Search results for: period change
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11581

Search results for: period change

8641 Integrated Decision Support for Energy/Water Planning in Zayandeh Rud River Basin in Iran

Authors: Safieh Javadinejad

Abstract:

In order to make well-informed decisions respecting long-term system planning, resource managers and policy creators necessitate to comprehend the interconnections among energy and water utilization and manufacture—and also the energy-water nexus. Planning and assessment issues contain the enhancement of strategies for declining the water and energy system’s vulnerabilities to climate alteration with also emissions of decreasing greenhouse gas. In order to deliver beneficial decision support for climate adjustment policy and planning, understanding the regionally-specific features of the energy-water nexus, and the history-future of the water and energy source systems serving is essential. It will be helpful for decision makers understand the nature of current water-energy system conditions and capacity for adaptation plans for future. This research shows an integrated hydrology/energy modeling platform which is able to extend water-energy examines based on a detailed illustration of local circumstances. The modeling links the Water Evaluation and Planning (WEAP) and the Long Range Energy Alternatives Planning (LEAP) system to create full picture of water-energy processes. This will allow water managers and policy-decision makers to simply understand links between energy system improvements and hydrological processing and realize how future climate change will effect on water-energy systems. The Zayandeh Rud river basin in Iran is selected as a case study to show the results and application of the analysis. This region is known as an area with large integration of both the electric power and water sectors. The linkages between water, energy and climate change and possible adaptation strategies are described along with early insights from applications of the integration modeling system.

Keywords: climate impacts, hydrology, water systems, adaptation planning, electricity, integrated modeling

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8640 Shifting Contexts and Shifting Identities: Campus Race-related Experiences, Racial Identity, and Achievement Motivation among Black College Students during the Transition to College

Authors: Tabbye Chavous, Felecia Webb, Bridget Richardson, Gloryvee Fonseca-Bolorin, Seanna Leath, Robert Sellers

Abstract:

There has been recent renewed attention to Black students’ experiences at predominantly White U.S. universities (PWIs), e.g., the #BBUM (“Being Black at the University of Michigan”), “I too am Harvard” social media campaigns, and subsequent student protest activities nationwide. These campaigns illuminate how many minority students encounter challenges to their racial/ethnic identities as they enter PWI contexts. Students routinely report experiences such as being ignored or treated as a token in classes, receiving messages of low academic expectations by faculty and peers, being questioned about their academic qualifications or belonging, being excluded from academic and social activities, and being racially profiled and harassed in the broader campus community due to race. Researchers have linked such racial marginalization and stigma experiences to student motivation and achievement. One potential mechanism is through the impact of college experiences on students’ identities, given the relevance of the college context for students’ personal identity development, including personal beliefs systems around social identities salient in this context. However, little research examines the impact of the college context on Black students’ racial identities. This study examined change in Black college students’ (N=329) racial identity beliefs over the freshman year at three predominantly White U.S. universities. Using cluster analyses, we identified profile groups reflecting different patterns of stability and change in students’ racial centrality (importance of race to overall self-concept), private regard (personal group affect/group pride), and public regard (perceptions of societal views of Blacks) from beginning of year (Time 1) to end of year (Time 2). Multinomial logit regression analyses indicated that the racial identity change clusters were predicted by pre-college background (racial composition of high school and neighborhood), as well as college-based experiences (racial discrimination, interracial friendships, and perceived campus racial climate). In particular, experiencing campus racial discrimination related to high, stable centrality, and decreases in private regard and public regard. Perceiving racial climates norms of institutional support for intergroup interactions on campus related to maintaining low and decreasing in private and public regard. Multivariate Analyses of Variance results showed change cluster effects on achievement motivation outcomes at the end of students’ academic year. Having high, stable centrality and high private regard related to more positive outcomes overall (academic competence, positive academic affect, academic curiosity and persistence). Students decreasing in private regard and public regard were particularly vulnerable to negative motivation outcomes. Findings support scholarship indicating both stability in racial identity beliefs and the importance of critical context transitions in racial identity development and adjustment outcomes among emerging adults. Findings also are consistent with research suggesting promotive effects of a strong, positive racial identity on student motivation, as well as research linking awareness of racial stigma to decreased academic engagement.

Keywords: diversity, motivation, learning, ethnic minority achievement, higher education

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8639 Governance Challenges for the Management of Water Resources in Agriculture: The Italian Way

Authors: Silvia Baralla, Raffaella Zucaro, Romina Lorenzetti

Abstract:

