Search results for: airport emergency plan
Commenced in January 2007
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Paper Count: 2801

Search results for: airport emergency plan

401 Unified Coordinate System Approach for Swarm Search Algorithms in Global Information Deficit Environments

Authors: Rohit Dey, Sailendra Karra

Abstract:

This paper aims at solving the problem of multi-target searching in a Global Positioning System (GPS) denied environment using swarm robots with limited sensing and communication abilities. Typically, existing swarm-based search algorithms rely on the presence of a global coordinate system (vis-à-vis, GPS) that is shared by the entire swarm which, in turn, limits its application in a real-world scenario. This can be attributed to the fact that robots in a swarm need to share information among themselves regarding their location and signal from targets to decide their future course of action but this information is only meaningful when they all share the same coordinate frame. The paper addresses this very issue by eliminating any dependency of a search algorithm on the need of a predetermined global coordinate frame by the unification of the relative coordinate of individual robots when within the communication range, therefore, making the system more robust in real scenarios. Our algorithm assumes that all the robots in the swarm are equipped with range and bearing sensors and have limited sensing range and communication abilities. Initially, every robot maintains their relative coordinate frame and follow Levy walk random exploration until they come in range with other robots. When two or more robots are within communication range, they share sensor information and their location w.r.t. their coordinate frames based on which we unify their coordinate frames. Now they can share information about the areas that were already explored, information about the surroundings, and target signal from their location to make decisions about their future movement based on the search algorithm. During the process of exploration, there can be several small groups of robots having their own coordinate systems but eventually, it is expected for all the robots to be under one global coordinate frame where they can communicate information on the exploration area following swarm search techniques. Using the proposed method, swarm-based search algorithms can work in a real-world scenario without GPS and any initial information about the size and shape of the environment. Initial simulation results show that running our modified-Particle Swarm Optimization (PSO) without global information we can still achieve the desired results that are comparable to basic PSO working with GPS. In the full paper, we plan on doing the comparison study between different strategies to unify the coordinate system and to implement them on other bio-inspired algorithms, to work in GPS denied environment.

Keywords: bio-inspired search algorithms, decentralized control, GPS denied environment, swarm robotics, target searching, unifying coordinate systems

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400 Boussinesq Model for Dam-Break Flow Analysis

Authors: Najibullah M, Soumendra Nath Kuiry

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Dams and reservoirs are perceived for their estimable alms to irrigation, water supply, flood control, electricity generation, etc. which civilize the prosperity and wealth of society across the world. Meantime the dam breach could cause devastating flood that can threat to the human lives and properties. Failures of large dams remain fortunately very seldom events. Nevertheless, a number of occurrences have been recorded in the world, corresponding in an average to one to two failures worldwide every year. Some of those accidents have caused catastrophic consequences. So it is decisive to predict the dam break flow for emergency planning and preparedness, as it poses high risk to life and property. To mitigate the adverse impact of dam break, modeling is necessary to gain a good understanding of the temporal and spatial evolution of the dam-break floods. This study will mainly deal with one-dimensional (1D) dam break modeling. Less commonly used in the hydraulic research community, another possible option for modeling the rapidly varied dam-break flows is the extended Boussinesq equations (BEs), which can describe the dynamics of short waves with a reasonable accuracy. Unlike the Shallow Water Equations (SWEs), the BEs taken into account the wave dispersion and non-hydrostatic pressure distribution. To capture the dam-break oscillations accurately it is very much needed of at least fourth-order accurate numerical scheme to discretize the third-order dispersion terms present in the extended BEs. The scope of this work is therefore to develop an 1D fourth-order accurate in both space and time Boussinesq model for dam-break flow analysis by using finite-volume / finite difference scheme. The spatial discretization of the flux and dispersion terms achieved through a combination of finite-volume and finite difference approximations. The flux term, was solved using a finite-volume discretization whereas the bed source and dispersion term, were discretized using centered finite-difference scheme. Time integration achieved in two stages, namely the third-order Adams Basforth predictor stage and the fourth-order Adams Moulton corrector stage. Implementation of the 1D Boussinesq model done using PYTHON 2.7.5. Evaluation of the performance of the developed model predicted as compared with the volume of fluid (VOF) based commercial model ANSYS-CFX. The developed model is used to analyze the risk of cascading dam failures similar to the Panshet dam failure in 1961 that took place in Pune, India. Nevertheless, this model can be used to predict wave overtopping accurately compared to shallow water models for designing coastal protection structures.

Keywords: Boussinesq equation, Coastal protection, Dam-break flow, One-dimensional model

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399 A Comparative Study on the Development of Webquest and Online Treasure Hunt as Instructional Materials in Teaching Motion in One Dimension for Grade VII Students

Authors: Mark Anthony Burdeos, Kara Ella Catoto, Alraine Pauyon, Elesar Malicoban

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This study sought to develop, validate, and implement the WebQuest and Online Treasure Hunt as instructional materials in teaching Motion in One Dimension for Grade 7 students and to determine its effects on the students’ conceptual learning, performance and attitude towards Physics. In the development stage, several steps were taken, such as the actual planning and developing the WebQuest and Online Treasure Hunt and making the lesson plan and achievement test. The content and the ICT(Information Communications Technology) effect of the developed instructional materials were evaluated by the Content and ICT experts using adapted evaluation forms. During the implementation, pretest and posttest were administered to determine students’ performance, and pre-attitude and post-attitude tests to investigate students’ attitudes towards Physics before and after the WebQuest and Online Treasure Hunt activity. The developed WebQuest and Online Treasure Hunt passed the validation of Content experts and ICT experts. Students acquired more knowledge on Motion in One Dimension and gained a positive attitude towards Physics after the utilization of WebQuest and Online Treasure Hunt, evidenced significantly higher scores in posttest compared to pretest and higher ratings in post-attitude than pre-attitude. The developed WebQuest and Online Treasure Hunt were proven good in quality and effective materials in teaching Motion in One Dimension and developing a positive attitude towards Physics. However, students performed better in the pretest and posttest and rated higher in the pre-attitude and post-attitude tests in the WebQuest than in the Online Treasure Hunt. This study would provide significant learning experiences to the students that would be useful in building their knowledge, in understanding concepts in a most understandable way, in exercising to use their higher-order thinking skills, and in utilizing their capabilities and abilities to relate Physics topics to real-life situations thereby, students can have in-depth learning about Motion in One Dimension. This study would help teachers to enhance the teaching strategies as the two instructional materials provide interesting, engaging, and innovative teaching-learning experiences for the learners, which are helpful in increasing the level of their motivation and participation in learning Physics. In addition, it would provide information as a reference in using technology in the classroom and to determine which of the two instructional materials, WebQuest and Online Treasure Hunt, is suitable for the teaching-learning process in Motion in One Dimension.

