing connections of hybrid girders with enhanced stud capacity with due consideration of their long-term shear behavior.

Keywords: finite element, hybrid girder, shear connections, sustained loading, time dependent behavior

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1063 Physics-Informed Convolutional Neural Networks for Reservoir Simulation

Authors: Jiangxia Han, Liang Xue, Keda Chen

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Despite the significant progress over the last decades in reservoir simulation using numerical discretization, meshing is complex. Moreover, the high degree of freedom of the space-time flow field makes the solution process very time-consuming. Therefore, we present Physics-Informed Convolutional Neural Networks(PICNN) as a hybrid scientific theory and data method for reservoir modeling. Besides labeled data, the model is driven by the scientific theories of the underlying problem, such as governing equations, boundary conditions, and initial conditions. PICNN integrates governing equations and boundary conditions into the network architecture in the form of a customized convolution kernel. The loss function is composed of data matching, initial conditions, and other measurable prior knowledge. By customizing the convolution kernel and minimizing the loss function, the neural network parameters not only fit the data but also honor the governing equation. The PICNN provides a methodology to model and history-match flow and transport problems in porous media. Numerical results demonstrate that the proposed PICNN can provide an accurate physical solution from a limited dataset. We show how this method can be applied in the context of a forward simulation for continuous problems. Furthermore, several complex scenarios are tested, including the existence of data noise, different work schedules, and different good patterns.

Keywords: convolutional neural networks, deep learning, flow and transport in porous media, physics-informed neural networks, reservoir simulation

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1062 An Evaluation of Neuropsychiatric Manifestations in Systemic Lupus Erythematosus Patients in Saudi Arabia and Their Associated Factors

Authors: Yousef M. Alammari, Mahmoud A. Gaddoury, Reem A. Almohaini, Sara A. Alharbi, Lena S. Alsaleem, Lujain H. Allowaihiq, Maha H. Alrashid, Abdullah H. Alghamdi, Abdullah A. Alaryni

Abstract:

Objective: The goal of this study was to establish the prevalence of neuropsychiatric symptoms in systemic lupus erythematosus (NPSLE) patients in Saudi Arabia and the variables that are linked to it. Methods: During June 2021, this cross-sectional study was carried out among SLE patients in Saudi Arabia. The Saudi Rheumatism Association exploited social media platforms to provide a self-administered online questionnaire to SLE patients. All data analyses were performed using the Statistical Packages for Social Sciences (SPSS) version 26. Results: Two hundred and five SLE patients participated in the study (females 91.3 % vs. males 8.7 %). In addition, 13.5 % of patients had a family history of SLE, and 26% had SLE for one to three years. Alteration or loss of sensation (53.4%), Fear (52.4%), and headache (48.1%) were the most prevalent signs of neuropsychiatric symptoms in systemic lupus erythematosus (NPSLE) patients. The prevalence of patients with NPSLE was 40%. In a multivariate regression model, fear, altered sensations, cerebrovascular illness, sleep disruption, and diminished interest in routine activities were identified as independent risk variables for NPSLE. Conclusion: Nearly half of SLE patients demonstrated NP manifestations, with significant symptoms including fear, alteration of sensation, cerebrovascular disease, sleep disturbance, and reduced interest in normal activities. To detect the pathophysiology of NPSLE, it is necessary to understand the relationship between neuropsychiatric morbidity and other relevant rheumatic disorders in the SLE population.

Keywords: neuropsychiatric, systemic lupus erythematosus, NPSLE, prevalence, SLE patients

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1061 Parameter Optimization and Thermal Simulation in Laser Joining of Coach Peel Panels of Dissimilar Materials

Authors: Masoud Mohammadpour, Blair Carlson, Radovan Kovacevic

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The quality of laser welded-brazed (LWB) joints were strongly dependent on the main process parameters, therefore the effect of laser power (3.2–4 kW), welding speed (60–80 mm/s) and wire feed rate (70–90 mm/s) on mechanical strength and surface roughness were investigated in this study. The comprehensive optimization process by means of response surface methodology (RSM) and desirability function was used for multi-criteria optimization. The experiments were planned based on Box– Behnken design implementing linear and quadratic polynomial equations for predicting the desired output properties. Finally, validation experiments were conducted on an optimized process condition which exhibited good agreement between the predicted and experimental results. AlSi3Mn1 was selected as the filler material for joining aluminum alloy 6022 and hot-dip galvanized steel in coach peel configuration. The high scanning speed could control the thickness of IMC as thin as 5 µm. The thermal simulations of joining process were conducted by the Finite Element Method (FEM), and results were validated through experimental data. The Fe/Al interfacial thermal history evidenced that the duration of critical temperature range (700–900 °C) in this high scanning speed process was less than 1 s. This short interaction time leads to the formation of reaction-control IMC layer instead of diffusion-control mechanisms.

