Search results for: emergency logistics
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1355

Search results for: emergency logistics

215 Enhancing the Performance of Automatic Logistic Centers by Optimizing the Assignment of Material Flows to Workstations and Flow Racks

Authors: Sharon Hovav, Ilya Levner, Oren Nahum, Istvan Szabo

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In modern large-scale logistic centers (e.g., big automated warehouses), complex logistic operations performed by human staff (pickers) need to be coordinated with the operations of automated facilities (robots, conveyors, cranes, lifts, flow racks, etc.). The efficiency of advanced logistic centers strongly depends on optimizing picking technologies in synch with the facility/product layout, as well as on optimal distribution of material flows (products) in the system. The challenge is to develop a mathematical operations research (OR) tool that will optimize system cost-effectiveness. In this work, we propose a model that describes an automatic logistic center consisting of a set of workstations located at several galleries (floors), with each station containing a known number of flow racks. The requirements of each product and the working capacity of stations served by a given set of workers (pickers) are assumed as predetermined. The goal of the model is to maximize system efficiency. The proposed model includes two echelons. The first is the setting of the (optimal) number of workstations needed to create the total processing/logistic system, subject to picker capacities. The second echelon deals with the assignment of the products to the workstations and flow racks, aimed to achieve maximal throughputs of picked products over the entire system given picker capacities and budget constraints. The solutions to the problems at the two echelons interact to balance the overall load in the flow racks and maximize overall efficiency. We have developed an operations research model within each echelon. In the first echelon, the problem of calculating the optimal number of workstations is formulated as a non-standard bin-packing problem with capacity constraints for each bin. The problem arising in the second echelon is presented as a constrained product-workstation-flow rack assignment problem with non-standard mini-max criteria in which the workload maximum is calculated across all workstations in the center and the exterior minimum is calculated across all possible product-workstation-flow rack assignments. The OR problems arising in each echelon are proved to be NP-hard. Consequently, we find and develop heuristic and approximation solution algorithms based on exploiting and improving local optimums. The LC model considered in this work is highly dynamic and is recalculated periodically based on updated demand forecasts that reflect market trends, technological changes, seasonality, and the introduction of new items. The suggested two-echelon approach and the min-max balancing scheme are shown to work effectively on illustrative examples and real-life logistic data.

Keywords: logistics center, product-workstation, assignment, maximum performance, load balancing, fast algorithm

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214 Evaluation of Natural Gums: Gum Tragacanth, Xanthan Gum, Guar Gum and Gum Acacia as Potential Hemostatic Agents

Authors: Himanshu Kushwah, Nidhi Sandal, Meenakshi K. Chauhan, Gaurav Mittal

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Excessive bleeding is the primary factor of avoidable death in both civilian trauma centers as well as the military battlefield. Hundreds of Indian troops die every year due to blood loss caused by combat-related injuries. These deaths are avoidable and can be prevented to a large extent by making available a suitable hemostatic dressing in an emergency medical kit. In this study, natural gums were evaluated as potential hemostatic agents in combination with calcium gluconate. The study compares the hemostatic activity of Gum Tragacanth (GT), Guar Gum (GG), Xanthan Gum (XG) and Gum Acacia (GA) by carrying out different in-vitro and in-vivo studies. In-vitro studies were performed using the Lee-White method and Eustrek method, which includes the visual and microscopic analysis of blood clotting. MTT assay was also performed using human lymphocytes to check the cytotoxicity of the gums. The in-vivo studies were performed in Sprague Dawley rats using tail bleeding assay to evaluate the hemostatic efficacy of the gums and compared with a commercially available hemostatic sponge, Surgispon. Erythrocyte agglutination test was also performed to check the interaction between blood cells and the natural gums. Other parameters like blood loss, adherence strength of the developed hemostatic dressing material incorporating these gums, re-bleeding, and survival of the animals were also studied. The data obtained from the MTT assay showed that Guar gum, Gum Tragacanth, and Gum Acacia were not significantly cytotoxic, but substantial cytotoxicity was observed in Xanthan gum samples at high concentrations. Also, Xanthan gum took the least time with its minimum concentration to achieve hemostasis, (approximately 50 seconds at 3mg concentration). Gum Tragacanth also showed efficient hemostasis at a concentration of 35mg at the same time, but the other two gums tested were not able to clot the blood in significantly less time. A sponge dressing made of Tragacanth gum was found to be more efficient in achieving hemostasis and showed better practical applicability among all the gums studied and also when compared to the commercially available product, Surgispon, thus making it a potentially better alternative.