Keywords: ICT integration, motion in one dimension, online treasure hunt, Webquest

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398 Participatory Planning of the III Young Sea Meeting: An Experience of the Young Albatroz Collective

Authors: Victor V. Ribeiro, Thais C. Lopes, Rafael A. A. Monteiro

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The Albatroz, Baleia Jubarte, Coral Vivo, Golfinho Rotador and Tamar projects make up the Young Sea Network (YSN), part of the BIOMAR Network, which aims to integrate the environmental youths of the Brazilian coast. For this, three editions of the Young Sea Meeting (YSM) were performed. Seeking to stimulate belonging, self-knowledge, participation, autonomy and youth protagonism, the Albatroz Project hosted the III YSM, in Bertioga (SP), in April 2019 and aimed to collectively plan the meeting. Five pillars of Environmental Education were used: identity, community, dialogue, power to act and happiness, the OCA Method and the Young Educates Young; Young Chooses Young; and One Generation Learns from the Other principals. In December 2018, still in the II YSM, the participatory planning of the III YSM began. Two "representatives" of each group were voluntarily elected to facilitate joint decisions, propose, receive and communicate demands from their groups and coordinators. The Young Albatroz Collective (YAC) facilitated the organization process as a whole. The purpose of the meeting was collectively constructed, answering the following question: "What is the YSM for?". Only two of the five pairs of representatives responded. There was difficulty gathering the young people in each group, because it was the end of the year, with people traveling. Thus, due to the short planning time, the YAC built a pre-programming to be validated by the other groups, defining as the objective of the meeting the strengthening of youth protagonism within the YSN. In the planning process, the YAC held 20 meetings, with 60 hours of face-to-face work, in three months, and two technical visits to the headquarters of the III YSM. The participatory dynamics of consultation, when it occurred, required up to two weeks, evidencing the limits of participation. The project coordinations stated that they were not being included in the process by their young people. There is a need to work more to be able to aloud the participation, developing skills and understanding about its principles. This training must take place in an articulated way between the network, implying the important role of the five projects in jointly developing and implementing educator processes with this objective in a national dimension, but without forgetting the specificities of each young group. Finally, it is worth highlighting the great potential of the III YSM by stimulating the exercise of leading environmental youth in more than 50 young people from Brazilian coast, linked to the YSN, stimulating the learning and mobilization of young people in favor of coastal and marine conservation.

Keywords: Marine Conservation, Environmental Education, Youth, Participation, Planning

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397 Logistical Optimization of Nuclear Waste Flows during Decommissioning

Authors: G. Dottavio, M. F. Andrade, F. Renard, V. Cheutet, A.-L. Ladier, S. Vercraene, P. Hoang, S. Briet, R. Dachicourt, Y. Baizet

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An important number of technological equipment and high-skilled workers over long periods of time have to be mobilized during nuclear decommissioning processes. The related operations generate complex flows of waste and high inventory levels, associated to information flows of heterogeneous types. Taking into account that more than 10 decommissioning operations are on-going in France and about 50 are expected toward 2025: A big challenge is addressed today. The management of decommissioning and dismantling of nuclear installations represents an important part of the nuclear-based energy lifecycle, since it has an environmental impact as well as an important influence on the electricity cost and therefore the price for end-users. Bringing new technologies and new solutions into decommissioning methodologies is thus mandatory to improve the quality, cost and delay efficiency of these operations. The purpose of our project is to improve decommissioning management efficiency by developing a decision-support framework dedicated to plan nuclear facility decommissioning operations and to optimize waste evacuation by means of a logistic approach. The target is to create an easy-to-handle tool capable of i) predicting waste flows and proposing the best decommissioning logistics scenario and ii) managing information during all the steps of the process and following the progress: planning, resources, delays, authorizations, saturation zones, waste volume, etc. In this article we present our results from waste nuclear flows simulation during decommissioning process, including discrete-event simulation supported by FLEXSIM 3-D software. This approach was successfully tested and our works confirms its ability to improve this type of industrial process by identifying the critical points of the chain and optimizing it by identifying improvement actions. This type of simulation, executed before the start of the process operations on the basis of a first conception, allow ‘what-if’ process evaluation and help to ensure quality of the process in an uncertain context. The simulation of nuclear waste flows before evacuation from the site will help reducing the cost and duration of the decommissioning process by optimizing the planning and the use of resources, transitional storage and expensive radioactive waste containers. Additional benefits are expected for the governance system of the waste evacuation since it will enable a shared responsibility of the waste flows.

Keywords: nuclear decommissioning, logistical optimization, decision-support framework, waste management

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396 Use and Effects of Kanban Board from the Aspects of Brothers Furniture Limited

Authors: Kazi Rizvan, Yamin Rekhu

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Due to high competitiveness in industries throughout the world, every industry is trying hard to utilize all their resources to keep their productivity as high as possible. Many tools have been being used to ensure smoother flow of an operation, to balance tasks, to maintain proper schedules for tasks, to maintain proper sequence for tasks, to reduce unproductive time. All of these tools are used to augment productivity within an industry. Kanban board is one of them and of the many important tools of lean production system. Kanban Board is a visual depiction of the status of tasks. Kanban board shows the actual status of the tasks. It conveys the progress and issues of tasks as well. Using Kanban Board, tasks can be distributed among workers and operation targets can be visually represented to them. In this paper, an example of Kanban board from the aspects of Brothers Furniture Limited was taken and how the Kanban board system was implemented, how the board was designed and how it was made easily perceivable for the less literate or illiterate workers. The Kanban board was designed for the packing section of Brothers Furniture Limited. It was implemented for the purpose of representing the tasks flow to the workers and to mitigate the time that was wasted while the workers remained wondering about what task they should start after they finish one. Kanban board subsumed seven columns and there was a column for comments where if any problem occurred during working on the tasks. Kanban board was helpful for the workers as the board showed the urgency of the tasks. It was also helpful for the store section as they could understand which products and how much of them could be delivered to store at any certain time. Kanban board had all the information centralized which is why the work-flow got paced up and idle time was minimized. Regardless of many workers being illiterate or less literate, Kanban board was still explicable for the workers as the Kanban cards were colored. Since the significance of colors can be conveniently interpretable to them, colored cards helped a great deal in that matter. Hence, the illiterate or less literate workers didn’t have to spend time wondering about the significance of the cards. Even when the workers weren’t told the significance of the colored cards, they could grow a feeling about their meaning as colors can trigger anyone’s mind to perceive the situation. As a result, the board elucidated the workers about what board required them to do, when to do and what to do next. Kanban board alleviated excessive time between tasks by setting day-plan for targeted tasks and it also reduced time during tasks as the workers were acknowledged of forthcoming tasks for a day. Being very specific to the tasks, Kanban board helped the workers become more focused on their tasks helped them do their job with more perfection. As a result, The Kanban board helped achieve a 8.75% increase in productivity than the productivity before the Kanban board was implemented.

Keywords: color, Kanban Board, Lean Tool, literacy, packing, productivity

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395 Accounting for Downtime Effects in Resilience-Based Highway Network Restoration Scheduling

Authors: Zhenyu Zhang, Hsi-Hsien Wei

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Highway networks play a vital role in post-disaster recovery for disaster-damaged areas. Damaged bridges in such networks can disrupt the recovery activities by impeding the transportation of people, cargo, and reconstruction resources. Therefore, rapid restoration of damaged bridges is of paramount importance to long-term disaster recovery. In the post-disaster recovery phase, the key to restoration scheduling for a highway network is prioritization of bridge-repair tasks. Resilience is widely used as a measure of the ability to recover with which a network can return to its pre-disaster level of functionality. In practice, highways will be temporarily blocked during the downtime of bridge restoration, leading to the decrease of highway-network functionality. The failure to take downtime effects into account can lead to overestimation of network resilience. Additionally, post-disaster recovery of highway networks is generally divided into emergency bridge repair (EBR) in the response phase and long-term bridge repair (LBR) in the recovery phase, and both of EBR and LBR are different in terms of restoration objectives, restoration duration, budget, etc. Distinguish these two phases are important to precisely quantify highway network resilience and generate suitable restoration schedules for highway networks in the recovery phase. To address the above issues, this study proposes a novel resilience quantification method for the optimization of long-term bridge repair schedules (LBRS) taking into account the impact of EBR activities and restoration downtime on a highway network’s functionality. A time-dependent integer program with recursive functions is formulated for optimally scheduling LBR activities. Moreover, since uncertainty always exists in the LBRS problem, this paper extends the optimization model from the deterministic case to the stochastic case. A hybrid genetic algorithm that integrates a heuristic approach into a traditional genetic algorithm to accelerate the evolution process is developed. The proposed methods are tested using data from the 2008 Wenchuan earthquake, based on a regional highway network in Sichuan, China, consisting of 168 highway bridges on 36 highways connecting 25 cities/towns. The results show that, in this case, neglecting the bridge restoration downtime can lead to approximately 15% overestimation of highway network resilience. Moreover, accounting for the impact of EBR on network functionality can help to generate a more specific and reasonable LBRS. The theoretical and practical values are as follows. First, the proposed network recovery curve contributes to comprehensive quantification of highway network resilience by accounting for the impact of both restoration downtime and EBR activities on the recovery curves. Moreover, this study can improve the highway network resilience from the organizational dimension by providing bridge managers with optimal LBR strategies.