Water management needs to cope with economic, societal, and environmental changes. This could be guaranteed through 'shifting from government to governance'. In the last decades, it was applied in Europe through and within important legislative pillars (Water Framework Directive and Common Agricultural Policy) and their measures focused on resilience and adaptation to climate change, with particular attention to the creation of synergies among policies and all the actors involved at different levels. Within the climate change context, the agricultural sector can play, through sustainable water management, a leading role for climate-resilient growth and environmental integrity. A recent analysis on the water management governance of different countries identified some common gaps dealing with administrative, policy, information, capacity building, funding, objective, and accountability. The ability of a country to fill these gaps is an essential requirement to make some of the changes requested by Europe, in particular the improvement of the agro-ecosystem resilience to the effect of climatic change, supporting green and digital transitions, and sustainable water use. This research aims to contribute in sharing examples of water governances and related advantages useful to fill the highlighted gaps. Italy has developed a strong and exhaustive model of water governance in order to react with strategic and synergic actions since it is one of the European countries most threatened by climate change and its extreme events (drought, floods). In particular, the Italian water governance model was able to overcome several gaps, specifically as concerns the water use in agriculture, adopting strategies as a systemic/integrated approach, the stakeholder engagement, capacity building, the improvement of planning and monitoring ability, and an adaptive/resilient strategy for funding activities. They were carried out, putting in place regulatory, structural, and management actions. Regulatory actions include both the institution of technical committees grouping together water decision-makers and the elaboration of operative manuals and guidelines by means of a participative and cross-cutting approach. Structural actions deal with the funding of interventions within European and national funds according to the principles of coherence and complementarity. Finally, management actions regard the introduction of operational tools to support decision-makers in order to improve planning and monitoring ability. In particular, two cross-functional and interoperable web databases were introduced: SIGRIAN (National Information System for Water Resources Management in Agriculture) and DANIA (National Database of Investments for Irrigation and the Environment). Their interconnection allows to support sustainable investments, taking into account the compliance about irrigation volumes quantified in SIGRIAN, ensuring a high level of attention on water saving, and monitoring the efficiency of funding. Main positive results from the Italian water governance model deal with a synergic and coordinated work at the national, regional, and local level among institutions, the transparency on water use in agriculture, a deeper understanding from the stakeholder side of the importance of their roles and of their own potential benefits and the capacity to guarantee continuity to this model, through a sensitization process and the combined use of management operational tools.

Keywords: agricultural sustainability, governance model, water management, water policies

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8638 Teaching for Social Justice: Towards Education for Sustainable Development

Authors: Nashwa Moheyeldine

Abstract:

Education for sustainable development (ESD) aims to preserve the rights of the present and future generations as well as preserving the globe, both humans and nature. ESD should aim not only to bring about consciousness of the current and future issues, but also to foster student agency to bring about change at schools, communities and nations. According to the Freirian concept of conscientização, (conscientization) — “learning to perceive social, political, and economic contradictions, and to take action against the oppressive elements of reality”, education aims to liberate people to understand and act upon their worlds. Social justice is greatly intertwined with a nation’s social, political and economic rights, and thus, should be targeted through ESD. “Literacy researchers have found that K-12 students who engage in social justice inquiries develop vital academic knowledge and skills, critical understandings about oppression in the world, and strong dispositions to continue working toward social justice beyond the initial inquiries they conduct”. Education for social justice greatly equips students with the critical thinking skills and sense of agency, that are required for responsible decision making that would ensure a sustainable world. In fact teaching for social justice is intersecting with many of the pedagogies such as multicultural education, cultural relevant pedagogy, education for sustainable development, critical theory pedagogy, (local and global) citizenship education, all of which aim to prepare students for awareness, responsibility and agency. Social justice pedagogy has three specific goals, including helping students develop 1) a sociopolitical consciousness - an awareness of the symbiotic relationship between the social and political factors that affect society, 2) a sense of agency, the freedom to act on one’s behalf and to feel empowered as a change agent, and 3) positive social and cultural identities. The keyword to social justice education is to expose the realities to the students, and challenge the students not only to question , but also to change. Social justice has been usually discussed through the subjects of history and social sciences, however, an interdisciplinary approach is essential to enhance the students’ understanding of their world. Teaching social justice through various subjects is also important, as it make students’ learning relevant to their lives. The main question that this paper seeks to answer is ‘How could social justice be taught through different subjects and tools, such as mathematics, literature through story-telling, geography, and service learning will be shown in this paper. Also challenges to education for social justice will be described. Education is not a neutral endeavor, but is either oriented toward the cause of liberation or in support of domination. In fact , classrooms can be “a microcosm of the emancipatory societies we seek to encourage”, education for the 21st century should be relevant to students' lives where it exposes life's realities to them. Education should also provide students with the basics of school subjects with the bigger goal of helping them make the world a better, more just place to live in.

Keywords: teaching for social justice, student agency, citizenship education, education

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8637 A 30 Year Audit of the Vascular Complications of Ports: Permanent Intravascular Access Devices

Authors: S. Kershaw, P. J. Barry, K. Webb

Abstract:

Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.

Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices

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8636 Alternative Ways to Measure Impacts of Dam Closure to the Structure of Fish Communities of a Neotropical River

Authors: Ana Carolina Lima, Carlos Sérgio Agostinho, Amadeu M. V. M. Soares, Kieran A. Monaghan

Abstract:

Neotropical freshwaters host some of the most biodiverse ecosystems in the world and are among the most threatened by habitat alterations. The high number of species and lack of basic ecological knowledge provides a major obstacle to understanding the effects of environmental change. We assessed the impact of dam closure on the fish communities of a neotropical river by applying simple descriptions of community organizations: Species Abundance Distribution (SAD) and Abundance Biomass Comparison (ABC) curves. Fish data were collected during three distinct time periods (one year before, one year after and five years after closure), at eight sites located downstream of the dam, in the reservoir and reservoir transition zone and upstream of the regulated flow. Dam closure was associated with changes in the structural and functional organization of fish communities at all sites. Species richness tended to increase immediately after dam closure while evenness decreased. Changes in taxonomic structure were accompanied by a change in the distribution of biomass with the proportionate contribution by smaller individuals significantly increased relative to larger individuals. Five years on, richness had fallen to below pre-closure levels at all sites, while the comparative stability of the transformed habitats was reflected by biomass-abundance distribution patterns that approximated pre-disturbance ratios. Despite initial generality, respective sites demonstrated distinct ecological responses that were related to the environmental characteristics of their transformed habitats. This simplistic analysis provides a sensitive and informative assessment of ecological conditions that highlights the impact to ecosystem process and ecological networks and has particular value in regions where detailed ecological knowledge precludes the application of traditional bioassessment methods.

Keywords: ABC curves, SADs, biodiversity, damming, tropical fish

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8635 Effect of Soil Corrosion in Failures of Buried Gas Pipelines

Authors: Saima Ali, Pathamanathan Rajeev, Imteaz A. Monzur

Abstract:

In this paper, a brief review of the corrosion mechanism in buried pipe and modes of failure is provided together with the available corrosion models. Moreover, the sensitivity analysis is performed to understand the influence of corrosion model parameters on the remaining life estimation. Further, the probabilistic analysis is performed to propagate the uncertainty in the corrosion model on the estimation of the renaming life of the pipe. Finally, the comparison among the corrosion models on the basis of the remaining life estimation will be provided to improve the renewal plan.

Keywords: corrosion, pit depth, sensitivity analysis, exposure period

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8634 Load Transfer of Steel Pipe Piles in Warming Permafrost

Authors: S. Amirhossein Tabatabaei, Abdulghader A. Aldaeef, Mohammad T. Rayhani

Abstract:

As the permafrost continues to melt in the northern regions due to global warming, a soil-water mixture is left behind with drastically lower strength; a phenomenon that directly impacts the resilience of existing structures and infrastructure systems. The frozen soil-structure interaction, which in ice-poor soils is controlled by both interface shear and ice-bonding, changes its nature into a sole frictional state. Adfreeze, the controlling mechanism in frozen soil-structure interaction, diminishes as the ground temperature approaches zero. The main purpose of this paper is to capture the altered behaviour of frozen interface with respect to rising temperature, especially near melting states. A series of pull-out tests are conducted on model piles inside a cold room to study how the strength parameters are influenced by the phase change in ice-poor soils. Steel model piles, embedded in artificially frozen cohesionless soil, are subjected to both sustained pull-out forces and constant rates of displacement to observe the creep behaviour and acquire load-deformation curves, respectively. Temperature, as the main variable of interest, is increased from a lower limit of -10°C up to the point of melting. During different stages of the temperature rise, both skin deformations and temperatures are recorded at various depths along the pile shaft. Significant reduction of pullout capacity and accelerated creep behaviour is found to be the primary consequences of rising temperature. By investigating the different pull-out capacities and deformations measured during step-wise temperature change, characteristics of the transition from frozen to unfrozen soil-structure interaction are studied.

Keywords: Adfreeze, frozen soil-structure interface, ice-poor soils, pull-out capacity, warming permafrost

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8633 Millennial Teachers of Canada: Innovation within the Boxed-In Constraints of Tradition

Authors: Lena Shulyakovskaya

Abstract:

Every year, schools aim to develop and adopt new technology and pedagogy as a way to equip today's students with the needed 21st Century skills. However, the field of primary and secondary education may not be as open to embracing change in reality. Despite the drive to reform and innovation, the field of education in Canada is still very much steeped in tradition and uses many of the practices that came into effect over 50 years ago. Among those are employment and retention practices. Millennials are the youngest generation of professionals entering the workplace at this time and the ones leaving their jobs within just a few years. Almost half of new teachers leave Canadian schools within their first five years on the job. This paper discusses one of the contributing factors that lead Canadian millennial teachers to either leave or stay in the profession - standardized education system. Using an exploratory case study approach, in-depth interviews with former and current millennial teachers were conducted to learn about their experiences within the K-12 system. Among the findings were the young teachers' concerns about the constant changes to teaching practices and technological implementations that claimed to advance teaching and learning, and yet in reality only disguised and reiterated the same traditional, outdated, and standardized practices that already existed. Furthermore, while many millennial teachers aspired to be innovative with their curriculum and teaching practices, they felt trapped and helpless in the hands of school leaders who were very reluctant to change. While many new program ideas and technological advancements are being made openly available to teachers on a regular basis, it is important to consider the education field as a whole and how it plays into the teachers' ability to realistically implement changes. By the year 2025, millennials will make up approximately 75% of the North American workforce. It is important to examine generational differences among teachers and understand how millennial teachers may be shaping the future of primary and secondary schools, either by staying or leaving the profession.

