Search results for: combined surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3601

Search results for: combined surgery

841 Investigating the Relationship of Age, Annual Income, and Education on Women's Investment Behavior in the Arab Region

Authors: Razan Salem

Abstract:

This study aims to investigate the investment behavior of Arab women (in regards to their herding behavior, risk tolerance, confidence and investment literacy levels). This study aims to investigate the relationship between three demographic factors (age, income, education) and the investment behavior of Arab women. On average, women in the Arab region face several obstacles that limit them from fully participating in stocks investments. In the context, this study focuses on extending the existing literature to include Arab women individuals and their investment behaviors. To achieve the study’s objective, the researcher distributed 600 close-ended online questionnaires to a sample of Arab male and female individual investors in both Saudi Arabia and Jordan. The researcher used quantitative statistical methods (frequency distribution along with the Kruskal-Wallis H Test and the Mann-Whitney U Test) to analyze the 550 questionnaire respondents. The findings indicated that only age, educational level, and annual income level are associated with the investment behavior of Arab women, where age is only negatively associated with their financial risk tolerance levels. Additionally, income level is positively associated with Arab women‘s confidence and investment literacy levels, while educational level is only associated positively with their investment confidence levels. According to annual income, Arab women with lower incomes have lower confidence and investment literacy levels. The limited income level might prevent the sample Arab women from investing in the financial information and advisors that may help in improving their investment literacy levels. Furthermore, Arab women with lower educational levels have lower investment literacy levels and thus, this may limit their stock investments. Overall, the study contributes to the existing literature by focusing directly on examining the investment behavior of Arab women and its association with age, annual income, and education. Generally, there are scarce existing studies that investigate the association of demographic factors with the investment behavior of women only in regards to their herding behavior, risk tolerance, investment confidence, and investment literacy levels (combined), especially Arab women investors.

Keywords: Arab region, demographic factors, investment behavior, women investors

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840 Identification and Management of Septic Arthritis of the Untouched Glenohumeral Joint

Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot

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Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.

Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder

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839 Managing Early Stakeholder Involvement at the Early Stages of a Building Project Life Cycle

Authors: Theophilus O. Odunlami, Hasan Haroglu, Nader Saleh-Matter

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The challenges facing the construction industry are often worsened by the compounded nature of projects coupled with the complexity of key stakeholders involved at different stages of the project. Projects are planned to achieve outlined benefits in line with the business case; however, a lack of effective management of key stakeholders can result in unrealistic delivery aspirations, unnecessary re-works, and overruns. The aim of this study is to examine the early stages of a project lifecycle and investigate the stakeholder management and involvement processes and their impact on the successful delivery of the project. The research engaged with conventional construction organisations and project personnel and stakeholders on diverse projects, using a research strategy to analyse existing project case studies, narrative enquiries, interviews, and surveys using a combined qualitative, quantitative, and mixed method of analysis. Research findings have shown that the involvement of stakeholders at different levels during the early stages has pronounced effects on project delivery; it helps to forge synergy and promotes a clear understanding of individual responsibilities, strengths, and weaknesses. This has often fostered a positive sense of productive collaboration right through the early stages of the project. These research findings intend to contribute to the development of a process framework for stakeholder and project team involvement in the early stages of a project. This framework will align with the selection criteria for stakeholders, contractors, and resources, ultimately contributing to the successful completion of projects. The primary question addressed in this study is stakeholder involvement and management of the early stages of a building project life cycle impacts project delivery. Findings showed that early-stage stakeholder involvement and collaboration between project teams and contractors significantly contribute to project success. However, a strong and healthy communication strategy would be required to maintain the flow of value-added ideas among stakeholders at the early stages to benefit the project at the execution stage.

Keywords: early stages, project lifecycle, stakeholders, decision-making strategy, project framework

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838 Urban Renewal, Social Housing, Relocation, and Violence in Algiers

Authors: Kahina Amal Djiar, Mouna Gharbi, Maha Messaoudene, Oumelkheir Chareb

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Over the last decade, Algerian authorities have implemented an ambitious program of urban renewal, which includes important relocation operations. The objectives behind such strategic interventions are on the one hand, to carry out an incremental approach aiming at eradicating precarious housing and on the other hand, to diversify alternative housing options for families requiring better living spaces. It is precisely for these same purposes that the Djenan el-Hassan and Carrières Jaubert estates, which are both located in Algiers, have undergone major urban transformations. These dwelling sites were built as part of the famous "Battle of Housing", which was launched by French colonial administration in the 1950s just before the independence of Algeria in 1962. Today, the Djenan el-Hassan estate is almost entirely demolished following the relocation of 171 families. The Carrières Jaubert estate, for its part, has seen two kinds of operations. The first has been shaped by a process of urban requalification and redevelopment, which allowed some of the residents to stay on site after the transformation of most housing cells into larger apartments. The second operation has required the relocation of over 300 families to entirely newly built dwellings. Such projects of urban renewal are supposed to create new opportunities, not only in terms of local urban development, but also in terms of social perspectives for those families who are involved, either directly or indirectly, in the process of relocation. In fact, the percentage of urban violence in Algiers has increased instead. Recent events in the newly built estates show that residents are repeatedly experiencing and even instigating episodes of brutality, hostility and aggression. The objective of this paper is to examine the causes that have engendered such rise in urban violence in newly built housing estates in Algiers. This paper aims to present the findings of a recent qualitative research and highlight the way that poorly designed neighbourhood, combined with a relocation process that leaves little room for community participation, create inevitably severe social tensions.