Keywords: disaster management, highway network, long-term bridge repair schedule, resilience, restoration downtime

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394 Small Community’s Proactive Thinking to Move from Zero to 100 Percent Water Reuse

Authors: Raj Chavan

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The City of Jal serves a population of approximately 3,500 people, including 2,100 permanent inhabitants and 1,400 oil and gas sector workers and RV park occupants. Over the past three years, Jal's population has increased by about 70 percent, mostly due to the oil and gas industry. The City anticipates that the population will exceed 4,200 by 2020, necessitating the construction of a new wastewater treatment plant (WWTP) because the old plant (aerated lagoon system) cannot accommodate such rapid population expansion without major renovations or replacement. Adhering to discharge permit restrictions has been challenging due to aging infrastructure and equipment replacement needs, as well as increasing nutrient loading to the wastewater collecting system from the additional oil and gas residents' recreational vehicles. The WWTP has not been able to maintain permit discharge standards for total nitrogen of less than 20 mg N/L and other characteristics in recent years. Based on discussions with the state's environmental department, it is likely that the future permit renewal would impose stricter conditions. Given its location in the dry, western part of the country, the City must rely on its meager groundwater supplies and scant annual precipitation. The city's groundwater supplies will be depleted sooner than predicted due to rising demand from the growing population for drinking, leisure, and other industrial uses (fracking). The sole type of reuse the city was engaging in (recreational reuse for a golf course) had to be put on hold because of an effluent water compliance issue. As of right now, all treated effluent is evaporated. The city's long-term goal is to become a zero-waste community that sends all of its treated wastewater effluent either to the golf course, Jal Lake, or the oil and gas industry for reuse. Hydraulic fracturing uses a lot of water, but if the oil and gas industry can use recycled water, it can reduce its impact on freshwater supplies. The City's goal of 100% reuse has been delayed by the difficulties of meeting the constraints of the regular discharge permit due to the large rise in influent loads and the aging infrastructure. The City of Jal plans to build a new WWTP that can keep up with the city's rapid population increase due to the oil and gas industry. Several treatment methods were considered in light of the City's needs and its long-term goals, but MBR was ultimately chosen recommended since it meets all of the permit's requirements while also providing 100 percent beneficial reuse. This talk will lay out the plan for the city to reach its goal of 100 percent reuse, as well as the various avenues for funding the small community that have been considered.

Keywords: membrane bioreactor, nitrogent, reuse, small community

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393 The Supply Chain Operation Reference Model Adaptation in the Developing Countries: An Empirical Study on the Egyptian Automotive Sector

Authors: Alaa Osman, Sara Elgazzar, Breksal Elmiligy

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The Supply Chain Operation Reference (SCOR) model is considered one of the most widely implemented supply chain performance measurement systems (SCPMSs). Several studies have been proposed on the SCOR model adaptation in developed countries context; while there is a limited availability of previous work on the SCPMSs application generally and the SCOR model specifically in developing nations. This paper presents a research agenda on the SCOR model adaptation in the developing countries. It aims at investigating the challenges of adapting the SCOR model to manage and measure supply chain performance in developing countries. The research will exemplify the system in the Egyptian automotive sector to gain a comprehensive understanding of how the application of the SCOR model can affect the performance of automotive companies in Egypt, with a necessary understanding of challenges and obstacles faced the adaptation of the model in the Egyptian supply chain context. An empirical study was conducted on the Egyptian automotive sector in three companies considering three different classes: BMW, Hyundai and Brilliance. First, in-depth interviews were carried out to gain an insight into the implementation and the relevance of the concepts of supply chain management and performance measurement in the Egyptian automotive industry. Then, a formal survey was designed based on the SCOR model five main processes (plan, source, make, deliver and return) and best practices to investigate the challenges and obstacles faced the adaptation of the SCOR model in the Egyptian automotive supply chain. Finally, based on the survey results, the appropriate best practices for each process were identified in order to overcome the SCOR model adaptation challenges. The results showed that the implementation of the SCOR model faced different challenges and unavailability of the required enablers. The survey highlighted the low integration of end-to-end supply chain, lacks commitment for the innovative ideas and technologies, financial constraints and lack of practical training and support as the main challenges faced the adaptation of the SCOR model in the Egyptian automotive supply chain. The research provides an original contribution to knowledge by proposing a procedure to identify challenges encountered during the process of SCOR model adoption which can pave a way for further research in the area of SCPMSs adaptation, particularly in the developing countries. The research can help managers and organizations to identify obstacles and difficulties of the SCOR model adaptation, subsequently this can facilitate measuring the improved performance or changes in the organizational performance.

Keywords: automotive sector, developing countries, SCOR model, supply chain performance

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392 Analyzing the Impact of Local and International Artists in Creating Cultural Identity through Public Art: Case Study of Chicago Public Policies

Authors: Kaesha M. Freyaldenhoven

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Chicago is a city in the United States whose cultural identity is largely shaped by public art pieces. Quintessential public works created by internationally renown artists – such as Anish Kapoor’s Cloud Gate in Millennium Park and 'The Picasso' in Daley Plaza – have historically contributed to developing a shared sense of community. In 2017, the city implemented a policy titled 50x50 Neighborhood Arts Project under the Chicago Public Art Plan. The policy promotes investments in contemporary public art to elevate neighborhood cultural assets and create a sense of place. Exclusively community-based artists were commissioned to accomplish the mission of the policy. Administrators felt only local artists would be capable of capturing the true essence of a neighborhood through art. This paper discusses the relationship between the public art and the culture of its respective neighborhood through close examination of aesthetic formal properties and social significance. Research compares the role of international artists with the role of local artists in cultivating the identity of a city through site-specific artworks in Chicago. Methodology unites theoretical research on understanding art and its function in the public space with empirical research on Chicago-based works. Theoretical frameworks provide an art historical foundation to explore the manner in which physical properties convey meaning through the work itself and its placement in an urban setting. Empirical research that examines policy documentation and press announcements released by the Department of Cultural Affairs and Special Events investigates project selection processes pertaining to the artists and neighborhoods. Ethnographies and interviews of individuals from diverse social segments in contemporary Chicago society measure impacts of the works on respective populations. Findings demonstrate works created by local artists activate neighborhoods and inculcate a sense of pride among community residents. Works created by international artists garner widespread media attention that frames the city’s cultural identity across temporal and geographic zones. This research can be utilized to inform future cultural policies pertaining to the commission of public art.