Keywords: 21st century skills, millennials, teacher attrition, tradition

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8632 Legal Problems with the Thai Political Party Establishment

Authors: Paiboon Chuwatthanakij

Abstract:

Each of the countries around the world has different ways of management and many of them depend on people to administrate their country. Thailand, for example, empowers the sovereignty of Thai people under constitution; however, our Thai voting system is not able to flow fast enough under the current Political management system. The sovereignty of Thai people is addressing this problem through representatives during current elections, in order to set a new policy for the countries ideology to change in the House and the Cabinet. This is particularly important in a democracy to be developed under our current political institution. The Organic Act on Political Parties 2007 is the establishment we have today that is causing confrontations within the establishment. There are many political parties that will soon be abolished. Many political parties have already been subsidized. This research study is to analyze the legal problems with the political party establishment under the Organic Act on Political Parties 2007. This will focus on the freedom of each political establishment compared to an effective political operation. Textbooks and academic papers will be referenced from studies home and abroad. The study revealed that Organic Act on Political Parties 2007 has strict provisions on the political structure over the number of members and the number of branches involved within political parties system. Such operations shall be completed within one year; but under the existing laws the small parties are not able to participate with the bigger parties. The cities are capable of fulfilling small political party requirements but fail to become coalesced because the current laws won't allow them to be united as one. It is important to allow all independent political parties to join our current political structure. Board members can’t help the smaller parties to become a large organization under the existing Thai laws. Creating a new establishment that functions efficiently throughout all branches would be one solution to these legal problems between all political parties. With this new operation, individual political parties can participate with the bigger parties during elections. Until current political institutions change their system to accommodate public opinion, these current Thai laws will continue to be a problem with all political parties in Thailand.

Keywords: coalesced, political party, sovereignty, elections

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8631 A Comparative Study of Insurance Policies Worldwide in Public Private Partnerships

Authors: Guanqun Shi, Xueqing Zhang

Abstract:

The frequent occurrence of failures in PPP projects which caused great loss has raised attention from the government as well as the concessionaire. PPPs are complex arrangements for its long operation period and multiple players. Many types of risks in PPP projects may cause the project fail. The insurance is an important tool to transfer the risks. Through a comparison and analysis of international government PPP guidelines and contracts as well as the case studies worldwide, we have identified eight main insurance principles, discussed thirteen insurance types in different stages. An overall procedure would be established to improve the practices in PPP projects.

Keywords: public private partnerships, insurance, contract, risk

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8630 Climatic and Human Impact on Karst Aquifer in Semi Arid Zone

Authors: Benhammadi Hocine, Fehdi Chemseddine, Chaffai Hicham

Abstract:

The study site is the plateau Cheria, a city in south eastern Algeria (Tebessa) thanks to its structure perched syncline is the region of Tebessa a real water tower. Special rates provided by some boreholes and wells around the city Cheria have long been led to believe that the reserves were virtually limitless. The investigations carried out in this region have located karstified limestone areas at depth of 100 meters of the carbonate formation. During the last two decades a rainfall deficit has increased the effect of drought has caused an increase in flow from this aquifer. The effect on water resources is a significant and progressive reduction of the static level of the karst aquifer. The qualitative aspect has also been marked by degradation. This climate variability marked by the decade of drought (1990/2000) has had the effect on the local population, a forced change of their activity primarily agricultural. Abandoning agro pastoral mode due to prolonged drought, populations chose agriculture maraichère consumer a lot of water, this increasing the depletion of water resources. This change in activity was accompanied by a rural exodus to urban areas. The result has led to an increase in population in the urban areas, this has resulted in an increase in water demand and an increase in emissions (waste water). Uncontrolled discharges contribute to pollute a little more groundwater. The second consequence is type Geotechnical, it is the appearance of sinkholes, results of the alternating periods of drought and violent floods. Sinkholes are a real concern for the management and urban development. An interdisciplinary contribution (geology, hydrology, climatology and management) is essential to reduce or avoid impacts in different sectors.

Keywords: aquifer, carbonate formation, drought, exodus, resources, chéria, Algéria

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8629 Identification and Classification of Stakeholders in the Transition to 3D Cadastre

Authors: Qiaowen Lin

Abstract:

The 3D cadastre is an inevitable choice to meet the needs of real cadastral management. Nowadays, more attention is given to the technical aspects of 3D cadastre, resulting in the imbalance within this field. To fulfill this research gap, the stakeholder, which has been regarded as the determining factor in cadastral change has been studied. Delphi method, Michael rating, and stakeholder mapping are used to identify and classify the stakeholders in 3D cadastre. It is concluded that the project managers should pay more attention to the interesting appeal of the key stakeholders and different coping strategies should be adopted to facilitate the transition to 3D cadastre.

Keywords: stakeholders, three dimension, cadastre, transtion

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8628 A Quantitative Analysis of Rural to Urban Migration in Morocco

Authors: Donald Wright

Abstract:

The ultimate goal of this study is to reinvigorate the philosophical underpinnings the study of urbanization with scientific data with the goal of circumventing what seems an inevitable future clash between rural and urban populations. To that end urban infrastructure must be sustainable economically, politically and ecologically over the course of several generations as cities continue to grow with the incorporation of climate refugees. Our research will provide data concerning the projected increase in population over the coming two decades in Morocco, and the population will shift from rural areas to urban centers during that period of time. As a result, urban infrastructure will need to be adapted, developed or built to fit the demand of future internal migrations from rural to urban centers in Morocco. This paper will also examine how past experiences of internally displaced people give insight into the challenges faced by future migrants and, beyond the gathering of data, how people react to internal migration. This study employs four different sets of research tools. First, a large part of this study is archival, which involves compiling the relevant literature on the topic and its complex history. This step also includes gathering data bout migrations in Morocco from public data sources. Once the datasets are collected, the next part of the project involves populating the attribute fields and preprocessing the data to make it understandable and usable by machine learning algorithms. In tandem with the mathematical interpretation of data and projected migrations, this study benefits from a theoretical understanding of the critical apparatus existing around urban development of the 20th and 21st centuries that give us insight into past infrastructure development and the rationale behind it. Once the data is ready to be analyzed, different machine learning algorithms will be experimented (k-clustering, support vector regression, random forest analysis) and the results compared for visualization of the data. The final computational part of this study involves analyzing the data and determining what we can learn from it. This paper helps us to understand future trends of population movements within and between regions of North Africa, which will have an impact on various sectors such as urban development, food distribution and water purification, not to mention the creation of public policy in the countries of this region. One of the strengths of this project is the multi-pronged and cross-disciplinary methodology to the research question, which enables an interchange of knowledge and experiences to facilitate innovative solutions to this complex problem. Multiple and diverse intersecting viewpoints allow an exchange of methodological models that provide fresh and informed interpretations of otherwise objective data.

Keywords: climate change, machine learning, migration, Morocco, urban development

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8627 The Effect of Sexual Assault on Sport Participation Trajectories from Adolescence through Young Adulthood

Authors: Chung Gun Lee

Abstract:

Objectives: Certain life change events were shown to have strong effects on physical activity-related behavior, but more research is needed to investigate the longer-term effects of different life change events on physical activity-related behaviors. The purpose of this study is to examine the effect of experiencing physically or non-physically forced sexual activity on sports participation from adolescence to young adulthood. Methods: This study used the National Longitudinal Study of Adolescent Health (Add Health) data. Group-based trajectory modeling was utilized to examine the effect of experiencing sexual assault on trajectories of sports participation from adolescence to young adulthood. Results: Male participants were divided into three trajectory groups (i.e., Low-stable, High-decreasing, and High-stable) and female participants were divided into two trajectory groups (i.e., Low-stable and High-decreasing). The main finding of this study is that women who experienced non-physically forced sexual activity significantly decreases sports participation throughout the trajectory in ‘High-decreasing group.’ The effect of non-physically forced sexual activity on women’s sports participation was considerably weakened and became insignificant after including psychological depression in the model as a potential mediator. Discussion: Special attention should be paid to sport participation among women victims of non-physically forced sexual activity. Further studies are needed to examine other potential mediators in addition to psychological depression when examining the effect of non-physically forced sexual activity on sport participation in women.

Keywords: adolescent, group-based trajectory modeling, sexual assault, young adult

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8626 Rectus Sheath Block to Extend the Effectiveness of Post Operative Epidural Analgesia

Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail

Abstract:

Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.

Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric

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8625 Analyzing Middle Actors' Influence on Land Use Policy: A Case Study in Central Kalimantan, Indonesia

Authors: Kevin Soubly, Kaysara Khatun

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This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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8624 Public Administrators, Code of Conduct and the Nigerian Society

Authors: Mahmud Adam, Inuwa Abdu Ibrahim

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The issue of ethics and values of public office holders in Nigerian has been and still is a matter of great mystery. Their behaviours in the discharge of their official responsibility remain unsatisfactory. The paper looks at the code of conduct and the societal values with which the Nigerian Administrators function today. Secondary sources of data were used. In conclusion, a change in attitude, reorientation, harsh and enforceable laws is required to reverse the trend.

Keywords: society, administrators, code of conduct, Nigeria

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8623 Modelling of Groundwater Resources for Al-Najaf City, Iraq

Authors: Hayder H. Kareem, Shunqi Pan

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Groundwater is a vital water resource in many areas in the world, particularly in the Middle-East region where the water resources become scarce and depleting. Sustainable management and planning of the groundwater resources become essential and urgent given the impact of the global climate change. In the recent years, numerical models have been widely used to predict the flow pattern and assess the water resources security, as well as the groundwater quality affected by the contaminants transported. In this study, MODFLOW is used to study the current status of groundwater resources and the risk of water resource security in the region centred at Al-Najaf City, which is located in the mid-west of Iraq and adjacent to the Euphrates River. In this study, a conceptual model is built using the geologic and hydrogeologic collected for the region, together with the Digital Elevation Model (DEM) data obtained from the "Global Land Cover Facility" (GLCF) and "United State Geological Survey" (USGS) for the study area. The computer model is also implemented with the distributions of 69 wells in the area with the steady pro-defined hydraulic head along its boundaries. The model is then applied with the recharge rate (from precipitation) of 7.55 mm/year, given from the analysis of the field data in the study area for the period of 1980-2014. The hydraulic conductivity from the measurements at the locations of wells is interpolated for model use. The model is calibrated with the measured hydraulic heads at the locations of 50 of 69 wells in the domain and results show a good agreement. The standard-error-of-estimate (SEE), root-mean-square errors (RMSE), Normalized RMSE and correlation coefficient are 0.297 m, 2.087 m, 6.899% and 0.971 respectively. Sensitivity analysis is also carried out, and it is found that the model is sensitive to recharge, particularly when the rate is greater than (15mm/year). Hydraulic conductivity is found to be another parameter which can affect the results significantly, therefore it requires high quality field data. The results show that there is a general flow pattern from the west to east of the study area, which agrees well with the observations and the gradient of the ground surface. It is found that with the current operational pumping rates of the wells in the area, a dry area is resulted in Al-Najaf City due to the large quantity of groundwater withdrawn. The computed water balance with the current operational pumping quantity shows that the Euphrates River supplies water into the groundwater of approximately 11759 m3/day, instead of gaining water of 11178 m3/day from the groundwater if no pumping from the wells. It is expected that the results obtained from the study can provide important information for the sustainable and effective planning and management of the regional groundwater resources for Al-Najaf City.