Keywords: relocation, social housing, violence, Algiers

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837 Rethinking the Value of Pancreatic Cyst CEA Levels from Endoscopic Ultrasound Fine-Needle Aspiration (EUS-FNA): A Longitudinal Analysis

Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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836 Machine Learning Approach for Predicting Students’ Academic Performance and Study Strategies Based on Their Motivation

Authors: Fidelia A. Orji, Julita Vassileva

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This research aims to develop machine learning models for students' academic performance and study strategy prediction, which could be generalized to all courses in higher education. Key learning attributes (intrinsic, extrinsic, autonomy, relatedness, competence, and self-esteem) used in building the models are chosen based on prior studies, which revealed that the attributes are essential in students’ learning process. Previous studies revealed the individual effects of each of these attributes on students’ learning progress. However, few studies have investigated the combined effect of the attributes in predicting student study strategy and academic performance to reduce the dropout rate. To bridge this gap, we used Scikit-learn in python to build five machine learning models (Decision Tree, K-Nearest Neighbour, Random Forest, Linear/Logistic Regression, and Support Vector Machine) for both regression and classification tasks to perform our analysis. The models were trained, evaluated, and tested for accuracy using 924 university dentistry students' data collected by Chilean authors through quantitative research design. A comparative analysis of the models revealed that the tree-based models such as the random forest (with prediction accuracy of 94.9%) and decision tree show the best results compared to the linear, support vector, and k-nearest neighbours. The models built in this research can be used in predicting student performance and study strategy so that appropriate interventions could be implemented to improve student learning progress. Thus, incorporating strategies that could improve diverse student learning attributes in the design of online educational systems may increase the likelihood of students continuing with their learning tasks as required. Moreover, the results show that the attributes could be modelled together and used to adapt/personalize the learning process.

Keywords: classification models, learning strategy, predictive modeling, regression models, student academic performance, student motivation, supervised machine learning

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835 Mesoporous Titania Thin Films for Gentamicin Delivery and Bone Morphogenetic Protein-2 Immobilization

Authors: Ane Escobar, Paula Angelomé, Mihaela Delcea, Marek Grzelczak, Sergio Enrique Moya

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The antibacterial capacity of bone-anchoring implants can be improved by the use of antibiotics that can be delivered to the media after the surgery. Mesoporous films have shown great potential in drug delivery for orthopedic applications, since pore size and thickness can be tuned to produce different surface area and free volume inside the material. This work shows the synthesis of mesoporous titania films (MTF) by sol-gel chemistry and evaporation-induced self-assembly (EISA) on top of glass substrates. Pores with a diameter of 12nm were observed by Transmission Electron Microscopy (TEM). A film thickness of 100 nm was measured by Scanning Electron Microscopy (SEM). Gentamicin was used to study the antibiotic delivery from the film by means of High-performance liquid chromatography (HPLC). The Staphilococcus aureus strand was used to evaluate the effectiveness of the penicillin loaded films toward inhibiting bacterial colonization. MC3T3-E1 pre-osteoblast cell proliferation experiments proved that MTFs have a good biocompatibility and are a suitable surface for MC3T3-E1 cell proliferation. Moreover, images taken by Confocal Fluorescence Microscopy using labeled vinculin, showed good adhesion of the MC3T3-E1 cells to the MTFs, as well as complex actin filaments arrangement. In order to improve cell proliferation Bone Morphogenetic Protein-2 (BMP-2) was adsorbed on top of the mesoporous film. The deposition of the protein was proved by measurements in the contact angle, showing an increment in the hydrophobicity while the protein concentration is higher. By measuring the dehydrogenase activity in MC3T3-E1 cells cultured in dually functionalized mesoporous titatina films with gentamicin and BMP-2 is possible to find an improvement in cell proliferation. For this purpose, the absorption of a yellow-color formazan dye, product of a water-soluble salt (WST-8) reduction by the dehydrogenases, is measured. In summary, this study proves that by means of the surface modification of MTFs with proteins and loading of gentamicin is possible to achieve an antibacterial effect and a cell growth improvement.

Keywords: antibacterial, biocompatibility, bone morphogenetic protein-2, cell proliferation, gentamicin, implants, mesoporous titania films, osteoblasts

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834 Surface Water Flow of Urban Areas and Sustainable Urban Planning

Authors: Sheetal Sharma

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Urban planning is associated with land transformation from natural areas to modified and developed ones which leads to modification of natural environment. The basic knowledge of relationship between both should be ascertained before proceeding for the development of natural areas. Changes on land surface due to build up pavements, roads and similar land cover, affect surface water flow. There is a gap between urban planning and basic knowledge of hydrological processes which should be known to the planners. The paper aims to identify these variations in surface flow due to urbanization for a temporal scale of 40 years using Storm Water Management Mode (SWMM) and again correlating these findings with the urban planning guidelines in study area along with geological background to find out the suitable combinations of land cover, soil and guidelines. For the purpose of identifying the changes in surface flows, 19 catchments were identified with different geology and growth in 40 years facing different ground water levels fluctuations. The increasing built up, varying surface runoff are studied using Arc GIS and SWMM modeling, regression analysis for runoff. Resulting runoff for various land covers and soil groups with varying built up conditions were observed. The modeling procedures also included observations for varying precipitation and constant built up in all catchments. All these observations were combined for individual catchment and single regression curve was obtained for runoff. Thus, it was observed that alluvial with suitable land cover was better for infiltration and least generation of runoff but excess built up could not be sustained on alluvial soil. Similarly, basalt had least recharge and most runoff demanding maximum vegetation over it. Sandstone resulted in good recharging if planned with more open spaces and natural soils with intermittent vegetation. Hence, these observations made a keystone base for planners while planning various land uses on different soils. This paper contributes and provides a solution to basic knowledge gap, which urban planners face during development of natural surfaces.

Keywords: runoff, built up, roughness, recharge, temporal changes

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833 Mesenteric Ischemia Presenting as Acalculous Cholecystitis: A Case Review of a Rare Complication and Aberrant Anatomy

Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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832 The Effect of Branched-Chain Amino Acids, Arginine, and Citrulline on Repeated Swimming Performance

