Search results for: WHO surgical safety checklist

Authors: Kyung Hoon Park, Hyung Jun Kim, Jong Wook Song

Abstract:

Super-tall building, large-scale and multi-purpose underground spaces reflect changes in construction trend. As current laws and codes such as Fire Services Act and construction codes are not enough to secure the fire safety of those structures and spaces, it is required to provide systemic supplement for performance-based design to establish or revise laws and technical standards to cope with the changes flexibly. In this study, the performance-based design standards of structures designed in Korea are compared with specification based design standards in an attempt to find the ways to establish fire safety standards for structures in Korea.

Keywords: performance based design, specification based design, fire safety design, life safety

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Authors: Balarabe Bilyaminu Ismail, Osman Cavus, Fügen Durlu Özkaya

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This study is aimed at determining the level of awareness of chefs and students of food science and technology on food safety in general and allergens in particular. To get appropriate data, a questionnaire comprising of 19 questions covering many food safety issues and allergens in foods were used to collect information for the study through face to face interviews. Interviews were conducted for 284 people in Nigeria and Turkey. Sixty-eight percent of respondents from Turkey; 31.3% were students and 68.7% were chefs. Thirty-one percent of respondents from Nigeria include 33.7% students and 66.3% chefs. The result of the study indicated that most of the findings of scientific studies on food safety issues have not been directly applied by the people working in the food sector. Additionally, the knowledge level of the gastronomy and culinary arts students on food safety and allergens are significantly higher than the restaurant chefs that prepare the food and serve it to the public. The study, therefore, concluded that proper training of food business operators is critical to ensuring the safety of foods and control of allergens.

Keywords: allergens, food safety, questionnaire survey, training

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Authors: Namhun Lee, Seong Jin Kim

Abstract:

The construction industry represents one of the largest industries in the United States, yet it continues to face several occupational health and safety challenges. Many workers on construction sites are suffering from extended exposure to stressful situations such as poor and hazardous work environments and task complexity. Stress can be commonly defined as a feeling of emotional or physical tension, which can easily impact construction safety and result in a higher rate of job-related injuries in the construction industry. Physiological signals transmitted from wearable biosensors can be used to detect excessive stress. Therefore, workers’ stress should be detected and mitigated to prevent any type of serious incident or accident proactively. By doing this, construction productivity, as well as job satisfaction, would also be improved in the construction industry. To establish a foundation in this field of research, a conceptual framework for using wearable technology for construction safety has been developed for continuous and automatic monitoring of worker’s stress. The conceptual framework will serve as a foothold in future studies on the application of wearable technology for construction safety.

Keywords: construction safety, occupational stress, stress monitoring, wearable biosensors

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Authors: Mohamed Ahmed Madkour, Haitham Magdy Hamad

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater like a knife or a scalpel. The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus. The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however we have not received a lengthy explanation of the various surgeries and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancient Egypt, archaeology, Egyptian history, ancient asurgical imaging, Egyptian civilization, civilization

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Authors: Samuel Opeyemi Williams, Razali Adul Hamid, Mohd Saidin Misman, Dominic Ileyemi Ajayi, Taki Eddine Seghier

Abstract:

Construction industry is famous with hazardous and high-risk environment with operatives facing a greater risk of work-related fatality or injury than operatives in other industries. It is characterised with different types of accident, ranging from electrocution, trip and slip, fall from height, struck-by, explosion, trench collapse, to scaffolding accidents, with each type being caused by different factors. However, accidents are unplanned, unforeseeable and unexpected events, but regardless of the high-risk nature of the industry, accidents are preventable. The aim of the paper is to determine the extent of the utilization of the safety measures, as well as identifying the factors underlining the non-usage. A research methodology consisting of a literature review was used to identify the types and causes of site accidents, while a well-structured questionnaire was used to determine the level of the usage of safety measures on site. The data were analysed with the results revealing the use of protective clothing, safety helmet, first aid, protective shoe, safety belt, and face shield to aid safety of workers, as well as ascribing non-usage of safety measures to cost, ignorance, lack of experts and non-inclusion in contract document. Recommendations are included in the paper suggesting the enforcement of the utilization of safety measures in reducing the spate of accident occurrence on construction sites.