Keywords: Al-Najaf city, conceptual modelling, groundwater, unconfined aquifer, visual MODFLOW

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8622 Using Multi-Specialist Team to Care for a Breast Cancer Patient Who Received Total Mastectomy during Pregnancy

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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8621 The Protection and Enhancement of the Roman Roads in Algeria

Authors: Tarek Ninouh, Ahmed Rouili

Abstract:

The Roman paths or roads offer a very interesting archaeological material, because they allow us to understand the history of human settlement and are also factors that increase territorial identity. Roman roads are one of the hallmarks of the Roman empire, which extends to North Africa. The objective of this investigation is to attract the attention of researchers to the importance of Roman roads and paths, which are found in Algeria, according to the quality of the materials and techniques used in this period of our history, and to encourage other decision makers to protect and enhance these routes because the current urbanization, intensive agricultural practices, or simply forgotten, decreases the sustainability of this important historical heritage.

Keywords: Roman paths, quality of materials, property, valuation

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8620 Hiding Power of the Scent in Marketing and New Marketing Strategy: The Scent Marketing

Authors: Shahram Keshavarzi

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Today, getting good service, having a good time, and leaving the company with good feelings are importanttforbothcustomers and businesses. It has been observed that when customersareexposedtopleasantsmells, their visit times increase by 26%, and theyvisittheaislesfor 3 times longer. Byusingtheeffect of scents on people, it is toensurethatcustomersshopmore, benefit from the service and be satisfied. Intoday'sresearch, visual memory can be 40% effective after a period of 4 months, whileolfactorymemory is 60% moreeffectiveevenafter 1 year. The purpose of the research is thehiddenandeffectivepower of skepticism in the behavior of consumersandtheeffectivestrategy of modern marketing. Special scentsdirectlyaffecttheincrease in sales by influencing the customer's-decision mechanism in purchasing products.

Keywords: modern marketing strategy, scent, scent marketing, consumer behavior

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8619 Discovering Causal Structure from Observations: The Relationships between Technophile Attitude, Users Value and Use Intention of Mobility Management Travel App

Authors: Aliasghar Mehdizadeh Dastjerdi, Francisco Camara Pereira

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The increasing complexity and demand of transport services strains transportation systems especially in urban areas with limited possibilities for building new infrastructure. The solution to this challenge requires changes of travel behavior. One of the proposed means to induce such change is multimodal travel apps. This paper describes a study of the intention to use a real-time multi-modal travel app aimed at motivating travel behavior change in the Greater Copenhagen Region (Denmark) toward promoting sustainable transport options. The proposed app is a multi-faceted smartphone app including both travel information and persuasive strategies such as health and environmental feedback, tailoring travel options, self-monitoring, tunneling users toward green behavior, social networking, nudging and gamification elements. The prospective for mobility management travel apps to stimulate sustainable mobility rests not only on the original and proper employment of the behavior change strategies, but also on explicitly anchoring it on established theoretical constructs from behavioral theories. The theoretical foundation is important because it positively and significantly influences the effectiveness of the system. However, there is a gap in current knowledge regarding the study of mobility-management travel app with support in behavioral theories, which should be explored further. This study addresses this gap by a social cognitive theory‐based examination. However, compare to conventional method in technology adoption research, this study adopts a reverse approach in which the associations between theoretical constructs are explored by Max-Min Hill-Climbing (MMHC) algorithm as a hybrid causal discovery method. A technology-use preference survey was designed to collect data. The survey elicited different groups of variables including (1) three groups of user’s motives for using the app including gain motives (e.g., saving travel time and cost), hedonic motives (e.g., enjoyment) and normative motives (e.g., less travel-related CO2 production), (2) technology-related self-concepts (i.e. technophile attitude) and (3) use Intention of the travel app. The questionnaire items led to the formulation of causal relationships discovery to learn the causal structure of the data. Causal relationships discovery from observational data is a critical challenge and it has applications in different research fields. The estimated causal structure shows that the two constructs of gain motives and technophilia have a causal effect on adoption intention. Likewise, there is a causal relationship from technophilia to both gain and hedonic motives. In line with the findings of the prior studies, it highlights the importance of functional value of the travel app as well as technology self-concept as two important variables for adoption intention. Furthermore, the results indicate the effect of technophile attitude on developing gain and hedonic motives. The causal structure shows hierarchical associations between the three groups of user’s motive. They can be explained by “frustration-regression” principle according to Alderfer's ERG (Existence, Relatedness and Growth) theory of needs meaning that a higher level need remains unfulfilled, a person may regress to lower level needs that appear easier to satisfy. To conclude, this study shows the capability of causal discovery methods to learn the causal structure of theoretical model, and accordingly interpret established associations.