Authors: Chun-Fang Hsueh, Chen-Kang Chang

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Introduction: Branched-chain amino acids (BCAA) could reduce cerebral uptake of tryptophan, leading to decreased synthesis of serotonin in the brain. Arginine and citrulline could reduce exercise-induced hyperammonemia by increasing nitric oxide synthesis and the urea cycle. The combination of these supplements could reduce exercise-induced central fatigue. The purpose of this study was to examine the effect of BCAA, arginine, and citrulline supplementation on repeated swimming performance in teenage athletes. Methods: Eight male and eight female high school swimmers ingested 0.085 g/kg BCAA, 0.05 g/kg arginine and 0.05 g/kg citrulline (AA trial) or placebo (PL trial) in a randomized cross-over design. One hour after the ingestion, the subjects performed a 50 m sprint with their best style every 2 min for 8 times in an indoor 25 m pool. The subjects were asked to swim with their maximal effort each time. The time, stroke frequency and stroke length in each sprint were recorded. Venous blood samples were collected before and after the exercise. The time for each sprint was analyzed by 2-way analysis of variance with repeated measurement. Results: When all subjects were pooled together, total time for the AA trial was significantly faster than the PL trial (AA: 244.02 ± 22.94 s; PL: 247.55 ± 24.17 s, p < .001). Individual sprint time showed significant trial (p= .001) and trial x time (p= .004) effects. The post-hoc analysis revealed that the AA trial was significantly faster than the PL trial in the 2nd, 5th, and 6th sprint. In female subjects, there is a significant trial effect (p= .004) with the AA trial being faster in the 1st, 2nd, and 5th sprint. On the other hand, the trial effect was not significant (p= .072) in male subjects. Conclusions: The combined supplementation could improve 8 x 50 m performance in high school swimmers. The blood parameters including BCAA, tryptophan, NH₃, nitric oxide, and urea, as well as the stroke frequency and length in each sprint, are being analyzed. The results will be presented in the conference.

Keywords: central fatigue, hyperammonemia, tryptophan, urea

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831 DSC2 Promotes the Proliferation, Metastasis and Drug Resistance of Lung Cancer by Activating the PI3K/AKT Pathway

Authors: Qi LI, Xu Lin, Nengming Lin

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Objective: The aim of this study was to investigate the role of desmocollin 2 (DSC2) protein in the proliferation, migration and drug resistance of lung cancer cells. Method: CCK-8 assays and colony formation assays were used to evaluate the effect of dsc2 regulation on cancer cell viability and colony formation. Transwell assays and wound healing assays were also performed. Cell flow double staining was used to detect the apoptosis rate of cells with DSC2, which was added cisplatin. Western blot assay was used to detect cell cycle, PI3k/Akt and apoptosis-related proteins. Results: Our data showed that dsc2 is upregulated in clinical lung cancer tissues compared with pericarcinomatous tissues, and it is differentially expressed in lung cancer cell lines. The down-regulation of dsc2 in A549 and H358 lung cancer cells significantly suppressed the cell proliferation, metastasis, and motility. In contrast, the opposite effects were observed in overexpression of dsc2 both in H23 and PC9 cell lines. In addition to lung adenocarcinoma cell lines, we also examined its expression in lung squamous cell lines, such as H226. Western blotting showed that dsc2 could reduce the level of phosphorylated Akt (Ser 473) and p-mTOR. Thus, it is speculated that dsc2 up-regulation promotes proliferation and invasiveness through activation of the PI3K/AKT pathway. Also, knockdown of dsc2 in A549 and H226 could significantly decreased in the levels of cyclinB and wee1 protein. Additionally, flow cytometry showed that dsc2 knockdown combined with cisplatin could significantly enhance cell apoptosis rate. Conclusion: These data suggest that dsc2 promotes the proliferation and migration of lung cancer cells in vitro. Also, the results suggested that dsc2 could affect the cell cycle and apoptosis of lung cells. Furthermore, knockdown of dsc2 could sensitize cisplatin in both lung adenocarcinoma and lung squamous cell lines. Thus we suggested that dsc2 can be used as a therapeutic target for lung cancer.

Keywords: desmocollin 2, cisplatin, lung cancer, PI3K/AKT, lung squamous cell

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830 Principal Component Analysis Combined Machine Learning Techniques on Pharmaceutical Samples by Laser Induced Breakdown Spectroscopy

Authors: Kemal Efe Eseller, Göktuğ Yazici

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Laser-induced breakdown spectroscopy (LIBS) is a rapid optical atomic emission spectroscopy which is used for material identification and analysis with the advantages of in-situ analysis, elimination of intensive sample preparation, and micro-destructive properties for the material to be tested. LIBS delivers short pulses of laser beams onto the material in order to create plasma by excitation of the material to a certain threshold. The plasma characteristics, which consist of wavelength value and intensity amplitude, depends on the material and the experiment’s environment. In the present work, medicine samples’ spectrum profiles were obtained via LIBS. Medicine samples’ datasets include two different concentrations for both paracetamol based medicines, namely Aferin and Parafon. The spectrum data of the samples were preprocessed via filling outliers based on quartiles, smoothing spectra to eliminate noise and normalizing both wavelength and intensity axis. Statistical information was obtained and principal component analysis (PCA) was incorporated to both the preprocessed and raw datasets. The machine learning models were set based on two different train-test splits, which were 70% training – 30% test and 80% training – 20% test. Cross-validation was preferred to protect the models against overfitting; thus the sample amount is small. The machine learning results of preprocessed and raw datasets were subjected to comparison for both splits. This is the first time that all supervised machine learning classification algorithms; consisting of Decision Trees, Discriminant, naïve Bayes, Support Vector Machines (SVM), k-NN(k-Nearest Neighbor) Ensemble Learning and Neural Network algorithms; were incorporated to LIBS data of paracetamol based pharmaceutical samples, and their different concentrations on preprocessed and raw dataset in order to observe the effect of preprocessing.