Keywords: cytotoxicity, hemostasis, natural gums, sponge

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213 Nurse-Led Codes: Practical Application in the Emergency Department during a Global Pandemic

Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

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212 Construction of a Dynamic Model of Cerebral Blood Circulation for Future Integrated Control of Brain State

Authors: Tomohiko Utsuki

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Currently, brain resuscitation becomes increasingly important due to revising various clinical guidelines pertinent to emergency care. In brain resuscitation, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) is required for stabilizing physiological state of brain, and is described as the essential treatment points in many guidelines of disorder and/or disease such as brain injury, stroke, and encephalopathy. Thus, an integrated control system of BT, ICP, and CBF will greatly contribute to alleviating the burden on medical staff and improving treatment effect in brain resuscitation. In order to develop such a control system, models related to BT, ICP, and CBF are required for control simulation, because trial and error experiments using patients are not ethically allowed. A static model of cerebral blood circulation from intracranial arteries and vertebral artery to jugular veins has already constructed and verified. However, it is impossible to represent the pooling of blood in blood vessels, which is one cause of cerebral hypertension in this model. And, it is also impossible to represent the pulsing motion of blood vessels caused by blood pressure change which can have an affect on the change of cerebral tissue pressure. Thus, a dynamic model of cerebral blood circulation is constructed in consideration of the elasticity of the blood vessel and the inertia of the blood vessel wall. The constructed dynamic model was numerically analyzed using the normal data, in which each arterial blood flow in cerebral blood circulation, the distribution of blood pressure in the Circle of Willis, and the change of blood pressure along blood flow were calculated for verifying against physiological knowledge. As the result, because each calculated numerical value falling within the generally known normal range, this model has no problem in representing at least the normal physiological state of the brain. It is the next task to verify the accuracy of the present model in the case of disease or disorder. Currently, the construction of a migration model of extracellular fluid and a model of heat transfer in cerebral tissue are in progress for making them parts of an integrated model of brain physiological state, which is necessary for developing an future integrated control system of BT, ICP and CBF. The present model is applicable to constructing the integrated model representing at least the normal condition of brain physiological state by uniting with such models.

Keywords: dynamic model, cerebral blood circulation, brain resuscitation, automatic control

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211 Hydrodynamic and Water Quality Modelling to Support Alternative Fuels Maritime Operations Incident Planning & Impact Assessments

Authors: Chow Jeng Hei, Pavel Tkalich, Low Kai Sheng Bryan

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Due to the growing demand for sustainability in the maritime industry, there has been a significant increase in focus on alternative fuels such as biofuels, liquefied natural gas (LNG), hydrogen, methanol and ammonia to reduce the carbon footprint of vessels. Alternative fuels offer efficient transportability and significantly reduce carbon dioxide emissions, a critical factor in combating global warming. In an era where the world is determined to tackle climate change, the utilization of methanol is projected to witness a consistent rise in demand, even during downturns in the oil and gas industry. Since 2022, there has been an increase in methanol loading and discharging operations for industrial use in Singapore. These operations were conducted across various storage tank terminals at Jurong Island of varying capacities, which are also used to store alternative fuels for bunkering requirements. The key objective of this research is to support the green shipping industries in the transformation to new fuels such as methanol and ammonia, especially in evolving the capability to inform risk assessment and management of spills. In the unlikely event of accidental spills, a highly reliable forecasting system must be in place to provide mitigation measures and ahead planning. The outcomes of this research would lead to an enhanced metocean prediction capability and, together with advanced sensing, will continuously build up a robust digital twin of the bunkering operating environment. Outputs from the developments will contribute to management strategies for alternative marine fuel spills, including best practices, safety challenges and crisis management. The outputs can also benefit key port operators and the various bunkering, petrochemicals, shipping, protection and indemnity, and emergency response sectors. The forecasted datasets provide a forecast of the expected atmosphere and hydrodynamic conditions prior to bunkering exercises, enabling a better understanding of the metocean conditions ahead and allowing for more refined spill incident management planning

Keywords: clean fuels, hydrodynamics, coastal engineering, impact assessments

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210 Against the Idea of Public Power as Free Will