Keywords: Chicago, cultural policy, public art, urban art

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391 Challenges and Pitfalls of Nutrition Labeling Policy in Iran: A Policy Analysis

Authors: Sareh Edalati, Nasrin Omidvar, Arezoo Haghighian Roudsari, Delaram Ghodsi, Azizollaah Zargaran

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Background and aim: Improving consumer’s food choices and providing a healthy food environment by governments is one of the essential approaches to prevent non-communicable diseases and to fulfill the sustainable development goals (SDGs). The present study aimed to provide an analysis of the nutrition labeling policy as one of the main components of the healthy food environment to provide learning lessons for the country and other low and middle-income countries. Methods: Data were collected by reviewing documents and conducting semi-structured interviews with stakeholders. Respondents were selected through purposive and snowball sampling and continued until data saturation. MAXQDA software was used to manage data analysis. A deductive content analysis was used by applying the Kingdon multiple streams and the policy triangulation framework. Results: Iran is the first country in the Middle East and North Africa region, which has implemented nutrition traffic light labeling. The implementation process has gone through two phases: voluntary and mandatory. In the voluntary labeling, volunteer food manufacturers who chose to have the labels would receive an honorary logo and this helped to reduce the food-sector resistance gradually. After this phase, the traffic light labeling became mandatory. Despite these efforts, there has been poor involvement of media for public awareness and sensitization. Also, the inconsistency of nutrition traffic light colors which are based on food standard guidelines, lack of consistency between nutrition traffic light colors, the healthy/unhealthy nature of some food products such as olive oil and diet cola and the absence of a comprehensive evaluation plan were among the pitfalls and policy challenges identified. Conclusions: Strengthening the governance through improving collaboration within health and non-health sectors for implementation, more transparency of truthfulness of nutrition traffic labeling initiating with real ingredients, and applying international and local scientific evidence or any further revision of the program is recommended. Also, developing public awareness campaigns and revising school curriculums to improve students’ skills on nutrition label applications should be highly emphasized.

Keywords: nutrition labeling, policy analysis, food environment, Iran

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390 Rare Case of Three Metachronous Cancers Occurring over the Period of Three Years: Clinical Importance of Investigating Neoplastic Growth Discovered during Follow-Up

Authors: Marin Kanarev, Delyan Stoyanov, Ivanna Popova, Nadezhda Petrova

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Thanks to increased survival rates in patients bearing oncological malignancies due to recent developments in anti-cancer therapies and diagnostic techniques, observation of clinical cases of metachronous cancers is more common and can provide more in-depth knowledge of their development and, as a result, help clinicians apply suitable therapy. This unusual case of three metachronous tumors presented the opportunity to follow their occurrence, progression, and treatment thoroughly. A 77-year-old male presented with carcinoma ventriculi of the pylorus region, which was surgically removed via upper subtotal stomach resection, a lateral antecolical gastro-enteroanastomosis, and a subsequent Braun anastomosis. An EOX chemotherapy regimen followed. A CT scan four months later showed no indication of recurrence or dissemination. The same scan, performed as a part of the follow-up plan two years later, showed an indication of neoplastic growth in the urinary bladder. After the patient had been directed to a urologist, the suspicion was confirmed, and the growth was histologically diagnosed as a carcinoma of the urinary bladder. An immunohistochemistry test showed an expression of PDL1 of less than 5%, which resulted in treatment with GemCis chemotherapy regimen that led to full remission. Two years and seven months after the first surgery, a CT scan showed again that the two carcinomas were gone. However, four months later, elevated tumor markers prompted a PET/CT scan, which showed data indicative of recurring neoplastic growth in the region of the stomach cardia. It was diagnosed as an adenocarcinoma infiltrating the esophagus. Preoperative chemotherapy with the ECF regimen was completed in four courses, and a CT scan showed no progression of the disease. In less than a month after therapy, the patient underwent laparotomy, debridement, gastrectomy, and a subsequent mechanical terminal-lateral esophago-jejunoanasthomosis. It was verified that the tumor originated from metastasis from the carcinoma ventriculi, which was located in the pylorus. In conclusion, this case report highlights the importance of patient follow-up and studying recurring neoplastic growth. Despite the absence of symptoms, clinicians should maintain a high level of suspicion when evaluating the patient data and choosing the most suitable therapy.

Keywords: carcinoma, follow-up, metachronous, neoplastic growth, recurrence

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389 Spatial Analysis of the Socio-Environmental Vulnerability in Medium-Sized Cities: Case Study of Municipality of Caraguatatuba SP-Brazil

Authors: Katia C. Bortoletto, Maria Isabel C. de Freitas, Rodrigo B. N. de Oliveira

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The environmental vulnerability studies are essential for priority actions to the reduction of disasters risk. The aim of this study is to analyze the socio-environmental vulnerability obtained through a Census survey, followed by both a statistical analysis (PCA/SPSS/IBM) and a spatial analysis by GIS (ArcGis/ESRI), taking as a case study the Municipality of Caraguatatuba-SP, Brazil. In the municipal development plan analysis the emphasis was given to the Special Zone of Social Interest (ZEIS), the Urban Expansion Zone (ZEU) and the Environmental Protection Zone (ZPA). For the mapping of the social and environmental vulnerabilities of the study area the exposure of people (criticality) and of the place (support capacity) facing disaster risk were obtained from the 2010 Census from the Brazilian Institute of Geography and Statistics (IBGE). Considering the criticality, the variables of greater influence were related to literate persons responsible for the household and literate persons with 5 or more years of age; persons with 60 years or more of age and income of the person responsible for the household. In the Support Capacity analysis, the predominant influence was on the good household infrastructure in districts with low population density and also the presence of neighborhoods with little urban infrastructure and inadequate housing. The results of the comparative analysis show that the areas with high and very high vulnerability classes cover the classes of the ZEIS and the ZPA, whose zoning includes: Areas occupied by low-income population, presence of children and young people, irregular occupations and land suitable to urbanization but underutilized. The presence of zones of urban sprawl (ZEU) in areas of high to very high socio-environmental vulnerability reflects the inadequate use of the urban land in relation to the spatial distribution of the population and the territorial infrastructure, which favors the increase of disaster risk. It can be concluded that the study allowed observing the convergence between the vulnerability analysis and the classified areas in urban zoning. The occupation of areas unsuitable for housing due to its characteristics of risk was confirmed, thus concluding that the methodologies applied are agile instruments to subsidize actions to the reduction disasters risk.

Keywords: socio-environmental vulnerability, urban zoning, reduction disasters risk, methodologies

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388 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines

Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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387 Stochastic Nuisance Flood Risk for Coastal Areas

Authors: Eva L. Suarez, Daniel E. Meeroff, Yan Yong

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The U.S. Federal Emergency Management Agency (FEMA) developed flood maps based on experts’ experience and estimates of the probability of flooding. Current flood-risk models evaluate flood risk with regional and subjective measures without impact from torrential rain and nuisance flooding at the neighborhood level. Nuisance flooding occurs in small areas in the community, where a few streets or blocks are routinely impacted. This type of flooding event occurs when torrential rainstorm combined with high tide and sea level rise temporarily exceeds a given threshold. In South Florida, this threshold is 1.7 ft above Mean Higher High Water (MHHW). The National Weather Service defines torrential rain as rain deposition at a rate greater than 0.3-inches per hour or three inches in a single day. Data from the Florida Climate Center, 1970 to 2020, shows 371 events with more than 3-inches of rain in a day in 612 months. The purpose of this research is to develop a data-driven method to determine comprehensive analytical damage-avoidance criteria that account for nuisance flood events at the single-family home level. The method developed uses the Failure Mode and Effect Analysis (FMEA) method from the American Society of Quality (ASQ) to estimate the Damage Avoidance (DA) preparation for a 1-day 100-year storm. The Consequence of Nuisance Flooding (CoNF) is estimated from community mitigation efforts to prevent nuisance flooding damage. The Probability of Nuisance Flooding (PoNF) is derived from the frequency and duration of torrential rainfall causing delays and community disruptions to daily transportation, human illnesses, and property damage. Urbanization and population changes are related to the U.S. Census Bureau's annual population estimates. Data collected by the United States Department of Agriculture (USDA) Natural Resources Conservation Service’s National Resources Inventory (NRI) and locally by the South Florida Water Management District (SFWMD) track the development and land use/land cover changes with time. The intent is to include temporal trends in population density growth and the impact on land development. Results from this investigation provide the risk of nuisance flooding as a function of CoNF and PoNF for coastal areas of South Florida. The data-based criterion provides awareness to local municipalities on their flood-risk assessment and gives insight into flood management actions and watershed development.