Keywords: machine learning, laser-induced breakdown spectroscopy, medicines, principal component analysis, preprocessing

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829 Meniere's Disease and its Prevalence, Symptoms, Risk Factors and Associated Treatment Solutions for this Disease

Authors: Amirreza Razzaghipour Sorkhab

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One of the most common disorders among humans is hearing impairment. This paper provides an evidence base that recovers understanding of Meniere’s disease and highlights the physical and mental health correlates of the disorder. Meniere's disease is more common in the elderly. The term idiopathic endolymphatic hydrops has been attributed to this disease by some in the previous. Meniere’s disease demonstrations a genetic tendency, and a family history is found in 10% of cases, with an autosomal dominant inheritance pattern. The COCH gene may be one of the hereditary factors contributing to Meniere’s disease, and the possibility of a COCH mutation should be considered in patients with Meniere’s disease symptoms. Should be considered Missense mutations in the COCH gene cause the autosomal dominant sensorineural hearing loss and vestibular disorder. Meniere’s disease is a complex, heterogeneous disorder of the inner ear and that is characterized by episodes of vertigo lasting from minutes to hours, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. The existing evidence supports the suggestion that age and sleep disorder are risk factors for Meniere's disease. Many factors have been reported to precipitate the progress of Menier, including endolymphatic hydrops, immunology, viral infection, inheritance, vestibular migraine, and altered intra-labyrinthine fluid dynamics. Although there is currently no treatment that has a proven helpful effect on hearing levels or on the long-term evolution of the disease, however, in the primary stages, the hearing may improve among attacks, but a permanent hearing loss occurs in the majority of cases. Current publications have proposed a role for the intratympanic use of medicine, mostly aminoglycosides, for the control of vertigo. more than 85% of patients with Meniere's disease are helped by either changes in lifestyle and medical treatment or minimally aggressive surgical procedures such as intratympanic steroid therapy, intratympanic gentamicin therapy, and endolymphatic sac surgery. However, unilateral vestibular extirpation methods (intratympanic gentamicin, vestibular nerve section, or labyrinthectomy) are more predictable but invasive approaches to control the vertigo attacks. Medical therapy aimed at reducing endolymph volume, such as low-sodium diet, diuretic use, is the typical initial treatment.

Keywords: meniere's disease, endolymphatic hydrops, hearing loss, vertigo, tinnitus, COCH gene

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828 Corridor Densification Option as a Means for Restructuring South African Cities

Authors: T. J. B. van Niekerk, J. Viviers, E. J. Cilliers

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Substantial efforts were made in South Africa, stemming from a historic political change in 1994, to remedy the inequality and injustice, resulting from a dispensation where spatial patterns were largely based on racial segregation. Spatially distorted patterns predominantly originated from colonialism in the beginning of the twentieth century, ensuing a physical imprint on South African cities relating to architecture, urban layout and planning, frequently reflecting European norms and standards. As a consequence of physical and land use barriers, and well-established dual cities, attempts to address spatial injustices, apart from limited occurrences in metropolitan areas, gravely failed. Interception of incessant segregated growth, combined with urban sprawl is becoming increasingly evident. Intervention is a prerequisite to duly address the impact of colonial planning and its legacy still prevalent in most urban areas. During 1998, the National Department of Transport prepared the “Moving South Africa” strategy; presenting the Corridor Densification Option Model for the first time, as it was deemed more fitting to the existing South African urban tenure patterns than more familiar planning approaches. Urban planners are progressively contemplating the Corridor Densification Option Model and its attributes, besides its transportation emphasis, as an alternative approach to address spatial imbalances and to attain the physical integration of contemporary urban forms. In attaining a clearer understanding of the Corridor Densification Option Model, its rationale was analysed in greater detail. This research further investigated the provisional applications of the model in spatially segregated cities and illustrated that viable options are present to effectively employ it. Research revealed that the application of the model will, however, be dependent on the occurrence of specific characteristics in spatially segregated cities to warrant augmentation thereof.

Keywords: corridor densification option model, spatially segregated settlements, integration, urban restructuring

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827 Field Study of Chlorinated Aliphatic Hydrocarbons Degradation in Contaminated Groundwater via Micron Zero-Valent Iron Coupled with Biostimulation

Authors: Naijin Wu, Peizhong Li, Haijian Wang, Wenxia Wei, Yun Song

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Chlorinated aliphatic hydrocarbons (CAHs) pollution poses a severe threat to human health and is persistent in groundwater. Although chemical reduction or bioremediation is effective, it is still hard to achieve their complete and rapid dechlorination. Recently, the combination of zero-valent iron and biostimulation has been considered to be one of the most promising strategies, but field studies of this technology are scarce. In a typical site contaminated by various types of CAHs, basic physicochemical parameters of groundwater, CAHs and their product concentrations, and microbial abundance and diversity were monitored after a remediation slurry containing both micron zero-valent iron (mZVI) and biostimulation components were directly injected into the aquifer. Results showed that groundwater could form and keep low oxidation-reduction potential (ORP), a neutral pH, and anoxic conditions after different degrees of fluctuations, which was benefit for the reductive dechlorination of CAHs. The injection also caused an obvious increase in the total organic carbon (TOC) concentration and sulfate reduction. After 253 days post-injection, the mean concentration of total chlorinated ethylene (CEE) from two monitoring wells decreased from 304 μg/L to 8 μg/L, and total chlorinated ethane (CEA) decreased from 548 μg/L to 108 μg/L. Occurrence of chloroethane (CA) suggested that hydrogenolysis dechlorination was one of the main degradation pathways for CEA, and also hints that biological dechlorination was activated. A significant increase of ethylene at day 67 post-injection indicated that dechlorination was complete. Additionally, the total bacterial counts increased by 2-3 orders of magnitude after 253 days post-injection. And the microbial species richness decreased and gradually changed to anaerobic/fermentative bacteria. The relative abundance of potential degradation bacteria increased corresponding to the degradation of CAHs. This work demonstrates that mZVI and biostimulation can be combined to achieve the efficient removal of various CAHs from contaminated groundwater sources.