Authors: Donato Vese

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According to the common interpretation, in a legal system, public powers are established by law. Exceptions are admitted in an emergency or particular relationship with public power. However, we currently agree that law allows public administration a margin of decision, even in the case of non-discretionary acts. Hence, the administrative decision not exclusively established by law becomes the rule in the ordinary state of things, non-only in state of exception. This paper aims to analyze and discuss different ideas on discretionary power on the Rule of Law and Rechtsstaat. Observing the legal literature in Europe and Nord and South America, discretionary power can be described as follow: it could be considered a margin that law accords to the executive power for political decisions or a choice between different interpretations of vague legal previsions. In essence, this explanation admits for the executive a decision not established by law or anyhow not exclusively established by law. This means that the discretionary power of public administration integrates the law. However, integrating law does not mean to decide according to the law, but it means to integrate law with a decision involving public power. Consequently, discretionary power is essentially free will. In this perspective, also the Rule of Law and the Rechtsstaat are notions explained differently. Recently, we can observe how the European notion of Rechtsstaat is founded on the formal validity of the law; therefore, for this notion, public authority’s decisions not regulated by law represent a problem. Thus, different systems of law integration have been proposed in legal literature, such as values, democracy, reasonableness, and so on. This paper aims to verify how, looking at those integration clauses from a logical viewpoint, integration based on the recourse to the legal system itself does not resolve the problem. The aforementioned integration clauses are legal rules that require hard work to explain the correct meaning of the law; in particular, they introduce dangerous criteria in favor of the political majority. A different notion of public power can be proposed. This notion includes two main features: (a) sovereignty belongs to persons and not the state, and (b) fundamental rights are not grounded but recognized by Constitutions. Hence, public power is a system based on fundamental rights. According to this approach, it can also be defined as the notion of public interest as concrete maximization of fundamental rights enjoyments. Like this, integration of the law, vague or subject to several interpretations, must be done by referring to the system of fundamental individual rights. We can think, for instance, to fundamental rights that are right in an objective view but not legal because not established by law.

Keywords: administrative discretion, free will, fundamental rights, public power, sovereignty

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209 Hypocalcaemia Inducing Heart Failure: A Rare Presentation

Authors: A. Kherraf, M. Bouziane, L. Azzouzi, R. Habbal

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Introduction: Hypocalcaemia is a rare cause of heart failure. We report the clinical case of a young patient with reversible dilated cardiomyopathy secondary to hypocalcaemia in the context of hyperparathyroidism. Clinical case: We report the clinical case of a 23-year-old patient with a history of thyroidectomy for papillary thyroid carcinoma 3 years previously, who presented to the emergency room with a progressive onset dyspnea and edema of the lower limbs. Clinical examination showed hypotension at 90/70 mmHg, tachycardia at 102 bpm, and edema of the lower limbs. The ECG showed a regular sinus rhythm with a prolonged corrected QT interval to 520ms. The chest x-ray showed cardiomegaly. Echocardiography revealed dilated cardiomyopathy with biventricular dysfunction and a left ventricular ejection fraction of 45%, as well as moderate mitral insufficiency by restriction of the posterior mitral leaflet, moderate tricuspid insufficiency, and a dilated inferior vena cava with a pulmonary arterial pressure estimated at 46 mmHg. Blood tests revealed severe hypocalcemia at 38 mg / l with normal albumin and thyroxine levels, as well as hyperphosphatemia and increased TSH. The patient received calcium intake and vitamin D supplementation and was treated with beta blockers, ACE inhibitors, and diuretics with good progress and progressive normalization of cardiac function. Discussion: The cardiovascular manifestations of hypocalcaemia usually appear with deeply low serum calcium levels. This can lead to hypotension, arrhythmias, ventricular fibrillation, prolonged QT interval, or even heart failure. Heart failure is a rare and serious complication of hypocalcemia but most often characterized by complete normalization of myocardial function after treatment. The etiology of the hypocalcaemia, in this case, was probably related to accidental parathyroid removal during thyroidectomy. This is why careful monitoring of calcium levels is recommended after surgery. Conclusion: Hypocalcemic heart failure is rare but reversible heart disease. Systematic monitoring of serum calcium should be performed in all patients after thyroid surgery to avoid any complications related to hypoparathyroidism.