Keywords: flood risk, nuisance flooding, urban flooding, FMEA

Procedia PDF Downloads 65
386 Availability Analysis of Process Management in the Equipment Maintenance and Repair Implementation

Authors: Onur Ozveri, Korkut Karabag, Cagri Keles

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It is an important issue that the occurring of production downtime and repair costs when machines fail in the machine intensive production industries. In the case of failure of more than one machine at the same time, which machines will have the priority to repair, how to determine the optimal repair time should be allotted for this machines and how to plan the resources needed to repair are the key issues. In recent years, Business Process Management (BPM) technique, bring effective solutions to different problems in business. The main feature of this technique is that it can improve the way the job done by examining in detail the works of interest. In the industries, maintenance and repair works are operating as a process and when a breakdown occurs, it is known that the repair work is carried out in a series of process. Maintenance main-process and repair sub-process are evaluated with process management technique, so it is thought that structure could bring a solution. For this reason, in an international manufacturing company, this issue discussed and has tried to develop a proposal for a solution. The purpose of this study is the implementation of maintenance and repair works which is integrated with process management technique and at the end of implementation, analyzing the maintenance related parameters like quality, cost, time, safety and spare part. The international firm that carried out the application operates in a free region in Turkey and its core business area is producing original equipment technologies, vehicle electrical construction, electronics, safety and thermal systems for the world's leading light and heavy vehicle manufacturers. In the firm primarily, a project team has been established. The team dealt with the current maintenance process again, and it has been revised again by the process management techniques. Repair process which is sub-process of maintenance process has been discussed again. In the improved processes, the ABC equipment classification technique was used to decide which machine or machines will be given priority in case of failure. This technique is a prioritization method of malfunctioned machine based on the effect of the production, product quality, maintenance costs and job security. Improved maintenance and repair processes have been implemented in the company for three months, and the obtained data were compared with the previous year data. In conclusion, breakdown maintenance was found to occur in a shorter time, with lower cost and lower spare parts inventory.

Keywords: ABC equipment classification, business process management (BPM), maintenance, repair performance

Procedia PDF Downloads 166
385 A Cooperative, Autonomous, and Continuously Operating Drone System Offered to Railway and Bridge Industry: The Business Model Behind

Authors: Paolo Guzzini, Emad Samuel M. Ebeid

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Bridges and Railways are critical infrastructures. Ensuring safety for transports using such assets is a primary goal as it directly impacts the lives of people. By the way, improving safety could require increased investments in O&M, and therefore optimizing resource usage for asset maintenance becomes crucial. Drones4Safety (D4S), a European project funded under the H2020 Research and Innovation Action (RIA) program, aims to increase the safety of the European civil transport by building a system that relies on 3 main pillars: • Drones operating autonomously in swarm mode; • Drones able to recharge themselves using inductive phenomena produced by transmission lines in the nearby of bridges and railways assets to be inspected; • Data acquired that are analyzed with AI-empowered algorithms for defect detection This paper describes the business model behind this disruptive project. The Business Model is structured in 2 parts: • The first part is focused on the design of the business model Canvas, to explain the value provided by the Drone4safety project; • The second part aims at defining a detailed financial analysis, with the target of calculating the IRR (Internal Return rate) and the NPV (Net Present Value) of the investment in a 7 years plan (2 years to run the project + 5 years post-implementation). As to the financial analysis 2 different points of view are assumed: • Point of view of the Drones4safety company in charge of designing, producing, and selling the new system; • Point of view of the Utility company that will adopt the new system in its O&M practices; Assuming the point of view of the Drones4safety company 3 scenarios were considered: • Selling the drones > revenues will be produced by the drones’ sales; • Renting the drones > revenues will be produced by the rental of the drones (with a time-based model); • Selling the data acquisition service > revenues will be produced by the sales of pictures acquired by drones; Assuming the point of view of a utility adopting the D4S system, a 4th scenario was analyzed taking into account the decremental costs related to the change of operation and maintenance practices. The paper will show, for both companies, what are the key parameters affecting most of the business model and which are the sustainable scenarios.

Keywords: a swarm of drones, AI, bridges, railways, drones4safety company, utility companies

Procedia PDF Downloads 111
384 Articles, Delimitation of Speech and Perception

Authors: Nataliya L. Ogurechnikova

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The paper aims to clarify the function of articles in the English speech and specify their place and role in the English language, taking into account the use of articles for delimitation of speech. A focus of the paper is the use of the definite and the indefinite articles with different types of noun phrases which comprise either one noun with or without attributes, such as the King, the Queen, the Lion, the Unicorn, a dimple, a smile, a new language, an unknown dialect, or several nouns with or without attributes, such as the King and Queen of Hearts, the Lion and Unicorn, a dimple or smile, a completely isolated language or dialect. It is stated that the function of delimitation is related to perception: the number of speech units in a text correlates with the way the speaker perceives and segments the denotation. The two following combinations of words the house and garden and the house and the garden contain different numbers of speech units, one and two respectively, and reveal two different perception modes which correspond to the use of the definite article in the examples given. Thus, the function of delimitation is twofold, it is related to perception and cognition, on the one hand, and, on the other hand, to grammar, if the subject of grammar is the structure of speech. Analysis of speech units in the paper is not limited by noun phrases and is amplified by discussion of peripheral phenomena which are nevertheless important because they enable to qualify articles as a syntactic phenomenon whereas they are not infrequently described in terms of noun morphology. With this regard attention is given to the history of linguistic studies, specifically to the description of English articles by Niels Haislund, a disciple of Otto Jespersen. A discrepancy is noted between the initial plan of Jespersen who intended to describe articles as a syntactic phenomenon in ‘A Modern English Grammar on Historical Principles’ and the interpretation of articles in terms of noun morphology, finally given by Haislund. Another issue of the paper is correlation between description and denotation, being a traditional aspect of linguistic studies focused on articles. An overview of relevant studies, given in the paper, goes back to the works of G. Frege, which gave rise to a series of scientific works where the meaning of articles was described within the scope of logical semantics. Correlation between denotation and description is treated in the paper as the meaning of article, i.e. a component in its semantic structure, which differs from the function of delimitation and is similar to the meaning of other quantifiers. The paper further explains why the relation between description and denotation, i.e. the meaning of English article, is irrelevant for noun morphology and has nothing to do with nominal categories of the English language.

Keywords: delimitation of speech, denotation, description, perception, speech units, syntax

Procedia PDF Downloads 218
383 Molecular Defects Underlying Genital Ambiguity in Egyptian Patients: A Systematic Review