Keywords: chlorinated aliphatic hydrocarbons, groundwater, field study, zero-valent iron, biostimulation

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826 Rare Internal Organ Trauma in Adolescent Athletes: Insights from a Pancreatic Injury Case Study

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

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

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

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825 Wicking Bed Cultivation System as a Strategic Proposal for the Cultivation of Milpa and Mexican Medicinal Plants in Urban Spaces

Authors: David Lynch Steinicke, Citlali Aguilera Lira, Andrea León García

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The proposal posed in this work comes from a researching-action approach. In Mexico, a dialogue of knowledge may function as a link between traditional, local, pragmatic knowledge, and technological, scientific knowledge. The advantage of generating this nexus lies on the positive impact in the environment, in society and economy. This work attempts to combine, on the one hand the traditional Mexican knowledge such as the usage of medicinal herb and the agroecosystem milpa; and on the other hand make use of a newly created agricultural ecotechnology which main function is to take advantage of the urban space and to save water. This ecotechnology is the wicking bed. In a globalized world, is relevant to have a proposal where the most important aspect is to revalorize the culture through the acquisition of traditional knowledge but at the same time adapting them to the new social and urbanized structures without threatening the environment. The methodology used in this work comes from a researching-action approach combined with a practical dimension where an experimental model made of three wickingbeds was implemented. In this model, there were cultivated medicinal herb and milpa components. The water efficiency and the social acceptance were compared with a traditional ground crop, all this practice was made in an urban social context. The implementation of agricultural ecotechnology has had great social acceptance as its irrigation involves minimal effort and it is economically feasible for low-income people. The wicking bed system raised in this project is attainable to be implemented in schools, urban and peri-urban environments, homemade gardens and public areas. The proposal managed to carry out an innovative and sustainable knowledge-based traditional Mexican agricultural technology, allowing regain Milpa agroecosystem in urban environments to strengthen food security in favour of nutritional and protein benefits for the Mexican fare.

Keywords: milpa, traditional medicine, urban agriculture, wicking bed

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824 Capacities of Early Childhood Education Professionals for the Prevention of Social Exclusion of Children

Authors: Dejana Bouillet, Vlatka Domović

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Both policymakers and researchers recognize that participating in early childhood education and care (ECEC) is useful for all children, especially for those who are exposed to the high risk of social exclusion. Social exclusion of children is understood as a multidimensional construct including economic, social, cultural, health, and other aspects of disadvantage and deprivation, which individually or combined can have an unfavorable effect on the current life and development of a child, as well as on the child’s development and on disadvantaged life chances in adult life. ECEC institutions should be able to promote educational approaches that portray developmental, cultural, language, and other diversity amongst children. However, little is known about the ways in which Croatian ECEC institutions recognize and respect the diversity of children and their families and how they respond to their educational needs. That is why this paper is dedicated to the analysis of the capacities of ECEC professionals to respond to the demands of educational needs of this very diverse group of children and their families. The results obtained in the frame of the project “Models of response to educational needs of children at risk of social exclusion in ECEC institutions,” funded by the Croatian Science Foundation, will be presented. The research methodology arises from explanations of educational processes and risks of social exclusion as a complex and heterogeneous phenomenon. The preliminary results of the qualitative data analysis of educational practices regarding capacities to identify and appropriately respond to the requirements of children at risk of social exclusion will be presented. The data have been collected by interviewing educational staff in 10 Croatian ECEC institutions (n = 10). The questions in the interviews were related to various aspects of inclusive institutional policy, culture, and practices. According to the analysis, it is possible to conclude that Croatian ECEC professionals are still faced with great challenges in the process of implementation of inclusive policies, culture, and practices. There are several baselines of this conclusion. The interviewed educational professionals are not familiar enough with the whole complexity and diversity of needs of children at risk of social exclusion, and the ECEC institutions do not have enough resources to provide all interventions that these children and their families need.

Keywords: children at risk of social exclusion, ECEC professionals, inclusive policies, culture and practices, quallitative analysis

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823 Effect of Climate Variability on Children Health Outcomes in Rural Uganda

Authors: Emily Injete Amondo, Alisher Mirzabaev, Emmanuel Rukundo

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Children in rural farming households are often vulnerable to a multitude of risks, including health risks associated with climate change and variability. Cognizant of this, this study empirically traced the relationship between climate variability and nutritional health outcomes in rural children while identifying the cause-and-effect transmission mechanisms. We combined four waves of the rich Uganda National Panel Survey (UNPS), part of the World Bank Living Standards Measurement Studies (LSMS) for the period 2009-2014, with long-term and high-frequency rainfall and temperature datasets. Self-reported drought and flood shock variables were further used in separate regressions for triangulation purposes and robustness checks. Panel fixed effects regressions were applied in the empirical analysis, accounting for a variety of causal identification issues. The results showed significant negative outcomes for children’s anthropometric measurements due to the impacts of moderate and extreme droughts, extreme wet spells, and heatwaves. On the contrary, moderate wet spells were positively linked with nutritional measures. Agricultural production and child diarrhea were the main transmission channels, with heatwaves, droughts, and high rainfall variability negatively affecting crop output. The probability of diarrhea was positively related to increases in temperature and dry spells. Results further revealed that children in households who engaged in ex-ante or anticipatory risk-reducing strategies such as savings had better health outcomes as opposed to those engaged in ex-post coping such as involuntary change of diet. These results highlight the importance of adaptation in smoothing the harmful effects of climate variability on the health of rural households and children in Uganda.

Keywords: extreme weather events, undernutrition, diarrhea, agricultural production, gridded weather data

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822 3D Microscopy, Image Processing, and Analysis of Lymphangiogenesis in Biological Models

Authors: Thomas Louis, Irina Primac, Florent Morfoisse, Tania Durre, Silvia Blacher, Agnes Noel

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In vitro and in vivo lymphangiogenesis assays are essential for the identification of potential lymphangiogenic agents and the screening of pharmacological inhibitors. In the present study, we analyse three biological models: in vitro lymphatic endothelial cell spheroids, in vivo ear sponge assay, and in vivo lymph node colonisation by tumour cells. These assays provide suitable 3D models to test pro- and anti-lymphangiogenic factors or drugs. 3D images were acquired by confocal laser scanning and light sheet fluorescence microscopy. Virtual scan microscopy followed by 3D reconstruction by image aligning methods was also used to obtain 3D images of whole large sponge and ganglion samples. 3D reconstruction, image segmentation, skeletonisation, and other image processing algorithms are described. Fixed and time-lapse imaging techniques are used to analyse lymphatic endothelial cell spheroids behaviour. The study of cell spatial distribution in spheroid models enables to detect interactions between cells and to identify invasion hierarchy and guidance patterns. Global measurements such as volume, length, and density of lymphatic vessels are measured in both in vivo models. Branching density and tortuosity evaluation are also proposed to determine structure complexity. Those properties combined with vessel spatial distribution are evaluated in order to determine lymphangiogenesis extent. Lymphatic endothelial cell invasion and lymphangiogenesis were evaluated under various experimental conditions. The comparison of these conditions enables to identify lymphangiogenic agents and to better comprehend their roles in the lymphangiogenesis process. The proposed methodology is validated by its application on the three presented models.