Keywords: laser welding-brazing, finite element, response surface methodology (RSM), multi-response optimization, cross-beam laser

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1060 Outcomes in New-Onset Diabetic Foot Ulcers Stratified by Etiology

Authors: Pedro Gomes, Lia Ferreira, Sofia Garcia, Jaime Babulal, Luís Costa, Luís Castelo, José Muras, Isabel Gonçalves, Rui Carvalho

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Introduction: Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. Objectives: The present study aims to evaluate the outcomes in terms of need for hospitalization, amputation, healing time and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology. Methods: A retrospective study based on clinical assessment of patients presenting with new ulcers to a multidisciplinary diabetic foot consult during 2012. Outcomes were determined until September 2014, from hospital registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic or neuroischemic. Results: 487 patients with new diabetic foot ulcers were observed; 36%, 15% and 49% of patients had neuropathic, ischemic and neuroischemic ulcers, respectively. For analysis, patients were classified as having predominantly neuropathic (36%) or ischemic foot (64%). The mean age was significantly higher in the group with ischemic foot (70±12 vs 63±12 years; p <0.001), as well as the duration of diabetes (18±10 vs 16 ± 10years, p <0.05). A history of previous amputation was also significantly higher in this group (24.7% vs 15.6%, p <0.05). The evolution of ischemic ulcers was significantly worse, with a greater need for hospitalization (27.2% vs 18%, p <0.05), amputation (11.5% vs 3.6% p <0.05) mainly major amputation (3% vs. 0%; p <0.001) and higher mean healing time (151 days vs 89 days, p <0.05). The mortality rate at 18 months, was also significantly higher in the ischemic foot group (7.3% vs 1.8%, p <0.05). Conclusions: All types of diabetic foot ulcers are associated with high morbidity and mortality, however, the presence of arterial disease confers a poor prognosis. Diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care.

Keywords: diabetes, foot ulcers, etiology, outcome

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1059 Designing the Maturity Model of Smart Digital Transformation through the Foundation Data Method

Authors: Mohammad Reza Fazeli

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Nowadays, the fourth industry, known as the digital transformation of industries, is seen as one of the top subjects in the history of structural revolution, which has led to the high-tech and tactical dominance of the organization. In the face of these profits, the undefined and non-transparent nature of the after-effects of investing in digital transformation has hindered many organizations from attempting this area of this industry. One of the important frameworks in the field of understanding digital transformation in all organizations is the maturity model of digital transformation. This model includes two main parts of digital transformation maturity dimensions and digital transformation maturity stages. Mediating factors of digital maturity and organizational performance at the individual (e.g., motivations, attitudes) and at the organizational level (e.g., organizational culture) should be considered. For successful technology adoption processes, organizational development and human resources must go hand in hand and be supported by a sound communication strategy. Maturity models are developed to help organizations by providing broad guidance and a roadmap for improvement. However, as a result of a systematic review of the literature and its analysis, it was observed that none of the 18 maturity models in the field of digital transformation fully meet all the criteria of appropriateness, completeness, clarity, and objectivity. A maturity assessment framework potentially helps systematize assessment processes that create opportunities for change in processes and organizations enabled by digital initiatives and long-term improvements at the project portfolio level. Cultural characteristics reflecting digital culture are not systematically integrated, and specific digital maturity models for the service sector are less clearly presented. It is also clearly evident that research on the maturity of digital transformation as a holistic concept is scarce and needs more attention in future research.