Keywords: hypocalcemia, heart failure, thyroid surgery, hypoparathyroidism

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208 Activities for Increasing Childhood Vaccination Coverage of the Refugee and Migrant Population, Greece, European Program PHILOS, 2017

Authors: C. Silvestros, K. Mellou, T. Georgakopoulou, A. Koustenis, E. Kokkinou, C. Botsi, A. Terzidis

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'PHILOS – Emergency health response to refugee crisis' is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP) funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. One of the main objectives of the program is the immunization coverage of the target – population to assure the prevention of vaccine-preventable diseases. The program foresees vaccination needs assessment of children hosted at camps at the mainland and implementation of interventions to cover the vaccination gaps in co-operation with the Ministry of Health. The National Immunization Advisory Committee in Greece recommended that MMR (Measles, Mumps, and Rubella), PCV (Pneumococcal conjugate vaccine) and HEXA (diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b) vaccines should be performed in priority. Recording was completed at 24 camps (May - June 2017); 3381 children (0-18 years) were recorded. The median number of children hosted at each camp was 95 (range: 5-553). For 68% of the children, the WHO vaccination booklet was available. 44%, 48.5% and 61% of the children were vaccinated with at least one dose of PCV, HEXA, and MMR, respectively. The proportion of vaccinated children for the three vaccines mentioned above is significantly lower for the remaining doses; PCV (second dose 8%, third dose 1.3%), HEXA (second dose 13%, third dose 2.7%, forth dose 0.1%) and MMR (second dose 23%). None of the 37 (10 from Afghanistan, 3 from Bangladesh, 23 from Pakistan, 1 from Syria) recorded unaccompanied children did not have a WHO vaccination booklet and were considered unvaccinated. There is no differentiation in vaccination coverage among different ethnicities. Massive catch up vaccination was performed at 4 camps, and 671 vaccinations were performed (245 PCV, 307 HEXA, and 119 MMR). Similar interventions are planned for all camps of the country. Recording reveled gaps in vaccination coverage of the population, mainly because of the mobility of the population, the influx of refugees- which is still ongoing- and new births. Mass vaccination campaigns are considered vital in order to increase vaccination coverage, and continuous efforts are needed in order all children living at the camps to have full access to the National Childhood Immunization Program.

Keywords: vaccine preventable, refugee–migrants camps, vaccination coverage, PCV, MMR, HEXA

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207 Orthopedic Trauma in Newborn Babies

Authors: Joanna Maj, Awais Hussain, Lyndsey Vu, Catherine Roxas

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Background: Bone injuries in babies are common conditions that arise during delivery. Fractures of the clavicle, humerus, femur, and skull are the most common neonatal bone injuries sustained from labor and delivery. During operative deliveries, zealous tractions, ineffective delivery techniques, improper uterine incision, and inadequate relaxation of the uterus can lead to bone fractures in the newborn. Neonatal anatomy is unique. Just as children are not mini-adults, newborns are not mini children. A newborn’s anatomy and physiology are significantly different from a pediatric patient's. In this paper, we describe common orthopedic trauma in newborn babies. We provide a comprehensive overview of the different types of bone injuries in newborns. We hypothesize that the rate of bone fractures sustained at birth is higher in cases of operative deliveries. Methods: Relevant literature was selected by using the PubMed database. Search terms included orthopedic conditions in newborns, neonatal anatomy, and bone fractures in neonates during operative deliveries. Inclusion criteria included age, gender, race, type of bone injury and progression of bone injury. Exclusion criteria were limited in the medical history of cases reviewed and comorbidities. Results: This review finds that a clavicle fracture is the most common type of neonatal orthopedic injury sustained at birth in both operative and non-operative deliveries. We confirm the hypothesis that infants born via operative deliveries have a significantly higher rate of bone fractures than non-cesarean section deliveries. Conclusion: Newborn babies born via operative deliveries have a higher rate of bone fractures of the clavicle, humerus, and femur. A clavicle bone fracture in newborns is most common during emergency operative deliveries in new mothers. We conclude that infants born via an operative delivery sustained more bone injuries than infants born via non-cesarean section deliveries.

Keywords: clavicle fracture, humerus fracture, neonates, newborn orthopedics, orthopedic surgery, pediatrics, orthopedic trauma, orthopedic trauma during delivery, cesarean section, obstetrics, neonatal anatomy, neonatal fractures, operative deliveries, labor and delivery, bone injuries in neonates

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206 Exploring the Potential of Modular Housing Designs for the Emergency Housing Need in Türkiye after the February Earthquake in 2023