Keywords: 3D image segmentation, 3D image skeletonisation, cell invasion, confocal microscopy, ear sponges, light sheet microscopy, lymph nodes, lymphangiogenesis, spheroids

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821 Evaluation of Neuroprotective Potential of Olea europaea and Malus domestica in Experimentally Induced Stroke Rat Model

Authors: Humaira M. Khan, Kanwal Asif

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Ischemic stroke is a neurological disorder with a complex pathophysiology associated with motor, sensory and cognitive deficits. Major approaches developed to treat acute ischemic stroke fall into two categories, thrombolysis and neuroprotection. The objectives of this study were to evaluate the neuroprotective and anti-thrombolytic effects of Olea europaea (olive oil) and Malus domestica (apple cider vinegar) and their combination in rat stroke model. Furthermore, histopathological analysis was also performed to assess the severity of ischemia among treated and reference groups. Male albino rats (12 months age) weighing 300- 350gm were acclimatized and subjected to middle cerebral artery occlusion method for stroke induction. Olea europaea and Malus domestica was administered orally in dose of 0.75ml/kg and 3ml/kg and combination was administered at dose of 0.375ml/kg and 1.5ml/kg prophylactically for consecutive 21 days. Negative control group was dosed with normal saline whereas piracetam (250mg/kg) was administered as reference. Neuroprotective activity of standard piracetam, Olea europaea, Malus domestica and their combination was evaluated by performing functional outcome tests i.e. Cylinder, pasta, ladder run, pole and water maize tests. Rats were subjected to surgery after 21 days of treatment for analysis from stroke recovery. Olea europaea and Malus domestica in individual doses of 0.75ml/kg and 3ml/kg respectively showed neuroprotection by significant improvement in ladder run test (121.6± 0.92;128.2 ± 0.73) as compare to reference (125.4 ± 0.74). Both test doses showed significant neuroprotection as compare to reference (9.60 ± 0.50) in pasta test (8.40 ± 0.24;9.80 ± 0.37) whereas with cylinder test, experimental groups showed significant increase in movements (6.60 ± 0.24; 8.40 ± 0.24) in contrast to reference (7.80 ± 0.37).There was a decrease in percentage time taken f to reach the hidden maize in water maize test (56.80 ± 0.58;61.80 ± 0.66) at doses 0.75ml/kg and 3ml/kg respectively as compare to piracetam (59.40 ± 1.07). Olea europaea and Malus domestica individually showed significant reduction in duration of mobility (127.0 ± 0.44; 123.0 ± 0.44) in pole test as compare to piracetam (124.0 ± 0.70). Histopathological analysis revealed the significant extent of protection from ischemia after prophylactic treatments. Hence it is concluded that Olea europaea and Malus domestica are effective neuroprotective agents alone as compare to their combination.

Keywords: ischemia, Malus domestica, neuroprotection, Olea europaea

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820 Implication of Built-Up Area, Vegetation, and Motorized Vehicles to Urban Microclimate in Bandung City Center

Authors: Ira Irawati, Muhammad Rangga Sururi

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The expansion of built-up areas in many cities, particularly, as the consequences of urbanization process, is a common phenomenon in our contemporary world. As happened in many cities in developing world, this horizontal expansion let only a handful size of the area left for green open spaces, creating an extreme unbalance between built-up and green spaces. Combined with the high density and variety of human activities with its transportation modes; a process of urban heat island will occur, resulting in an increase in air temperature. This is one of the indicators of decreasing of the quality of urban microclimate. This paper will explore the effect of several variables of built-up areas and open spaces to the increase of air temperature using multiple linear regression analysis. We selected 11 zones within the radius of 1 km in Inner Bandung city center, and each zones measured within 300 m radius to represent the variety of land use, as well as the composition of buildings and green open spaces. By using a quantitative method which is multiple linear regression analysis, six dependent variables which are a) tree density-x1, b) shade level of tree-x2, c) surface area of buildings’ side which are facing west and east-x3, d) surface area of building side material-x4, e) surface area of pathway material, and f) numbers of motorized vehicles-x6; are calculated to find those influence to the air temperature as an independent variable-y. Finally, the relationship between those variables shows in this equation: y = 30.316 - 3.689 X1 – 6.563 X2 + 0.002 X3 – 2,517E6 X4 + 1.919E-9 X5 + 1.952E-4 X6. It shows that the existence of vegetation has a great impact on lowering temperature. In another way around, built up the area and motorized vehicles would increase the temperature. However, one component of built up area, the surface area of buildings’ sides which are facing west and east, has different result due to the building material is classified in low-middle heat capacity.

Keywords: built-up area, microclimate, vehicles, urban heat island, vegetation

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819 Managing of Cobalt and Chromium Ions by Patients with Metal-on-Metal Hip Prosthesis

Authors: Alina Beraudi, Simona Catalani, Dalila De Pasquale, Eva Bianconi, Umberto Santoro, Susanna Stea, Pietro Apostoli

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Recently the European Community, in line with the international scientific community such as with the Consensus Statement, has determined to stop the use of metal-on-metal big head stemmed hip prosthesis. Among the factors accounted as responsible for the high failure rates of these hip implants are the release and accumulation of metal ions. Many studies have correlated the presence of these ions, besides other factors, with the induction of oxidative stress response. In our study on 12 subjects, we observed the patient specific capability to eliminate metal ions after revision surgery. While for cobalt all the patients were able to completely excrete cobalt ions within 5-7 months after metal-on-metal bearing removal, for chromium ions it didn’t happen. If on the one hand the toxicokinetic differences between the two types of ions are confirmed by toxicological and occupational studies, on the other hand, this peculiar way of exposition represents a novel and important point of view. Thus, two different approaches were performed to better understand the subject specific capability to transport metal ions (albumin study) and to manage the response to them (heme-oxygenase-1 study): - a mutational screening of ALBUMIN gene was conducted in 30 MoM prosthetic patients resulting in the absence of nucleotidic changes compared with the ALB reference sequence. To this study was also added the analysis of expression of modified albumin protein; - a gene and protein expression study on 44 patients of heme-oxygenase-1, that is one of the most important antioxidant enzyme induced by metallic ions, was performed. This study resulted in no statistically significant differences in the expression of the gene and protein heme-oxygenase-1 between prosthetic and non-prosthetic patients, as well as between patients with high and low ions levels. Our results show that the protein studied (albumin and heme-oxygenase-1) seem to be not involved in determining chromium and cobalt ions level. On the other hand, achromium and cobalt elimination rates are different, but similar in all patients analyzed, suggesting that this process could be not patient-related. We support the importance of researching more about ions transport within the organism once released by hip prosthesis, about the chemical species involved, the districts where they are contained and the mechanisms of elimination, not excluding the existence of a subjective susceptibility to these metals ions.