Authors: Y. Z. Gad

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Disorders of Sex Development (DSD) are defined as congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. The DSD are relatively prevalent in Egypt. In spite of that, the relative rarity of the individual disease types or their molecular pathologies frequently resulted in reporting on single or few cases. This augmented the challenging nature of phenotype-genotype correlation in this disease group and its utilization in the management of such medical emergency. Through critical assessment of the published DSD reports, the current review aims at analyzing the clinical characteristics of the various DSD forms in relation to the underlying molecular pathologies. A systematic literature search was done in Pubmed, using relevant keywords (Egypt versus DSD, genital ambiguity or ambiguous genitalia, the old terms of 'intersex, hermaphroditism and pseudohermaphroditism', and a list of the DSD entities and their related genes). The search yielded 24 reports of molecular data in Egyptian patients presenting with ambiguous genitalia. However, only 21 publications fulfilled the criteria of inclusion of detailed clinical descriptions and definitive molecular diagnoses of individual patients. Curation of the data yielded a total of 53 cases that were ascertained from 40 families. Fifty-one patients present with ambiguous genitalia only while 2 had multiple congenital anomalies. Parental consanguinity was noted in 60% of cases. Sex of rearing at initial presentation was female in 75% and 60% in 46,XY and 46,XX DSD cases, respectively. The external genital phenotype in 2/3 of the 46,XY DSD cases showed moderate undermasculinization [Quigley scores 3 & 4] and 1/3 had severe presentations [scores 5 & 6]. For 46,XX subjects, 1 had severe virilization of the external genitalia while 8 had moderate phenotype. Hormonal data were inconclusive or contradictory to final diagnosis in a forth of cases. Collectively, 31 families [31/40, 77.5%] with 46,XY DSD had molecular defects in the genes, 5 alpha reductase 2 (SRD5A2) [12/31], 17 beta-hydroxysteroid dehydrogenase 3 [8/31], androgen receptor [7/31], Steroidogenic factor 1 [2/31], luteinizing hormone receptor [1/31], and fibroblast growth factor receptor 1 [1/31]. In a multiethnic study, 9 families afflicted with 46,XX DSD due to 11 beta hydroxylase (CYP11B1) deficiency were documented. Two recurrent mutations, G34R and N160D, in SRD5A2 were present, respectively, in 42 and 17% of cases. Similarly, 4 recurrent mutations resulted in 89% of the CYP11B1 presentations. In conclusion, this analysis highlights the importance of autosomal recessive inheritance and inbreeding among DSD presentations, the importance of founder effect in at least 2 disorders, the difficulties in relating the genotype with the indeterminate genital phenotype, the under-reporting of some DSD subtypes, and the notion that the reported mutational profiles among Egyptian DSD cases are relatively different from those reported in other ethnic groups.

Keywords: disorders of sex development, genital ambiguity, mutation, molecular diagnosis, Egypt

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382 Investigate the Competencies Required for Sustainable Entrepreneurship Development in Agricultural Higher Education

Authors: Ehsan Moradi, Parisa Paikhaste, Amir Alam Beigi, Seyedeh Somayeh Bathaei

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The need for entrepreneurial sustainability is as important as the entrepreneurship category itself. By transferring competencies in a sustainable entrepreneurship framework, entrepreneurship education can make a significant contribution to the effectiveness of businesses, especially for start-up entrepreneurs. This study analyzes the essential competencies of students in the development of sustainable entrepreneurship. It is an applied causal study in terms of nature and field in terms of data collection. The main purpose of this research project is to study and explain the dimensions of sustainability entrepreneurship competencies among agricultural students. The statistical population consists of 730 junior and senior undergraduate students of the Campus of Agriculture and Natural Resources, University of Tehran. The sample size was determined to be 120 using the Cochran's formula, and the convenience sampling method was used. Face validity, structure validity, and diagnostic methods were used to evaluate the validity of the research tool and Cronbach's alpha and composite reliability to evaluate its reliability. Structural equation modeling (SEM) was used by the confirmatory factor analysis (CFA) method to prepare a measurement model for data processing. The results showed that seven key dimensions play a role in shaping sustainable entrepreneurial development competencies: systems thinking competence (STC), embracing diversity and interdisciplinary (EDI), foresighted thinking (FTC), normative competence (NC), action competence (AC), interpersonal competence (IC), and strategic management competence (SMC). It was found that acquiring skills in SMC by creating the ability to plan to achieve sustainable entrepreneurship in students through the relevant mechanisms can improve entrepreneurship in students by adopting a sustainability attitude. While increasing students' analytical ability in the field of social and environmental needs and challenges and emphasizing curriculum updates, AC should pay more attention to the relationship between the curriculum and its content in the form of entrepreneurship culture promotion programs. In the field of EDI, it was found that the success of entrepreneurs in terms of sustainability and business sustainability of start-up entrepreneurs depends on their interdisciplinary thinking. It was also found that STC plays an important role in explaining the relationship between sustainability and entrepreneurship. Therefore, focusing on these competencies in agricultural education to train start-up entrepreneurs can lead to sustainable entrepreneurship in the agricultural higher education system.

Keywords: sustainable entrepreneurship, entrepreneurship education, competency, agricultural higher education

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381 A Discussion on Urban Planning Methods after Globalization within the Context of Anticipatory Systems

Authors: Ceylan Sozer, Ece Ceylan Baba

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The reforms and changes that began with industrialization in cities and continued with globalization in 1980’s, created many changes in urban environments. City centers which are desolated due to industrialization, began to get crowded with globalization and became the heart of technology, commerce and social activities. While the immediate and intense alterations are planned around rigorous visions in developed countries, several urban areas where the processes were underestimated and not taken precaution faced with irrevocable situations. When the effects of the globalization in the cities are examined, it is seen that there are some anticipatory system plans in the cities about the future problems. Several cities such as New York, London and Tokyo have planned to resolve probable future problems in a systematic scheme to decrease possible side effects during globalization. The decisions in urban planning and their applications are the main points in terms of sustainability and livability in such mega-cities. This article examines the effects of globalization on urban planning through 3 mega cities and the applications. When the applications of urban plannings of the three mega-cities are investigated, it is seen that the city plans are generated under light of past experiences and predictions of a certain future. In urban planning, past and present experiences of a city should have been examined and then future projections could be predicted together with current world dynamics by a systematic way. In this study, methods used in urban planning will be discussed and ‘Anticipatory System’ model will be explained and relations with global-urban planning will be discussed. The concept of ‘anticipation’ is a phenomenon that means creating foresights and predictions about the future by combining past, present and future within an action plan. The main distinctive feature that separates anticipatory systems from other systems is the combination of past, present and future and concluding with an act. Urban plans that consist of various parameters and interactions together are identified as ‘live’ and they have systematic integrities. Urban planning with an anticipatory system might be alive and can foresight some ‘side effects’ in design processes. After globalization, cities became more complex and should be designed within an anticipatory system model. These cities can be more livable and can have sustainable urban conditions for today and future.In this study, urban planning of Istanbul city is going to be analyzed with comparisons of New York, Tokyo and London city plans in terms of anticipatory system models. The lack of a system in İstanbul and its side effects will be discussed. When past and present actions in urban planning are approached through an anticipatory system, it can give more accurate and sustainable results in the future.

Keywords: globalization, urban planning, anticipatory system, New York, London, Tokyo, Istanbul

Procedia PDF Downloads 122
380 Experimental Investigation of Cutting Forces and Temperature in Bone Drilling

Authors: Vishwanath Mali, Hemant Warhatkar, Raju Pawade

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Drilling of bone has been always challenging for surgeons due to the adverse effect it may impart to bone tissues. Force has to be applied manually by the surgeon while performing conventional bone drilling which may lead to permanent death of bone tissues and nerves. During bone drilling the temperature of the bone tissues increases to higher values above 47 ⁰C that causes thermal osteonecrosis resulting into screw loosening and subsequent implant failures. An attempt has been made here to study the input drilling parameters and surgical drill bit geometry affecting bone health during bone drilling. A One Factor At a Time (OFAT) method is used to plan the experiments. Input drilling parameters studied include spindle speed and feed rate. The drill bit geometry parameter studied include point angle and helix angle. The output variables are drilling thrust force and bone temperature. The experiments were conducted on goat femur bone at room temperature 30 ⁰C. For measurement of thrust forces KISTLER cutting force dynamometer Type 9257BA was used. For continuous data acquisition of temperature NI LabVIEW software was used. Fixture was made on RPT machine for holding the bone specimen while performing drilling operation. Bone specimen were preserved in deep freezer (LABTOP make) under -40 ⁰C. In case of drilling parameters, it is observed that at constant feed rate when spindle speed increases, thrust force as well as temperature decreases and at constant spindle speed when feed rate increases thrust force as well as temperature increases. The effect of drill bit geometry shows that at constant helix angle when point angle increases thrust force as well as temperature increases and at constant point angle when helix angle increase thrust force as well as temperature decreases. Hence it is concluded that as the thrust force increases temperature increases. In case of drilling parameter, the lowest thrust force and temperature i.e. 35.55 N and 36.04 ⁰C respectively were recorded at spindle speed 2000 rpm and feed rate 0.04 mm/rev. In case of drill bit geometry parameter, the lowest thrust force and temperature i.e. 40.81 N and 34 ⁰C respectively were recorded at point angle 70⁰ and helix angle 25⁰ Hence to avoid thermal necrosis of bone it is recommended to use higher spindle speed, lower feed rate, low point angle and high helix angle. The hard nature of cortical bone contributes to a greater rise in temperature whereas a considerable drop in temperature is observed during cancellous bone drilling.