Keywords: digital transformation, organizational performance, maturity models, maturity assessment

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1058 Challenging Heteronormativity and Mononormativity in Academia: Incorporating Consensual Non-Monogamy into Psychological Romantic Relationship Research

Authors: Jessica Wood, Serge Desmarais

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There has been recent resurgence in the popular and academic interest of consensual non-monogamous (CNM) relationships- an umbrella term that defines relationships in which each partner has openly agreed to engage in additional romantic and/or sexual relationships outside of their primary partnership. Despite an increase in the academic study of CNM, little psychological attention has been paid to the study of CNM, with the consideration of these relationships commonly occurring within related social science disciplines such as sociology or anthropology. As a discipline, psychology has a history of conducting research in the area of intimate relationships, and psychologists have amassed a wealth of theoretical knowledge in this field. However, historically individuals who engage in "alternative" sexual and romantic behaviours, such as non-heterosexual sex or sex with multiple partners have been pathologized within psychological research. Individuals in CNM relationships or individuals identifying as lesbian, gay, bisexual, trans or queer have often been excluded from research or “othered” in psychological interpretations of what healthy relationships entail. Thus, our current theoretical understandings of romantic relationships are limited to heterosexual, monogamous relationships. The goal of this presentation is to examine commonly cited components of relationship satisfaction (e.g., commitment, communication) and to critically assess how CNM experiences are presented in, or missing from, the psychological literature on romantic relationships. Additionally, the presentation will also consider how CNM relationships may add to our understanding or enhancement of traditional psychological theories and address issues related to heteronormativity and mononormativity within the discipline. Finally, we will close with a consideration of additional theoretical perspectives that may aid in our understanding of CNM relationships and suggest directions for future research.

Keywords: heteronormativity, mononormativity, psychological research, diverse relationships, gender, sexuality, feminism, queer theory

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1057 The Impact of Women’s Leadership in Panchayati Raj Institutions: Some of the Insights on Indian Rural Governance

Authors: Avneet Kaur

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India is a nation of villages. Traditionally, women had enjoyed a high social status in India. Our mythology, folklore and history are full of women who were epitomes of virtue, wisdom, power, and position. The important concern about their entry into the politics is of great importance all over the world. Women have performed excellently in social, economic and political sphere. However, the fact remains that despite constituting half of the population their representation among elected post continue to remain negligible in Panchayati Raj Institutions. Women in India suffered from many social economic handicaps such as illiteracy, economically dependent, social customs, traditions and rituals that are the main causes of their inactive participation in local governance. There is still widespread patriarchal outlook in the villages and the lack of experience on the part of women leadership are some of the major issues of debate. The implementation of the 73rd Amendment Act of the Indian Constitution in 1992 reserved 1/3 rd of the seats for women empowerment. It was a major step to encourage them to take part in the village politics. This kind of revolution was the beginning of women leadership in villages. The paper intends to study the role and importance of women leadership in Panchayati Raj Institutions in India. The paper is divided into four sections. First section deals with the introduction by taking into account the available research on this particular subject. Second section talks about the role played by women leadership in these institutions after the passing of 73rd Amendment Act. Third section deals with some of the critical insights of the study by discussing the problems faced by the active women’s leadership at the grassroots. Finally, the paper concludes with policy suggestions.

Keywords: women, leadership, grassroots, Panchayati Raj

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1056 Political Deprivations, Political Risk and the Extent of Skilled Labor Migration from Pakistan: Finding of a Time-Series Analysis

Authors: Syed Toqueer Akhter, Hussain Hamid

Abstract:

Over the last few decades an upward trend has been observed in the case of labor migration from Pakistan. The emigrants are not just economically motivated and in search of a safe living environment towards more developed countries in Europe, North America and Middle East. The opportunity cost of migration comes in the form of brain drain that is the loss of qualified and skilled human capital. Throughout the history of Pakistan, situations of political instability have emerged ranging from violation of political rights, political disappearances to political assassinations. Providing security to the citizens is a major issue faced in Pakistan due to increase in crime and terrorist activities. The aim of the study is to test the impact of political instability, appearing in the form of political terror, violation of political rights and civil liberty on skilled migration of labor. Three proxies are used to measure the political instability; political terror scale (based on a scale of 1-5, the political terror and violence that a country encounters in a particular year), political rights (a rating of 1-7, that describes political rights as the ability for the people to participate without restraint in political process) and civil liberty (a rating of 1-7, civil liberty is defined as the freedom of expression and rights without government intervention). Using time series data from 1980-2011, the distributed lag models were used for estimation because migration is not a onetime process, previous events and migration can lead to more migration. Our research clearly shows that political instability appearing in the form of political terror, political rights and civil liberty all appeared significant in explaining the extent of skilled migration of Pakistan.