Keywords: chromium, cobalt, hip prosthesis, individual susceptibility

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818 Present Status, Driving Forces and Pattern Optimization of Territory in Hubei Province, China

Authors: Tingke Wu, Man Yuan

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“National Territorial Planning (2016-2030)” was issued by the State Council of China in 2017. As an important initiative of putting it into effect, territorial planning at provincial level makes overall arrangement of territorial development, resources and environment protection, comprehensive renovation and security system construction. Hubei province, as the pivot of the “Rise of Central China” national strategy, is now confronted with great opportunities and challenges in territorial development, protection, and renovation. Territorial spatial pattern experiences long time evolution, influenced by multiple internal and external driving forces. It is not clear what are the main causes of its formation and what are effective ways of optimizing it. By analyzing land use data in 2016, this paper reveals present status of territory in Hubei. Combined with economic and social data and construction information, driving forces of territorial spatial pattern are then analyzed. Research demonstrates that the three types of territorial space aggregate distinctively. The four aspects of driving forces include natural background which sets the stage for main functions, population and economic factors which generate agglomeration effect, transportation infrastructure construction which leads to axial expansion and significant provincial strategies which encourage the established path. On this basis, targeted strategies for optimizing territory spatial pattern are then put forward. Hierarchical protection pattern should be established based on development intensity control as respect for nature. By optimizing the layout of population and industry and improving the transportation network, polycentric network-based development pattern could be established. These findings provide basis for Hubei Territorial Planning, and reference for future territorial planning in other provinces.

Keywords: driving forces, Hubei, optimizing strategies, spatial pattern, territory

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817 Parametric Investigation of Aircraft Door’s Emergency Power Assist System (EPAS)

Authors: Marshal D. Kafle, Jun H. Kim, Hyun W. Been, Kyoung M. Min

Abstract:

Fluid viscous damping systems are well suited for many air vehicles subjected to shock and vibration. These damping system work with the principle of viscous fluid throttling through the orifice to create huge pressure difference between compression and rebound chamber and obtain the required damping force. One application of such systems is its use in aircraft door system to counteract the door’s velocity and safely stop it. In exigency situations like crash or emergency landing where the door doesn’t open easily, possibly due to unusually tilting of fuselage or some obstacles or intrusion of debris obstruction to move the parts of the door, such system can be combined with other systems to provide needed force to forcefully open the door and also securely stop it simultaneously within the required time i.e.less than 8seconds. In the present study, a hydraulic system called snubber along with other systems like actuator, gas bottle assembly which together known as emergency power assist system (EPAS) is designed, built and experimentally studied to check the magnitude of angular velocity, damping force and time required to effectively open the door. Whenever needed, the gas pressure from the bottle is released to actuate the actuator and at the same time pull the snubber’s piston to operate the emergency opening of the door. Such EPAS installed in the suspension arm of the aircraft door is studied explicitly changing parameters like orifice size, oil level, oil viscosity and bypass valve gap and its spring of the snubber at varying temperature to generate the optimum design case. Comparative analysis of the EPAS at several cases is done and conclusions are made. It is found that during emergency condition, the systemopening time and angular velocity, when snubber with 0.3mm piston and shaft orifice and bypass valve gap of 0.5 mm with its original spring is used,shows significant improvement over the old ones.

Keywords: aircraft door damper, bypass valve, emergency power assist system, hydraulic damper, oil viscosity

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816 Elements of Critical Event Management: A Qualitative Study of Trauma Teams

Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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815 Development of Pothole Management Method Using Automated Equipment with Multi-Beam Sensor

Authors: Sungho Kim, Jaechoul Shin, Yujin Baek, Nakseok Kim, Kyungnam Kim, Shinhaeng Jo

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The climate change and increase in heavy traffic have been accelerating damages that cause the problems such as pothole on asphalt pavement. Pothole causes traffic accidents, vehicle damages, road casualties and traffic congestion. A quick and efficient maintenance method is needed because pothole is caused by stripping and accelerates pavement distress. In this study, we propose a rapid and systematic pothole management by developing a pothole automated repairing equipment including a volume measurement system of pothole. Three kinds of cold mix asphalt mixture were investigated to select repair materials. The materials were evaluated for satisfaction with quality standard and applicability to automated equipment. The volume measurement system of potholes was composed of multi-sensor that are combined with laser sensor and ultrasonic sensor and installed in front and side of the automated repair equipment. An algorithm was proposed to calculate the amount of repair material according to the measured pothole volume, and the system for releasing the correct amount of material was developed. Field test results showed that the loss of repair material amount could be reduced from approximately 20% to 6% per one point of pothole. Pothole rapid automated repair equipment will contribute to improvement on quality and efficient and economical maintenance by not only reducing materials and resources but also calculating appropriate materials. Through field application, it is possible to improve the accuracy of pothole volume measurement, to correct the calculation of material amount, and to manage the pothole data of roads, thereby enabling more efficient pavement maintenance management. Acknowledgment: The author would like to thank the MOLIT(Ministry of Land, Infrastructure, and Transport). This work was carried out through the project funded by the MOLIT. The project name is 'development of 20mm grade for road surface detecting roadway condition and rapid detection automation system for removal of pothole'.