Keywords: travel app, behavior change, persuasive technology, travel information, causality

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8618 Anticipating the Change: Visions and Perspectives towards a Post-Car World

Authors: Farzaneh Bahrami

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Different indicators, such as modal shares in mobility practices or car ownership, may suggest that the century of car dominance - at least in Europe and North America - is already behind us. If the emergence of the car had radical spatial and social consequences, what would be the implications of its gradual disappearance - which could be expected in the context of ecological consciousness, economic and energetic constraints as a result of both urban policies as well as lifestyle choices? To what extend shall urban experts account for this limited but visible transition from car-dominated systems towards alternative models of mobility in which the individual-motorized mobility (car) is not central; what models of urbanity could be imagined to support such a transformation? We have examined a selection of projects at different scales and within different contexts - new planned cities, dense urban areas or territories of dispersion – whose visions involve a significant shift from the current car system. We have been looking into their tools, strategies and different measures of car reduction, as well as their varied approaches to public space as an inevitable corollary to this change. The car’s dominance was formerly questioned by advocates of public space, rather than through interests in ecological urban design or other urban planning concerns. In the 60s already a universal longing for the qualities of traditional urban space led to a critique of the proliferation of fast roads, and thus the car’s colonization of everyday life. Reclamation of public space as the city’s quintessential social territory reappears today in contemporary discourses and reinforces the shift-provoking trends towards a new urbanity freed from car dominance. In a hypothetical process of the progressive phasing-out of the car, we shall expect fundamental transformations in spatial practices of the city, accompanied by the physical configuration of its public spaces. What will be the main characteristics of the new emerging spaces of sociability and where shall we encounter them? This contribution is an ongoing research within the framework of Post-Car World, an interdisciplinary project that explores the future of mobility through the role of the car.

Keywords: mobility, urbanity, future visions, public space

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8617 Twin Deficits Hypothesis: The Case of Turkey

Authors: Mehmet Mucuk, Ayşen Edirneligil

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Budget and current account deficits are main problems for all countries. There are different approaches about the relationship between budget deficit and current account deficit. While Keynesian view accepts that there is a casual link between these variables, Ricardian equivalence hypothesis rejects it. The aim of this study is to analyze the validity of Keynesian view for Turkish Economy using VAR analysis with the monthly data in the period of 2006-2014. In this context, it will be used Johansen Cointegration Test, Impulse-Response Function and Variance Decomposition Tests.

Keywords: budget deficit, current account deficit, Turkish economy, twin deficits

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8616 Thermodynamic Performance of a Low-Cost House Coated with Transparent Infrared Reflective Paint

Authors: Ochuko K. Overen, Edson L. Meyer

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Uncontrolled heat transfer between the inner and outer space of low-cost housings through the thermal envelope result in indoor thermal discomfort. As a result, an excessive amount of energy is consumed for space heating and cooling. Thermo-optical properties are the ability of paints to reduce the rate of heat transfer through the thermal envelope. The aim of this study is to analyze the thermal performance of a low-cost house with its walls inner surface coated with transparent infrared reflective paint. The thermo-optical properties of the paint were analyzed using Scanning Electron Microscopy/ Energy Dispersive X-ray spectroscopy (SEM/EDX), Fourier Transform Infra-Red (FTIR) and thermal photographic technique. Meteorological indoor and ambient parameters such as; air temperature, relative humidity, solar radiation, wind speed and direction of a low-cost house in Golf-course settlement, South Africa were monitored. The monitoring period covers both winter and summer period before and after coating. The thermal performance of the coated walls was evaluated using time lag and decrement factor. The SEM image shows that the coat is transparent to light. The presence of Al as Al2O and other elements were revealed by the EDX spectrum. Before coating, the average decrement factor of the walls in summer was found to be 0.773 with a corresponding time lag of 1.3 hours. In winter, the average decrement factor and corresponding time lag were 0.467 and 1.6 hours, respectively. After coating, the average decrement factor and corresponding time lag were 0.533 and 2.3 hour, respectively in summer. In winter, an average decrement factor of 1.120 and corresponding time lag of 3 hours was observed. The findings show that the performance of the coats is influenced by the seasons. With a 74% reduction in decrement factor and 1.4 time lag increase in winter, it implies that the coatings have more ability to retain heat within the inner space of the house than preventing heat flow into the house. In conclusion, the results have shown that transparent infrared reflective paint has the ability to reduce the propagation of heat flux through building walls. Hence, it can serve as a remedy to the poor thermal performance of low-cost housings in South Africa.