Keywords: construction industry, safety measures, accident, prevention

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Authors: Jolai R. Garca, Sergio Mahinay Jr., Fathma Dubpaleg, Rhea Jaberina, Jovanne Mabit II

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The COVID-19 pandemic has still been going on for almost two years now, but because of the health and safety practices of the citizens, together with the action of the Local Government Unit, it has slowly dissipated. This study investigated the relationship between the health and safety protocols as well as the status of governance of the Local Government Unit of Midsayap using the evidence-based key indicators of Good Governance aggregated from the Organisation for Economic Co-operation and Development (OECD). A quantitative research design was employed to determine the relationship of the variables under study. Findings showed that the residents of Midsayap often practice the necessary health and safety measures against COVID-19 and that the Local Government Unit of Midsayap is effective in responding to the pandemic.

Keywords: governance, health and safety practices, covid-19, local government unit

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Authors: Ahmed Hefny Mohamed El-Badwy

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases, and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater, like a knife or a scalpel, there is evidence of surgery performed in ancient Egypt during the dynastic period (323 – 3200 BC). The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods, including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise, its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus (recipes from 863 to 877). The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however, we have not received a lengthy explanation of the various surgeries, and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancientegypt, egypt, archaeology, the ancient egyptian

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Authors: Bouba Oumarou Aboubakar, HongXia Li, Sardar Annes Farooq

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The Belt and Road Initiative’s success strongly depends on the safety of all the million workers on construction projects sites. As the new BRI is directed toward Africa and meets a completely different culture from the Chinese project managers, maintaining low risk for workers risks shall be closely related to cultural sharing and mutual understanding. This is why this work introduces a cultural-wise safety management framework for Chinese Construction projects in Africa. The theoretical contribution of this paper is an improved risk assessment framework that integrates language, culture and difficulty of controlling risk factors into one approach. Practically, this study provides not only a useful tool for project safety management practitioners but the full understanding of all risks that may arise in the BRI projects in Africa.

Keywords: cultural-wise, safety culture, risk assessment, Chinese construction, BRI projects, Africa

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Authors: Ali Sagiroglu, Sema Noyan Alacali, Guray Arslan

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This paper presents a study on the influence of the safety factor in the concrete contribution to shear strength of high-strength concrete (HSC) beams according to TS500. In TS500, the contribution of concrete to shear strength is obtained by reducing diagonal cracking strength with a safety factor of 0.8. It was investigated that the coefficient of 0.8 considered in determining the contribution of concrete to the shear strength corresponds to which value of failure probability. Also, the changes in the reduction factor depending on different coefficients of variation of concrete were examined.

Keywords: reinforced concrete, beam, shear strength, failure probability, safety factor

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Authors: Fadwa Alhalaiqa, Othman Alfuqaha, Anas H. Khalifeh, Mahmoud Alsaraireh, Rami Masa’Deh, Natija S Manaa

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Background: Post-traumatic stress disorders (PTSD) usually occur after traumatic occurrences that exceed the range of common human experience. This study aimed to test the psychometric properties of PCL-5 checklist for the 20 PTSD symptoms from DSM-5 among Lebanese population and to identify the prevalence of PTSD. Methods: A cross sectional survey of PCL5 among 950 Lebanese using the online survey platform by Google form was conducted. Snowball recruitment was used to identify participants for the survey. STROBE guideline was used in reporting the current study. Results: Face content, construct, discriminant, and convergent validity had been accomplished of PCL-5. The reliability by Cronbach alpha, composite, and average variance extracted were set superior. We found also that more than half of the participants (55.6%) scored 33 or above, which is the cutoff score for a likely diagnosis of PTSD. Conclusion: The current study provides further support for the Arabic version PCL-5 validity and reliability among non-Western populations. This support using this tool in the screening of PTSD.

Keywords: post traumatic stress disorder, psychometric properties, stress, adult population

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Authors: Haitham Nabil Zaghlol Hasan

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases, and they divide them into internal and external diseases even though this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater, like a knife or a scalpel, there is evidence of surgery performed in ancient Egypt during the dynastic period (323 – 3200 BC). The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods, including sedation. The ancient Egyptians reached great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires surgical intervention, otherwise, its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus (recipes from 863 to 877). The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however, we have not received a lengthy explanation of the various surgeries, and the surgeon has usually only said: “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: egypt, ancient_egypt, civilization, archaeology

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Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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Authors: Emine Laarouchi, Daniela Cancila, Laurent Soulier, Hakima Chaouchi