Keywords: automated equipment, management, multi-beam sensor, pothole

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814 Effect of Operative Stabilization on Rib Fracture Healing in Porcine Experimental Model: A Pilot Study

Authors: Maria Stepankova, Lucie Vistejnova, Pavel Klein, Tereza Blassova, Marketa Slajerova, Radek Sedlacek, Martin Bartos, Jaroslav Chlupac

Abstract:

Background: Clinical outcome benefits of the segment rib fracture surgical therapy are well known and follow from better stabilization of the chest wall. Despite this, some authors still incline to conservative therapy and point out to possible rib fracture healing failure in connection with the bone vascular supply disturbance caused by metal plate implantation. This suggestion met neither experimental nor clinical verification and remains the object of discussion. In our pilot study we investigated the titanium plate fixation effect on the rib fracture healing in porcine model and its histological, biomechanical and radiological aspects. Materials and Method: Two porcine models (experimental group) underwent the operative chest wall stabilization with a titanium plate implantation after osteotomy. Two other porcine models (control group) were treated conservatively after osteotomy. Three weeks after surgery, all animals were sacrificed, treated ribs were explanted and the histological analysis, µCT imaging and biomechanical testing of the calluses tissue were performed. Results: In µCT imaging, experimental group showed a higher cortical bone volume compared to the control group. Histological analysis using the non-decalcified bone tissue blocks demonstrated more maturated callus with higher newly-formed osseous tissue ratio in experimental group in comparison to controls. In contrast, no significant differences in bone blood vessels supply in both groups were observed. This finding suggests that the bone blood supply in experimental group was not impaired. Biomechanical analysis using 3-point bending test demonstrated significantly higher bending stiffness and the maximum force in experimental group. Conclusion: Based on our observation, it could be concluded, that the titanium plate fixation of the rib fractures leads to faster bone callus maturation whereas does not cause the vascular supply impairment after 3 weeks and thus has a beneficial effect on the rib fracture healing.

Keywords: bone vascular supply, chest wall stabilization, fracture healing, histological analysis, titanium plate implantation

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813 Multi-Elemental Analysis Using Inductively Coupled Plasma Mass Spectrometry for the Geographical Origin Discrimination of Greek Giant Beans “Gigantes Elefantes”

Authors: Eleni C. Mazarakioti, Anastasios Zotos, Anna-Akrivi Thomatou, Efthimios Kokkotos, Achilleas Kontogeorgos, Athanasios Ladavos, Angelos Patakas

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“Gigantes Elefantes” is a particularly dynamic crop of giant beans cultivated in western Macedonia (Greece). This variety of large beans growing in this area and specifically in the regions of Prespes and Kastoria is a protected designation of origin (PDO) species with high nutritional quality. Mislabeling of geographical origin and blending with unidentified samples are common fraudulent practices in Greek food market with financial and possible health consequences. In the last decades, multi-elemental composition analysis has been used in identifying the geographical origin of foods and agricultural products. In an attempt to discriminate the authenticity of Greek beans, multi-elemental analysis (Ag, Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, Ga, Ge, K, Li, Mg, Mn, Mo, Na, Nb, Ni, P, Pb, Rb, Re, Se, Sr, Ta, Ti, Tl, U, V, W, Zn, Zr) was performed by inductively coupled plasma mass spectrometry (ICP-MS) on 320 samples of beans, originated from Greece (Prespes and Kastoria), China and Poland. All samples were collected during the autumn of 2021. The obtained data were analysed by principal component analysis (PCA), an unsupervised statistical method, which allows for to reduce of the dimensionality of the enormous datasets. Statistical analysis revealed a clear separation of beans that had been cultivated in Greece compared with those from China and Poland. An adequate discrimination of geographical origin between bean samples originating from the two Greece regions, Prespes and Kastoria, was also evident. Our results suggest that multi-elemental analysis combined with the appropriate multivariate statistical method could be a useful tool for bean’s geographical authentication. Acknowledgment: This research has been financed by the Public Investment Programme/General Secretariat for Research and Innovation, under the call “YPOERGO 3, code 2018SE01300000: project title: ‘Elaboration and implementation of methodology for authenticity and geographical origin assessment of agricultural products.

Keywords: geographical origin, authenticity, multi-elemental analysis, beans, ICP-MS, PCA

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812 Reliability Levels of Reinforced Concrete Bridges Obtained by Mixing Approaches

Authors: Adrián D. García-Soto, Alejandro Hernández-Martínez, Jesús G. Valdés-Vázquez, Reyna A. Vizguerra-Alvarez

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Reinforced concrete bridges designed by code are intended to achieve target reliability levels adequate for the geographical environment where the code is applicable. Several methods can be used to estimate such reliability levels. Many of them require the establishment of an explicit limit state function (LSF). When such LSF is not available as a close-form expression, the simulation techniques are often employed. The simulation methods are computing intensive and time consuming. Note that if the reliability of real bridges designed by code is of interest, numerical schemes, the finite element method (FEM) or computational mechanics could be required. In these cases, it can be quite difficult (or impossible) to establish a close-form of the LSF, and the simulation techniques may be necessary to compute reliability levels. To overcome the need for a large number of simulations when no explicit LSF is available, the point estimate method (PEM) could be considered as an alternative. It has the advantage that only the probabilistic moments of the random variables are required. However, in the PEM, fitting of the resulting moments of the LSF to a probability density function (PDF) is needed. In the present study, a very simple alternative which allows the assessment of the reliability levels when no explicit LSF is available and without the need of extensive simulations is employed. The alternative includes the use of the PEM, and its applicability is shown by assessing reliability levels of reinforced concrete bridges in Mexico when a numerical scheme is required. Comparisons with results by using the Monte Carlo simulation (MCS) technique are included. To overcome the problem of approximating the probabilistic moments from the PEM to a PDF, a well-known distribution is employed. The approach mixes the PEM and other classic reliability method (first order reliability method, FORM). The results in the present study are in good agreement whit those computed with the MCS. Therefore, the alternative of mixing the reliability methods is a very valuable option to determine reliability levels when no close form of the LSF is available, or if numerical schemes, the FEM or computational mechanics are employed.

Keywords: structural reliability, reinforced concrete bridges, combined approach, point estimate method, monte carlo simulation

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