Keywords: skilled labor migration, political terror, political rights, civil liberty, distributed lag model

Procedia PDF Downloads 1028
1055 Estimation of Hysteretic Damping in Steel Dual Systems with Buckling Restrained Brace and Moment Resisting Frame

Authors: Seyed Saeid Tabaee, Omid Bahar

Abstract:

Nowadays, using energy dissipation devices has been commonly used in structures. A high rate of energy absorption during earthquakes is the benefit of using such devices, which results in damage reduction of structural elements specifically columns. The hysteretic damping capacity of energy dissipation devices is the key point that it may adversely complicate analysis and design of such structures. This effect may be generally represented by equivalent viscous damping. The equivalent viscous damping may be obtained from the expected hysteretic behavior under the design or maximum considered displacement of a structure. In this paper, the hysteretic damping coefficient of a steel moment resisting frame (MRF), which its performance is enhanced by a buckling restrained brace (BRB) system has been evaluated. Having the foresight of damping fraction between BRB and MRF is inevitable for seismic design procedures like Direct Displacement-Based Design (DDBD) method. This paper presents an approach to calculate the damping fraction for such systems by carrying out the dynamic nonlinear time history analysis (NTHA) under harmonic loading, which is tuned to the natural frequency of the system. Two steel moment frame structures, one equipped with BRB, and the other without BRB are simultaneously studied. The extensive analysis shows that proportion of each system damping fraction may be calculated by its shear story portion. In this way, the contribution of each BRB in the floors and their general contribution in the structural performance may be clearly recognized, in advance.

Keywords: buckling restrained brace, direct displacement based design, dual systems, hysteretic damping, moment resisting frames

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1054 Effects of Political, Economic and Educational Considerations on Medium of Instruction (MOI) Policy in Asia: A Hong Kong Example

Authors: Edward Y. W. Chu

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This paper exemplifies how the political and educational considerations have shaped the heavy-handed MOI policy in Hong Kong after its handover to China in 1997. Its result, a significant degeneration of English standard among the non-elite students, will be reported based on a detailed analysis of the public exam statistics available and other empirical studies. The remedial action taken by the Education Bureau out of the economic and educational considerations will be reported with reference to the official documents. The political, economic and educational considerations exemplified in different stages of Mother-tongue MOI policy in Hong Kong are found to be influential in the MOI policy in other Asian countries as well. For example, out of rapid internationalization and marketization, there has been increasing adoption of English as the MOI in post-secondary institutions in China, Japan & South Korea. On the other hand, while colonial languages were firmly made as the MOI in former colonies such as Vietnam and India, they were greatly retrieved upon independence for political and educational reasons. Malaysia also followed the same pattern upon independence but re-introduced partial English MOI policy in late 90s hoping to capitalize favourable globalization benefits. The short-lived policy was abandoned in 2009 because of the perceived political threat of national identity as well as the lack of educational effectiveness. Based on the great majority of Asian countries studied, this paper argues that MOI policy in Asia is much more than an educational issue, and that there is a clear pattern of how decisions of MOI matters are made. Studying the history and development of MOI in Hong Kong and other Asian countries provides a unique angle to view of how Asian countries prepare for the political, economic and educational challenges nowadays.