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Cyber-Physical Systems as drones proved their efficiency for supporting emergency applications. For these particular applications, travel time and autonomous navigation algorithms are of paramount importance, especially when missions are performed in urban environments with high obstacle density. In this context, however, safety properties are not properly addressed. Our ambition is to optimize the system safety level under autonomous navigation systems, by preserving performance of the CPS. At this aim, we introduce genetic algorithms in the autonomous navigation process of the drone to better infer its trajectory considering the possible obstacles. We first model the wished safety requirements through a cost function and then seek to optimize it though genetics algorithms (GA). The main advantage in the use of GA is to consider different parameters together, for example, the level of battery for navigation system selection. Our tests show that the GA introduction in the autonomous navigation systems minimize the risk of safety lossless. Finally, although our simulation has been tested for autonomous drones, our approach and results could be extended for other autonomous navigation systems such as autonomous cars, robots, etc.

Keywords: safety, unmanned aerial vehicles , CPS, ACPS, drones, path planning, genetic algorithms

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Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

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Authors: Jaydip M. Desai, Antonio Valdevit, Arthur Ritter

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Robotic surgery is used to enhance minimally invasive surgical procedure. It provides greater degree of freedom for surgical tools but lacks of haptic feedback system to provide sense of touch to the surgeon. Surgical robots work on master-slave operation, where user is a master and robotic arms are the slaves. Current, surgical robots provide precise control of the surgical tools, but heavily rely on visual feedback, which sometimes cause damage to the inner organs. The goal of this research was to design and develop a real-time simulink based robotic system to study force feedback mechanism during instrument-object interaction. Setup includes three Velmex XSlide assembly (XYZ Stage) for three dimensional movement, an end effector assembly for forceps, electronic circuit for four strain gages, two Novint Falcon 3D gaming controllers, microcontroller board with linear actuators, MATLAB and Simulink toolboxes. Strain gages were calibrated using Imada Digital Force Gauge device and tested with a hard-core wire to measure instrument-object interaction in the range of 0-35N. Designed simulink model successfully acquires 3D coordinates from two Novint Falcon controllers and transfer coordinates to the XYZ stage and forceps. Simulink model also reads strain gages signal through 10-bit analog to digital converter resolution of a microcontroller assembly in real time, converts voltage into force and feedback the output signals to the Novint Falcon controller for force feedback mechanism. Experimental setup allows user to change forward kinematics algorithms to achieve the best-desired movement of the XYZ stage and forceps. This project combines haptic technology with surgical robot to provide sense of touch to the user controlling forceps through machine-computer interface.

Keywords: surgical robot, haptic feedback, MATLAB, strain gage, simulink

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Authors: Omid Adibi, Nategheh Najafpour, Bijan Farhanieh, Hossein Afshin

Abstract:

Energy transmission pipelines are one of the most vital parts of each country which several strict laws have been conducted to enhance the safety of these lines and their vicinity. One of these laws is the safety distance around high pressure gas pipelines. Safety distance refers to the minimum distance from the pipeline where people and equipment do not confront with serious damages. In the present study, safety distance around high pressure gas transmission pipelines were determined by using numerical methods. For this purpose, gas leakages from cracked pipeline and created jet fires were simulated as continuous ignition, three dimensional, unsteady and turbulent cases. Numerical simulations were based on finite volume method and turbulence of flow was considered using k-ω SST model. Also, the combustion of natural gas and air mixture was applied using the eddy dissipation method. The results show that, due to the high pressure difference between pipeline and environment, flow chocks in the cracked area and velocity of the exhausted gas reaches to sound speed. Also, analysis of the incident radiation results shows that safety distances around 42 inches high pressure natural gas pipeline based on 5 and 15 kW/m² criteria are 205 and 272 meters, respectively.

Keywords: gas pipelines, incident radiation, numerical simulation, safety distance

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Authors: Tas Yong Koh, Steve Rowlinson, Yuzhong Shen