Keywords: energy efficiency, decrement factor, low-cost housing, paints, rural development, thermal comfort, time lag

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8615 Early Outcomes and Lessons from the Implementation of a Geriatric Hip Fracture Protocol at a Level 1 Trauma Center

Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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8614 Targeted Delivery of Sustained Release Polymeric Nanoparticles for Cancer Therapy

Authors: Jamboor K. Vishwanatha

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Among the potent anti-cancer agents, curcumin has been found to be very efficacious against various cancer cells. Despite multiple medicinal benefits of curcumin, poor water solubility, poor physiochemical properties and low bioavailability continue to pose major challenges in developing a formulation for clinical efficacy. To improve its potential application in the clinical area, we formulated poly lactic-co-glycolic acid (PLGA) nanoparticles. The PLGA nanoparticles were formulated using solid-oil/water emulsion solvent evaporation method and then characterized for percent yield, encapsulation efficiency, surface morphology, particle size, drug distribution within nanoparticles and drug polymer interaction. Our studies showed the successful formation of smooth and spherical curcumin loaded PLGA nanoparticles with a high percent yield of about 92.01±0.13% and an encapsulation efficiency of 90.88±0.14%. The mean particle size of the nanoparticles was found to be 145nm. The in vitro drug release profile showed 55-60% drug release from the nanoparticles over a period of 24 hours with continued sustained release over a period of 8 days. Exposure to curcumin loaded nanoparticles resulted in reduced cell viability of cancer cells compared to normal cells. We used a novel non-covalent insertion of a homo-bifunctional spacer for targeted delivery of curcumin to various cancer cells. Functionalized nanoparticles for antibody/targeting agent conjugation was prepared using a cross-linking ligand, bis(sulfosuccinimidyl) suberate (BS3), which has reactive carboxyl group to conjugate efficiently to the primary amino groups of the targeting agents. In our studies, we demonstrated successful conjugation of antibodies, Annexin A2 or prostate specific membrane antigen (PSMA), to curcumin loaded PLGA nanoparticles for targeting to prostate and breast cancer cells. The percent antibody attachment to PLGA nanoparticles was found to be 92.8%. Efficient intra-cellular uptake of the targeted nanoparticles was observed in the cancer cells. These results have emphasized the potential of our multifunctional curcumin nanoparticles to improve the clinical efficacy of curcumin therapy in patients with cancer.

Keywords: polymeric nanoparticles, cancer therapy, sustained release, curcumin

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8613 Utility of Thromboelastography to Reduce Coagulation-Related Mortality and Blood Component Rate in Neurosurgery ICU

Authors: Renu Saini, Deepak Agrawal

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Background: Patients with head and spinal cord injury frequently have deranged coagulation profiles and require blood products transfusion perioperatively. Thromboelastography (TEG) is a ‘bedside’ global test of coagulation which may have role in deciding the need of transfusion in such patients. Aim: To assess the usefulness of TEG in department of neurosurgery in decreasing transfusion rates and coagulation-related mortality in traumatic head and spinal cord injury. Method and Methodology: A retrospective comparative study was carried out in the department of neurosurgery over a period of 1 year. There are two groups in this study. ‘Control’ group constitutes the patients in whom data was collected over 6 months (1/6/2009-31/12/2009) prior to installation of TEG machine. ‘Test’ group includes patients in whom data was collected over 6months (1/1/2013-30/6/2013) post TEG installation. Total no. of platelet, FFP, and cryoprecipitate transfusions were noted in both groups along with in hospital mortality and length of stay. Result: Both groups were matched in age and sex of patients, number of head and spinal cord injury cases, number of patients with thrombocytopenia and number of patients who underwent operation. Total 178 patients (135 head injury and 43 spinal cord injury patents) were admitted in neurosurgery department during time period June 2009 to December 2009 i.e. prior to TEG installation and after TEG installation a total of 243 patients(197 head injury and 46 spinal cord injury patents) were admitted. After TEG introduction platelet transfusion significantly reduced (p=0.000) compare to control group (67 units to 34 units). Mortality rate was found significantly reduced after installation (77 patients to 57 patients, P=0.000). Length of stay was reduced significantly (Prior installation 1-211days and after installation 1-115days, p=0.02). Conclusion: Bedside TEG can dramatically reduce platelet transfusion components requirement in department of neurosurgery. TEG also lead to a drastic decrease in mortality rate and length of stay in patients with traumatic head and spinal cord injuries. We recommend its use as a standard of care in the patients with traumatic head and spinal cord injuries.

Keywords: blood component transfusion, mortality, neurosurgery ICU, thromboelastography

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8612 Comparative Evaluation of a Dynamic Navigation System Versus a Three-Dimensional Microscope in Retrieving Separated Endodontic Files: An in Vitro Study

Authors: Mohammed H. Karim, Bestoon M. Faraj

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Introduction: This study aimed to compare the effectiveness of a Dynamic Navigation System (DNS) and a three-dimensional microscope in retrieving broken rotary NiTi files when using trepan burs and the extractor system. Materials and Methods: Thirty maxillary first bicuspids with sixty separate roots were split into two comparable groups based on a comprehensive Cone-Beam Computed Tomography (CBCT) analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated NiTi rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. Results: The microscope-guided group had a higher success rate than the DNS guidance, but the difference was insignificant (p > 0.05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, required less time to retrieve the fragments and caused minimal change in the root canal volume (p < 0.05). Conclusion: Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.

Keywords: separated instruments retrieval, dynamic navigation system, 3D video microscope, trephine burs, extractor

Procedia PDF Downloads 54