Keywords: economics, Hong Kong, medium of instruction, politics

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1053 Customer Churn Prediction by Using Four Machine Learning Algorithms Integrating Features Selection and Normalization in the Telecom Sector

Authors: Alanoud Moraya Aldalan, Abdulaziz Almaleh

Abstract:

A crucial component of maintaining a customer-oriented business as in the telecom industry is understanding the reasons and factors that lead to customer churn. Competition between telecom companies has greatly increased in recent years. It has become more important to understand customers’ needs in this strong market of telecom industries, especially for those who are looking to turn over their service providers. So, predictive churn is now a mandatory requirement for retaining those customers. Machine learning can be utilized to accomplish this. Churn Prediction has become a very important topic in terms of machine learning classification in the telecommunications industry. Understanding the factors of customer churn and how they behave is very important to building an effective churn prediction model. This paper aims to predict churn and identify factors of customers’ churn based on their past service usage history. Aiming at this objective, the study makes use of feature selection, normalization, and feature engineering. Then, this study compared the performance of four different machine learning algorithms on the Orange dataset: Logistic Regression, Random Forest, Decision Tree, and Gradient Boosting. Evaluation of the performance was conducted by using the F1 score and ROC-AUC. Comparing the results of this study with existing models has proven to produce better results. The results showed the Gradients Boosting with feature selection technique outperformed in this study by achieving a 99% F1-score and 99% AUC, and all other experiments achieved good results as well.

Keywords: machine learning, gradient boosting, logistic regression, churn, random forest, decision tree, ROC, AUC, F1-score

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1052 Synergistic Effect of Chondroinductive Growth Factors and Synovium-Derived Mesenchymal Stem Cells on Regeneration of Cartilage Defects in Rabbits

Authors: M. Karzhauov, А. Mukhambetova, M. Sarsenova, E. Raimagambetov, V. Ogay

Abstract:

Regeneration of injured articular cartilage remains one of the most difficult and unsolved problems in traumatology and orthopedics. Currently, for the treatment of cartilage defects surgical techniques for stimulation of the regeneration of cartilage in damaged joints such as multiple microperforation, mosaic chondroplasty, abrasion and microfractures is used. However, as shown by clinical practice, they can not provide a full and sustainable recovery of articular hyaline cartilage. In this regard, the current high hopes in the regeneration of cartilage defects reasonably are associated with the use of tissue engineering approaches to restore the structural and functional characteristics of damaged joints using stem cells, growth factors and biopolymers or scaffolds. The purpose of the present study was to investigate the effects of chondroinductive growth factors and synovium-derived mesenchymal stem cells (SD-MSCs) on the regeneration of cartilage defects in rabbits. SD-MSCs were isolated from the synovium membrane of Flemish giant rabbits, and expanded in complete culture medium α-MEM. Rabbit SD-MSCs were characterized by CFU-assay and by their ability to differentiate into osteoblasts, chondrocytes and adipocytes. The effects of growth factors (TGF-β1, BMP-2, BMP-4 and IGF-I) on MSC chondrogenesis were examined in micromass pellet cultures using histological and biochemical analysis. Articular cartilage defect (4mm in diameter) in the intercondylar groove of the patellofemoral joint was performed with a kit for the mosaic chondroplasty. The defect was made until subchondral bone plate. Delivery of SD-MSCs and growth factors was conducted in combination with hyaloronic acid (HA). SD-MSCs, growth factors and control groups were compared macroscopically and histologically at 10, 30, 60 and 90 days aftrer intra-articular injection. Our in vitro comparative study revealed that TGF-β1 and BMP-4 are key chondroinductive factors for both the growth and chondrogenesis of SD-MSCs. The highest effect on MSC chondrogenesis was observed with the synergistic interaction of TGF-β1 and BMP-4. In addition, biochemical analysis of the chondrogenic micromass pellets also revealed that the levels of glycosaminoglycans and DNA after combined treatment with TGF-β1 and BMP-4 was significantly higher in comparison to individual application of these factors. In vivo study showed that for complete regeneration of cartilage defects with intra-articular injection of SD-MSCs with HA takes time 90 days. However, single injection of SD-MSCs in combiantion with TGF-β1, BMP-4 and HA significantly promoted regeneration rate of the cartilage defects in rabbits. In this case, complete regeneration of cartilage defects was observed in 30 days after intra-articular injection. Thus, our in vitro and in vivo study demonstrated that combined application of rabbit SD-MSC with chondroinductive growth factors and HA results in strong synergistic effect on the chondrogenesis significantly enhancing regeneration of the damaged cartilage.