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In construction safety management, safety climate has long been linked to workers' safety behaviors and performance. For this reason, safety climate concept and tools have been used as heuristics to diagnose a range of safety-related issues by some progressive contractors in Hong Kong and elsewhere. However, as a diagnostic tool, safety climate tends to treat the different components of the climate construct in a linear fashion. Safety management in construction projects, in reality, is a multi-faceted and multilevel phenomenon that resembles a complex system. Hence, understanding safety management in construction projects requires not only the understanding of safety climate but also the organizational-systemic nature of the phenomenon. Our involvement, diagnoses, and interpretations of a range of safety climate-related issues which culminated in the project’s sub-optimum safety performance in an infrastructure construction project have brought about such revelation. In this study, a range of data types had been collected from various hierarchies of the project site organization. These include the frontline workers and supervisors from the main and sub-contractors, and the client supervisory personnel. Data collection was performed through the administration of safety climate questionnaire, interviews, observation, and document study. The findings collectively indicate that what had emerged in parallel of the seemingly linear climate-based exploration is the exposition of the organization-systemic nature of the phenomenon. The results indicate the negative impacts of climate perceptions mismatch, insufficient work planning, and risk management, mixed safety leadership, workforce negative attributes, lapsed safety enforcement and resources shortages collectively give rise to the project sub-optimum safety performance. From the dynamic causation and multilevel perspective, the analyses show that the individual, group, and organizational levels issues are interrelated and these interrelationships are linked to negative safety climate. Hence the adoption of both perspectives has enabled a fuller understanding of the phenomenon of safety management that point to the need for an organizational-systemic intervention strategy. The core message points to the fact that intervention at an individual level will only meet with limited success if the risks embedded in the higher levels in group and project organization are not addressed. The findings can be used to guide the effective development of safety infrastructure by linking different levels of systems in a construction project organization.

Keywords: construction safety management, dynamic causation, multilevel analysis, safety climate

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Authors: Carine Cridelich, Pablo Juesas Cano, Emmanuel Ramasso, Noureddine Zerhouni, Bernd Weiler

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Safety is one of the most important considerations when buying a new car. While active safety aims at avoiding accidents, passive safety systems such as airbags and seat belts protect the occupant in case of an accident. In addition to legal regulations, organizations like Euro NCAP provide consumers with an independent assessment of the safety performance of cars and drive the development of safety systems in automobile industry. Those ratings are mainly based on injury assessment reference values derived from physical parameters measured in dummies during a car crash test. The components and sub-systems of a safety system are designed to achieve the required restraint performance. Sled tests and other types of tests are then carried out by car makers and their suppliers to confirm the protection level of the safety system. A Knowledge Discovery in Databases (KDD) process is proposed in order to minimize the number of tests. The KDD process is based on the data emerging from sled tests according to Euro NCAP specifications. About 30 parameters of the passive safety systems from different data sources (crash data, dummy protocol) are first analysed together with experts opinions. A procedure is proposed to manage missing data and validated on real data sets. Finally, a procedure is developed to estimate a set of rough initial parameters of the passive system before testing aiming at reducing the number of tests.

Keywords: KDD process, passive safety systems, sled test, dummy injury assessment reference values, frontal impact

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Authors: J. Szpor, K. Witczak, M. Storman, A. Orchel, D. Hodorowicz-Zaniewska, K. Okoń, A. Klimkowska

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Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease. In comparison to fine needle aspiration (FNA), CNB provides more architectural information allowing for the evaluation of prognostic and predictive factors for breast cancer, including histological grade—one of three prognostic factors used to calculate the Nottingham Prognostic Index. Several studies have previously described the concordance rate between CNB and surgical excision specimen in determination of histological grade (HG). The concordance rate previously ascribed to overall grade varies widely across literature, ranging from 59-91%. The aim of this study is to see how the data looks like in material at authors’ institution and are the results as compared to those described in previous literature. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. Both materials were evaluated for the determination of histological grade (scale from 1 to 3). HG was assessed only in core needle biopsies containing at least 10 well preserved HPF with invasive tumor. The degree of concordance between CNB and surgical excision specimen for the determination of tumor grade was assessed by Cohen’s kappa coefficient. The level of agreement between core needle biopsy and surgical resection specimen for overall histologic grading was 73% (113 of 155 cases). CNB correctly predicted the grade of the surgical excision specimen in 21 cases for grade 1 tumors (Kappa coefficient κ = 0.525 95% CI (0.3634; 0.6818), 52 cases for grade 2 (Kappa coefficient κ = 0.5652 95% CI (0.458; 0.667) and 40 cases for stage 3 tumors (Kappa coefficient κ = 0.6154 95% CI (0.4862; 0.7309). The highest level of agreement was observed in grade 3 malignancies. In 9 of 42 (21%) discordant cases, the grade was higher in the CNB than in the surgical excision. This composed 6% of the overall discordance. These results correspond to the noted in the literature, showing that underestimation occurs more frequently than overestimation. This study shows that authors’ institution’s histologic grading of CNBs and surgical excisions shows a fairly good correlation and is consistent with findings in previous reports. Despite the inevitable limitations of CNB, CNB is an effective method for diagnosing breast cancer and managing treatment options. Assessment of tumour grade by CNB is useful for the planning of treatment, so in authors’ opinion it is worthy to implement it in daily practice.