Keywords: bone drilling, helix angle, point angle, thrust force, temperature, thermal necrosis

Procedia PDF Downloads 283
379 Trauma Scores and Outcome Prediction After Chest Trauma

Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

Procedia PDF Downloads 389
378 Investigating the Relationship between Job Satisfaction, Role Identity, and Turnover Intention for Nurses in Outpatient Department

Authors: Su Hui Tsai, Weir Sen Lin, Rhay Hung Weng

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There are numerous outpatient departments at hospitals with enormous amounts of outpatients. Although the work of outpatient nursing staff does not include the ward, emergency and critical care units that involve patient life-threatening conditions, the work is cumbersome and requires facing and dealing with a large number of outpatients in a short period of time. Therefore, nursing staff often do not feel satisfied with their work and cannot identify with their professional role, leading to intentions to leave their job. Thus, the main purpose of this study is to explore the correlation between the job satisfaction and role identity of nursing staff with turnover intention. This research was conducted using a questionnaire, and the subjects were outpatient nursing staff in three regional hospitals in Southern Taiwan. A total of 175 questionnaires were distributed, and 166 valid questionnaires were returned. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The influence of role identity and job satisfaction on nursing staff’s turnover intention was analyzed by descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. Results showed that 'role identity' had significant differences in different types of marriages. Job satisfaction of 'grasp of environment' had significant differences in different levels of education. Job satisfaction of 'professional growth' and 'shifts and days off' showed significant differences in different types of marriages. 'Role identity' and 'job satisfaction' were negatively correlated with turnover intention respectively. Job satisfaction of 'salary and benefits' and 'grasp of environment' were significant predictors of role identity. The higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. Job satisfaction of 'patient and family interaction' were significant predictors of turnover intention. The lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. This study found that outpatient nursing staff had the lowest satisfaction towards salary structure. It is recommended that bonuses, promotion opportunities and other incentives be established to increase the role identity of outpatient nursing staff. The results showed that the higher the job satisfaction of 'salary and benefits' and 'grasp of environment', the higher the role identity. It is recommended that regular evaluations be conducted to reward nursing staff with excellent service and invite nursing staff to share their work experiences and thoughts, to enhance nursing staff’s expectation and identification of their occupational role, as well as instilling the concept of organizational service and organizational expectations of emotional display. The results showed that the lower the job satisfaction of 'patient and family interaction', the higher the turnover intention. It is recommended that interpersonal communication and workplace violence prevention educational training courses be organized to enhance the communication and interaction of nursing staff with patients and their families.

Keywords: outpatient, job satisfaction, turnover, intention

Procedia PDF Downloads 125
377 Just a Heads Up: Approach to Head Shape Abnormalities

Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

Procedia PDF Downloads 70
376 Challenges for Nurses in the Medical Profession to Bring Their Expertise to the School Setting: Focusing on Supporting the School Life of Children with Complex Medical Care Needs

Authors: Ikuko Tomomatsu, Beverley Anne Yamamoto

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Background: There has been an increase in the number of Children with Complex Medical Care Needs (CCMCN) living outside hospital settings in Japan. Most CCMCNs require someone to provide or support them in the provision of care and to respond in the case of an emergency in their everyday lives, including in school settings. One or two yoga teachers qualified within the teacher-training system to work in the health rooms in schools, are assigned to schools in Japan based on enrollment numbers, and are responsible for all students' health. CCMCN requires individualized support, which the Yogo teachers cannot adequately provide. Clinically trained nurses have increasingly been allocated to mainstream schools to provide medical care support for the CCMCN as a new kind of school nurse, but the supply has fallen far short of demand. In 2021, the Act on Support for Children with Complex Medical Care Needs and their Families was passed, requiring local governments to assign school nurses to schools to support CCMCN. The study aimed to understand these nurses' experiences (job description, rewards, challenges) allocated to schools to provide medical care for CCMCN. The study also aimed to explore what professional development looks like for nurses working in schools. Methods: Using a semi-structured interview technique, we interviewed sixteen nurses currently providing care to CCMCN in mainstream schools. Using an interview guide, they were asked about their work, satisfaction, challenges and concerns, thoughts on professionalism, and the educational and training environment. The interviews were audio-recorded and transcribed. We conducted a thematic analysis of the data. Results: The main concerns and problems were not directly related to medical care delivery but to communication with the children, the teachers' understanding of educational policy, and the principal's philosophy. Unlike medical institutions, where treatment is the priority, most children do not need treatment in schools. Even those needing medical care do not need interventions for most of the day. In this environment, the nurses interviewed reported that it is important to understand the school situation and the teachers' philosophies when providing medical care. One of the main challenges is knowing what to do when not providing care, especially if requests from school staff have nothing to do with their professional skills. Conclusion: Through the analysis of concerns and challenges faced by the nurses, the process of providing medical care in a school setting as a health care provider was discussed as follows. Each nurse contemplates the methods and implications of safely implementing medical care in schools. This was considered a process of situating the implementation of medical care by the nurses in the context of education. This requires that the nurses develop new skills and knowledge, which some nurses find stimulating while others find challenging.

Keywords: school nurse, children with complex medical care needs, professionalization, mainstream school

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375 Nature of Cities: Ontological Dimension of the Urban

Authors: Ana Cristina García-Luna Romero

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This document seeks to reflect on the urban project from its conceptual identity root. In the first instance, a proposal is made on how the city project is sustained from the conceptual root, from the logos: it opens a way to assimilate the imagination; what we imagine becomes a reality. In this way, firstly, the need to use language as a vehicle for transmitting the stories that sustain us as humanity can be deemed as an important social factor that enables us to social behavior. Secondly, the need to attend to the written language as a mechanism of power, as a means to consolidate a dominant ideology or a political position, is raised; as it served to carry out the modernization project, it is therefore addressed differences between the real and the literate city. Thus, the consolidated urban-architectural project is based on logos, the project, and planning. Considering the importance of materiality and its relation to subjective well-being contextualized from a socio-urban approach, we question ourselves into how we can look at something that is doubtful. From a philosophy perspective, the truth is considered to be nothing more than a matter of correspondence between the observer and the observed. To understand beyond the relative of the gaze, it is necessary to expose different perspectives since it depends on the understanding of what is observed and how it is critically analyzed. Therefore, the analysis of materiality, as a political field, takes a proposal based on this research in the principles in transgenesis: principle of communication, representativeness, security, health, malleability, availability of potentiality or development, conservation, sustainability, economy, harmony, stability, accessibility, justice, legibility, significance, consistency, joint responsibility, connectivity, beauty, among others. The (urban) human being acts because he wants to live in a certain way: in a community, in a fair way, with opportunity for development, with the possibility of managing the environment according to their needs, etc. In order to comply with this principle, it is necessary to design strategies from the principles in transgenesis, which must be named, defined, understood, and socialized by the urban being, the companies, and from themselves. In this way, the technical status of the city in the neoliberal present determines extraordinary conditions for reflecting on an almost emergency scenario created by the impact of cities that, far from being limited to resilient proposals, must aim at the reflection of the urban process that the present social model has generated. Therefore, can we rethink the paradigm of the perception of life quality in the current neoliberal model in the production of the character of public space related to the practices of being urban. What we are trying to do within this document is to build a framework to study under what logic the practices of the social system that make sense of the public space are developed, what the implications of the phenomena of the inscription of action and materialization (and its results over political action between the social and the technical system) are and finally, how we can improve the quality of life of individuals from the urban space.