Keywords: Mesenchymal stem cells, synovium, chondroinductive factors, TGF-β1, BMP-2, BMP-4, IGF-I

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1051 Direct-Displacement Based Design for Buildings with Non-Linear Viscous Dampers

Authors: Kelly F. Delgado-De Agrela, Sonia E. Ruiz, Marco A. Santos-Santiago

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An approach is proposed for the design of regular buildings equipped with non-linear viscous dissipating devices. The approach is based on a direct-displacement seismic design method which satisfies seismic performance objectives. The global system involved is formed by structural regular moment frames capable of supporting gravity and lateral loads with elastic response behavior plus a set of non-linear viscous dissipating devices which reduce the structural seismic response. The dampers are characterized by two design parameters: (1) a positive real exponent α which represents the non-linearity of the damper, and (2) the damping coefficient C of the device, whose constitutive force-velocity law is given by F=Cvᵃ, where v is the velocity between the ends of the damper. The procedure is carried out using a substitute structure. Two limits states are verified: serviceability and near collapse. The reduction of the spectral ordinates by the additional damping assumed in the design process and introduced to the structure by the viscous non-linear dampers is performed according to a damping reduction factor. For the design of the non-linear damper system, the real velocity is considered instead of the pseudo-velocity. The proposed design methodology is applied to an 8-story steel moment frame building equipped with non-linear viscous dampers, located in intermediate soil zone of Mexico City, with a dominant period Tₛ = 1s. In order to validate the approach, nonlinear static analyses and nonlinear time history analyses are performed.

Keywords: based design, direct-displacement based design, non-linear viscous dampers, performance design

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1050 The Terminology of Mandatory Mediation on Commercial Disputes in Türkiye and the Differences from England and Wales’s Approaches

Authors: Sevgi Karaca

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Since December 6, 2018, mediation has become mandatory for commercial disputes under the Turkish Commercial Code. Mandatory mediation became one of the “causes of action”, and being compulsory means starting the mediation process before going to court. As it contemplates looking at “the causes of the action”, the terminology may lead to misinterpretation of the core of the phrases. However, the terms pertain to a prerequisite for starting the lawsuit. The court will examine failure to comply with such requirements, and the case will be dismissed without further action. Türkiye’s use of obligatory mediation is highly unusual. It is neither judge-led nor judge-assisted mediation but rather a mediation conducted outside of court with the participation of a third party (mediators). What distinguishes it is the incorporation of obligatory mediation into the causes of actions listed in the Code of Civil Procedure. Being one of the causes of action in a legal case implies that the absence of any of them may result in the procedural dismissal of the case without any further action. The case must be presented to the mediator first, and if the parties are unable to reach an agreement, they must deliver the results of the mediation session. Other than submitting the minutes, parties are ineligible to file a lawsuit. However, despite a lengthy history of use in England and Wales, there are considerable reservations about making mediation mandatory. The Civil Procedure Code does not explicitly mention making mediation mandatory. For the time being, there is no Mediation Code, and case law limits the growth of obligatory mediation. Some renowned judges voiced their desire to re-evaluate the notion of required mediation, prompting the Civil Justice Council to release a study in 2021 on the significance of amending case law and the high value of mandatory mediation. By contrasting the approaches to mandatory mediation in England and Wales, the study will investigate the method of controlled mandatory mediation and its effects on the success of mediation in Türkiye.

Keywords: alternative dispute resolution, case law, cause of action, litigation process, mandatory mediation

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1049 A City Adapting to the Mobile Government and Hybrid Culture Established by Khitan-Liao (907-1125): Up-Capital (Shangjing) and its Special Tent Zone

Authors: Robin Ruowei Yang

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The Khitan-Liao dynasty (907-1125) was founded by the nomadic Khitan people and showed its peculiarities. This regime not only effectively ruled their own nomads, but also ruled the farming ethnic groups of the Han (漢) and others. It also controlled vast territories that included the northern border domains of China, East Asia, and even Central Asia. Different from the practice of other nomadic people, Khitan-Liao built settlement towns and cities on the Mongolia steppe from beginning of the dynasty, which made the politics, economy and culture of the steppe area develop significantly. In the process of cities’ construction, Khitan-Liao set up five capitals respectively. Except three of them were rebuilt or expanded based on existing cities in agricultural areas, two new capitals were built, namely up-capital (Shangjing) and middle-capital (Zhongjing) in the steppe area. This article takes the up-capital (Shangjing) as an example to investigate a special zone in the capital for settling movable tents which adapted Khitan nomads, especially its nomadic government officials to live in. By using primary Chinese historical records and newly archaeological excavations, this article examines how the special tent zone used by the Khitan rulers, discusses how the Khitan-Liao manifested its hybrid cultural characteristics in urban planning, and its implications in studying the history of Khitan-Liao. The information, discussion and argument presented in this article are also worth considering the influence of urbanization of Khitan-Liao’s urbaization on subsequent dynasties in pre-modern China and Inner Asia.