Keywords: breast cancer, concordance, core needle biopsy, histological grade

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

Abstract:

Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan

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Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila, Lamara Abdelhak

Abstract:

Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with postsurgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariable analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature, particularly in surgeries that are more prone to chronicization.

Keywords: post-surgical chronic pain, post-surgical chronic neuropathic pain, regional anesthesia-analgesia techniques, neuropathic pain score DN2, preventive impact

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Authors: Mohamed Ghoz, Hala Alsabeh

Abstract:

Context: Macroscopic Nose Macroneedling (MNM) is a new non-surgical procedure for lifting and tightening the nose. It is a tissue-non-invasive technique that uses a needle to create micro-injuries in the skin. These injuries stimulate the production of collagen and elastin, which results in the tightening and lifting of the skin. Research Aim: The research aim of this study was to investigate the efficacy and safety of MNM for the treatment of nasal deformities. Methodology A total of 100 patients with nasal deformities were included in this study. The patients were randomly assigned to either the MNM group or the control group. The MNM group received a single treatment of MNM, while the control group received no treatment. The patients were evaluated at baseline, 6 months, and 12 months after treatment. Findings: The results of this study showed that MNM was effective in improving the appearance of the nose in patients with nasal deformities. At 6 months after treatment, the patients in the MNM group had significantly improved nasal tip projection, nasal bridge height, and nasal width compared to the patients in the control group. The improvements in nasal appearance were maintained at 12 months after treatment. Theoretical Importance: The findings of this study provide support for the use of MNM as a safe and effective treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities. Data Collection: Data was collected from the patients using a variety of methods, including clinical assessments, photographic assessments, and patient-reported outcome measures. Analysis Procedures: The data was analyzed using a variety of statistical methods, including descriptive statistics, inferential statistics, and meta-analysis. Question Addressed: The research question addressed in this study was whether MNM is an effective and safe treatment for nasal deformities. Conclusion: The findings of this study suggest that MNM is an effective and safe treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities.

Keywords: nose, surgery, tie, suture

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Authors: Michael Scott, Phil Jarrell

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Digitalization seems to be everywhere these days. So if one was to digitalize Functional Safety, what would that require: • Ability to directly use data from intelligent P&IDs / process design in a PHA / LOPA • Ability to directly use data from intelligent P&IDs in the SIS Design to support SIL Verification Calculations, SRS, C&Es, Functional Test Plans • Ability to create Unit Operation / SIF Libraries to radically reduce engineering manhours while ensuring consistency and improving quality of SIS designs • Ability to link data directly from a PHA / LOPA to SIS Designs • Ability to leverage reliability models and SRS details from SIS Designs to automatically program the Safety PLC • Ability to leverage SIS Test Plans to automatically create Safety PLC application logic Test Plans for a virtual FAT • Ability to tie real-time data from Process Historians / CMMS to assumptions in the PHA / LOPA and SIS Designs to generate leading indicators on protection layer health • Ability to flag SIS bad actors for proactive corrective actions prior to a near miss or loss of containment event What if I told you all of this was available today? This paper will highlight how the digital revolution has revolutionized the way Safety Instrumented Systems are designed, configured, operated and maintained.

Keywords: IEC 61511, safety instrumented systems, functional safety, digitalization, IIoT

Procedia PDF Downloads 140

Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

Procedia PDF Downloads 351

Authors: Sibongiseni Thabethe, Ian Korir

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The effective management of spent fuel pool (SFP) safety has been raised as one of the emerging issues to further enhance nuclear installation safety after the Fukushima accident on March 11, 2011. Before then, SFP safety-related issues have been mainly focused on (a) controlling the configuration of the fuel assemblies in the pool with no loss of pool coolants and (b) ensuring adequate pool storage space to prevent fuel criticality owing to chain reactions of the fission products and the ability for neutron absorption to keep the fuel cool. A probabilistic safety (PSA) assessment was performed using the systems analysis program for hands-on integrated reliability evaluations (SAPHIRE) computer code. Event and fault tree analysis was done to develop a PSA model for the Koeberg SFP. We present preliminary PSA results of events that lead to boiling and cause fuel uncovering, resulting in possible fuel damage in the Koeberg SFP.