Keywords: cities, nature, society, urban quality of life

Procedia PDF Downloads 103
374 Identifying the Needs for Renewal of Urban Water Infrastructure Systems: Analysis of Material, Age, Types and Areas: Case Study of Linköping in Sweden

Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

Abstract:

Urban water infrastructure is crucial for efficient and reliable water supply in growing cities. With the growth of cities, the need for maintenance and renewal of these systems increases but often goes unfulfilled due to a variety of reasons, such as limited funding, political priorities, or lack of public awareness. Neglecting the renewal needs of these systems can lead to frequent malfunctions and reduced quality and reliability of water supply, as well as increased costs and health and environmental hazards. It is important for cities to prioritize investment in water infrastructure and develop long-term plans to address renewal needs. Drawing general conclusions about the rate of renewal of urban water infrastructure systems at an international or national level can be challenging due to the influence of local management decisions. In many countries, the responsibility for water infrastructure management lies with the municipal authorities, who are responsible for making decisions about the allocation of resources for repair, maintenance, and renewal. These decisions can vary widely based on factors such as local finances, political priorities, and public perception of the importance of water infrastructure. As a result, it is difficult to make generalizations about the rate of renewal across different countries or regions. In Sweden, the situation is not different, and the information from Svenskt Vatten indicates that the rate of renewal varies across municipalities and can be insufficient, leading to a buildup of maintenance and renewal needs. This study aims to examine the adequacy of the rate of renewal of urban water infrastructure in Linköping case city in Sweden. Using a case study framework, the study will assess the current status of the urban water system and the need for renewal. The study will also consider the role of factors such as proper identification processes, limited funding, competing for political priorities, and local management decisions in contributing to insufficient renewal. The study investigates the following questions: (1) What is the current status of water and sewerage networks in terms of length, age distribution, and material composition, estimated total water leakage in the network per year, damages, leaks, and outages occur per year, both overall and by district? (2) What are the main causes of these damages, leaks, and interruptions, and how are they related to lack of maintenance and renewal? (3) What is the current status of renewal work for the water and sewerage networks, including the renewal rate and changes over time, recent renewal material composition, and the budget allocation for renewal and emergency repairs? (4) What factors influence the need for renewal and what conditions should be considered in the assessment? The findings of the study provide insights into the challenges facing urban water infrastructure and identify strategies for improving the rate of renewal to ensure a reliable and sustainable water supply.

Keywords: case study, infrastructure, management, renewal need, Sweden

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373 Evaluation of the Quality of Education Offered to Students with Special Needs in Public Schools in the City of Bauru, Brazil

Authors: V. L. M. F. Capellini, A. P. P. M. Maturana, N. C. M. Brondino, M. B. C. L. B. M. Peixoto, A. J. Broughton

Abstract:

A paradigm shift is a process. The process of implementing inclusive education, a system constructed to support all learners, requires planning, identification, experimentation, and evaluation. In this vein, the purpose of the present study was to evaluate the capacity of one Brazilian state school systems to provide special education students with a quality inclusive education. This study originated at the behest of concerned families of students with special needs who filed complaints with the Municipality of Bauru, São Paulo. These families claimed, 1) children with learning differences and educational needs had not been identified for services, and 2) those who had been identified had not received sufficient specialized educational assistance (SEA) in schools across the City of Bauru. Hence, the Office of Civil Rights for the state of São Paulo (Ministério Público de São Paulo) summoned the local higher education institution, UNESP, to design a research study to investigate these allegations. In this exploratory study, descriptive data were gathered from all elementary and middle schools including 58 state schools and 17 city schools, for a total of 75 schools overall. Data collection consisted of each school's annual strategic action plan, surveys and interviews with all school stakeholders to determine their perceptions of the inclusive education available to students with Special Education Needs (SEN). The data were collected as one of four stages in a larger study which also included field observations of a focal students' experience and a continuing education course for all teachers and administrators in both state and city schools. For the purposes of this study, the researchers were interested in understanding the perceptions of school staff, parents, and students across all schools. Therefore, documents and surveys from 75 schools were analyzed for adherence to federal legislation guaranteeing students with SEN the right to special education assistance within the regular school setting. Results shows that while some schools recognized the legal rights of SEN students to receive special education, the plans to actually deliver services were absent. In conclusion, the results of this study revealed both school staff and families have insufficient planning and accessibility resources, and the schools have inadequate infrastructure for full-time support to SEN students, i.e., structures and systems to support the identification of SEN and delivery of services within schools of Bauru, SP. Having identified the areas of need, the city is now prepared to take next steps in the process toward preparing all schools to be inclusive.

Keywords: inclusion, school, special education, special needs

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372 Comparative Study of Various Treatment Positioning Technique: A Site Specific Study-CA. Breast

Authors: Kamal Kaushik, Dandpani Epili, Ajay G. V., Ashutosh, S. Pradhaan

Abstract:

Introduction: Radiation therapy has come a long way over a period of decades, from 2-dimensional radiotherapy to intensity-modulated radiation therapy (IMRT) or VMAT. For advanced radiation therapy, we need better patient position reproducibility to deliver precise and quality treatment, which raises the need for better image guidance technologies for precise patient positioning. This study presents a two tattoo simulation with roll correction technique which is comparable to other advanced patient positioning techniques. Objective: This is a site-specific study is aimed to perform a comparison between various treatment positioning techniques used for the treatment of patients of Ca- Breast undergoing radiotherapy. In this study, we are comparing 5 different positioning methods used for the treatment of ca-breast, namely i) Vacloc with 3 tattoos, ii) Breast board with three tattoos, iii) Thermoplastic cast with three fiducials, iv) Breast board with a thermoplastic mask with 3 tattoo, v) Breast board with 2 tattoos – A roll correction method. Methods and material: All in one (AIO) solution immobilization was used in all patient positioning techniques for immobilization. The process of two tattoo simulations includes positioning of the patient with the help of a thoracic-abdomen wedge, armrest & knee rest. After proper patient positioning, we mark two tattoos on the treatment side of the patient. After positioning, place fiducials as per the clinical borders markers (1) sternum notch (lower border of clavicle head) (2) 2 cm below from contralateral breast (3) midline between 1 & 2 markers (4) mid axillary on the same axis of 3 markers (Marker 3 & 4 should be on the same axis). During plan implementation, a roll depth correction is applied as per the anterior and lateral positioning tattoos, followed by the shifts required for the Isocentre position. The shifts are then verified by SSD on the patient surface followed by radiographic verification using Cone Beam Computed Tomography (CBCT). Results: When all the five positioning techniques were compared all together, the produced shifts in Vertical, Longitudinal and lateral directions are as follows. The observations clearly suggest that the Longitudinal average shifts in two tattoo roll correction techniques are less than every other patient positioning technique. Vertical and lateral Shifts are also comparable to other modern positioning techniques. Concluded: The two tattoo simulation with roll correction technique provides us better patient setup with a technique that can be implemented easily in most of the radiotherapy centers across the developing nations where 3D verification techniques are not available along with delivery units as the shifts observed are quite minimal and are comparable to those with Vacloc and modern amenities.

Keywords: Ca. breast, breast board, roll correction technique, CBCT

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