Keywords: cities on Steppe, special tent zone in cities, Khitan-Liao, hybrid culture

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1048 Modernizer'ness as Madness: A Comparative Historical Study of Emperor Tewodros II of Ethiopia and Sultan Selim III of Ottoman Turkey's Modernization Reforms

Authors: Seid Ahmed Mohammed, Nedim Yalansiz

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Many historians hardly gave due attention for historical comparison as their methods of study. They were still stunt supporter of the use of their own historical research method in their studies. But this method lacks the way to analyze some worldwide dynamics of events in comparative perspectives. Some dynamics like revolution, modernization, societal change and transformation needs broader analysis for broadening our historical knowledge’s by comparing and contrasting of the causes, courses and consequences of such dynamics historical developments in the world at large. In this paper, our study focuses up on ‘the dynamics of modernization’ and the challenge of modernity of the old regimes. For instance, countries like Turkey, Ethiopia, China, Russia, Iran, Afghanistan and Thailand have almost the same dynamics in facing the challenge of modernity. In such countries, the old regimes tried to introduce modernization and ‘reform from the above’ in order to tackle the gradual decline of the empire that faced strong challenge from the outside world. The other similarity of them was that as the rulers attempted to introduce the modernization reforms the old traditional and the religious institutions strongly opposed the reforms as the reforms alienated the power and prestige of the traditional classes. Similarly, the rules introduced modernization for maintaining their own unique socio-cultural and religious dynamics not as borrowing and acculturation of the west by complete destruction of their own. Therefore, this paper attempted to give a comparative analysis of two modernizers Tewodros II (1855-1868) of Ethiopia and Sultan Selim III (1739-1808) of Ottoman Turkey who tried to modernize their empire unfortunately they paid their precious life as a result of modernization.

Keywords: comparative history, Ethiopia, modernization, Ottoman Turkey

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1047 A Case Report on Diaphragm Disease of Small Bowel Following Usage of Non-Steroidal Anti-Inflammatory Drugs

Authors: Shivani Kuttuva, Bridget Fergie, Andrew Mishreki, Shovkat Mir, Fintan Bergin

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Diaphragm disease (DD) of the small bowel is a condition wherein the bowel lumen is divided into a series of short compartments by multiple circumferential membranes of mucosa and submucosa, leading to pinhole lumen and subsequent obstruction. It is a rare condition commonly attributed to non-steroidal anti-inflammatory drugs (NSAIDs) usage. Herein we present a 31-yr-old-female with a history of NSAIDs usage for one year following neurosurgery, who presented with recurrent idiopathic small bowel obstruction, recalcitrant anaemia, and impaction of capsule endoscope on investigating for anaemia. The capsule endoscopy images demonstrated multiple circumferential strictures with ulcers at its tip and villous atrophy in the proximal bowel, suggestive of NSAIDs related damage. However, due to the lack of awareness of the detrimental effects of NSAIDs on bowel mucosa distal to the duodenum, the underlying aetiology of this clinical presentation remained a mystery for a significant duration. The patient had to undergo repeated laparotomies in order to relieve the symptoms of recurring acute small bowel obstruction. Upon examining the resected specimen under microscopy, the histopathological hallmark of expanded, fibrotic, and congested submucosa was picked up, leading to the confirmation of diaphragm disease. Thus, this case report aims to widen the awareness among clinicians and aid surgeons in devising a management plan for young individuals presenting with recurring episodes of obstruction due to Diaphragm disease.

Keywords: capsule endoscopy, diaphragm disease, NSAIDs, recurrent small bowel obstruction

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1046 Blunt Abdominal Trauma Management in Adult Patients: An Investigation on Safety of Discharging Patients with Normal Initial Findings

Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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