Keywords: computer code, fuel assemblies, probabilistic risk assessment, spent fuel pool

Procedia PDF Downloads 133

Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

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Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

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Authors: Khair Jadaan, Qasem Alqasem

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School children are vulnerable road user groups and are particularly at high risk calling for the need to improve their safety. Safe Routes to Schools (SRTS) concept is considered as one safety improvement approach that would effectively help improve school children’s safety. This paper aims to determine the best practice SRTS for Jordan based on the international experience attained through extensive and selected literature review falling under the 5 E’s and additionally on information/data collected through a survey performed using an online predesigned questionnaire to investigate the reactions and attitudes of students and their parents towards the proposed SRTS program. Data are analyzed using SPSS and MS software, especially Excel, in addition to some literature reviews inserted in this study. The results represent some recommendations that are strongly believed to help decision makers to develop the current safety conditions of the school routes. The challenges that the implementation of this program would face including COVID-19 protection for teachers and students are addressed.

Keywords: children, COVID-19, Jordan, safety, school, SRTS, 5 E’s

Procedia PDF Downloads 87

Authors: Laura Brennan, Ram Balakumar

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ChatGPT has been developed by Open AI (Nov 2022) as a powerful artificial intelligence (AI) language model which has been designed to produce human-like text from user written prompts. To gain the most from the system, user written prompts must give context specific information. This article aims to give guidance on how to optimise the ChatGPT system in the context of education for otolaryngology. Otolaryngology is a specialist field which sees little time dedicated to providing education to both medical students and doctors. Additionally, otolaryngology trainees have seen a reduction in learning opportunities since the COVID-19 pandemic. In this article we look at these various barriers to medical education in Otolaryngology training and suggest ways that ChatGPT can overcome them and assist in simulation-based training. Examples provide how this can be achieved using the Authors’ experience to further highlight the practicalities. What this article has found is that while ChatGPT cannot replace traditional mentorship and practical surgical experience, it can serve as an invaluable supplementary resource to simulation based medical education in Otolaryngology.

Keywords: artificial intelligence, otolaryngology, surgical training, medical education

Procedia PDF Downloads 121

Authors: Jae-Woo Kim, Kyung-Jung Lee, Hyun-Sik Ahn

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This paper presents a design methodology for the motor driven automotive subsystems with the consideration of the functional safety. There are many such modules in vehicles which use DC/AC motors for an electronic throttle control system, a motor driven power steering, a motor driven seat belt systems and for HVAC systems. The functional safety for the automotive electrical and electronic parts are standardized as ISO 26262, but the development procedure is very complex to be followed. We focus on the functional safe motor controller design process and show the designed motor controller hardware satisfies the required safety integrity level by using metric calculations with the safety mechanism.

Keywords: AUTOSAR, MDPS, Simulink, software component

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Authors: Achim Washington, Reece Clothier, Jose Silva

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System Safety Regulations (SSR) are a central component to the airworthiness certification of Unmanned Aircraft Systems (UAS). There is significant debate on the setting of appropriate SSR for UAS. Putting this debate aside, the challenge lies in how to apply the system safety process to UAS, which lacks the data and operational heritage of conventionally piloted aircraft. The limited knowledge and lack of operational data result in uncertainty in the system safety assessment of UAS. This uncertainty can lead to incorrect compliance findings and the potential certification and operation of UAS that do not meet minimum safety performance requirements. The existing system safety assessment and compliance processes, as used for conventional piloted aviation, do not adequately account for the uncertainty, limiting the suitability of its application to UAS. This paper discusses the challenges of undertaking system safety assessments for UAS and presents current and envisaged research towards addressing these challenges. It aims to highlight the main advantages associated with adopting a risk based framework to the System Safety Performance Requirement (SSPR) compliance process that is capable of taking the uncertainty associated with each of the outputs of the system safety assessment process into consideration. Based on this study, it is made clear that developing a framework tailored to UAS, would allow for a more rational, transparent and systematic approach to decision making. This would reduce the need for conservative assumptions and take the risk posed by each UAS into consideration while determining its state of compliance to the SSR.

Keywords: Part 1309 regulations, risk models, uncertainty, unmanned aircraft systems

Procedia PDF Downloads 156