Authors: Hailemikael Negussie, Sebla Arın Ensarioğlu

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In February 2023 Southeastern Türkiye and Northwestern Syria were hit by two consecutive earthquakes with high magnitude leaving thousands dead and thousands more homeless. The housing crisis in the affected areas has resulted in the need for a fast and qualified solution. There are a number of solutions, one of which is the use of modular designs to rebuild the cities that have been affected. Modular designs are prefabricated building components that can be quickly and efficiently assembled on-site, making them ideal to build structures with faster speed and higher quality. These structures are flexible, adaptable, and can be customized to meet the specific needs of the inhabitants, in addition to being more energy-efficient and sustainable. The prefabricated nature also assures that the quality of the products can be easily controlled. The reason for the collapse of most of the buildings during the earthquakes was found out to be the lack of quality during the construction stage. Using modular designs allows a higher control over the quality of the construction materials being used. The use of modular designs for a project of this scale presents some challenges, including the high upfront cost to design and manufacture components. However, if implemented correctly, modular designs can offer an effective and efficient solution to the urgent housing needs. The aim of this paper is to explore the potential of modular housing for mid- and long-term earthquake-resistant housing needs in the affected disaster zones after the earthquakes of February 2023. In the scope of this paper the adaptability of modular, prefabricated housing designs for the post-disaster environment, the advantages and disadvantages of this system will be examined. Elements such as; the current conditions of the region where the destruction happened, climatic data, topographic factors will be examined. Additionally, the paper will examine; examples of similar local and international modular post-earthquake housing projects. The region is projected to enter a rapid reconstruction phase in the following periods. Therefore, this paper will present a proposal for a system that can be used to produce safe and healthy urbanization policies without causing new aggrievements while meeting the housing needs of the people in the affected regions.

Keywords: post-disaster housing, earthquake-resistant design, modular design, housing, Türkiye

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205 The Development of Documentary Filmmaking in Early Independent India

Authors: Camille Deprez

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This paper proposes to present research findings of an ongoing Hong Kong government-funded project on ‘The Documentary Film in India (1948-1975)’ (GRF 1240314), for which an extensive research fieldwork has been carried out in various archives in India. This project investigates the role and significance of the Indian documentary film sector from the inauguration of the state-sponsored Films Division one year after independence in 1948 until the declaration of a ‘State of Emergency’ in 1975. The documentary film production of this first period of national independence was characterised by increasing formal experimentation and analytical social and political enquiry, and by a complex, mixed structure of state-sponsored monopoly and free-market operation. However, that production remains significantly under-researched. What were the main production, distribution and exhibition strategies over this period? What were the recurrent themes and stylistic features of the films produced? In the new context of national independence (in which the State considered film as means of mass persuasion), consolidation of the commercial film, and the emergence of television and art cinema, what role did official, professional and creative factors play in the development of the documentary film sector? What were the impact of such films and the challenges faced by the documentary film in India? Based upon the crossed-analysis of primary written research documents, interviews and relevant films, this study interweaves empirical study of the sector's financing, production, distribution and exhibition strategies, as well as the films' content and form, with the larger historical context of India over the period from 1948 to 1975. Whilst most of the films made within the sector explored social issues, they were rarely able to do so from an overtly critical perspective. However, this paper proposes to analyse the contribution of important filmmakers and producers, including Ezra Mir, Paul Zils, Jean Bhownagary, S. Sukhdev, S. N. S. Sastri, and P. Pati, to the development of the Indian documentary film sector and style within and outside the remits of Films Division. It will more specifically assess the extent to which they criticised the State, showed the inequalities in Indian society and explored film form.

Keywords: documentary film, film archives, film history, India

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204 The Impact of Shifting Trading Pattern from Long-Haul to Short-Sea to the Car Carriers’ Freight Revenues

Authors: Tianyu Wang, Nikita Karandikar

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The uncertainty around cost, safety, and feasibility of the decarbonized shipping fuels has made it increasingly complex for the shipping companies to set pricing strategies and forecast their freight revenues going forward. The increase in the green fuel surcharges will ultimately influence the automobile’s consumer prices. The auto shipping demand (ton-miles) has been gradually shifting from long-haul to short-sea trade over the past years following the relocation of the original equipment manufacturer (OEM) manufacturing to regions such as South America and Southeast Asia. The objective of this paper is twofold: 1) to investigate the car-carriers freight revenue development over the years when the trade pattern is gradually shifting towards short-sea exports 2) to empirically identify the quantitative impact of such trade pattern shifting to mainly freight rate, but also vessel size, fleet size as well as Green House Gas (GHG) emission in Roll on-Roll Off (Ro-Ro) shipping. In this paper, a model of analyzing and forecasting ton-miles and freight revenues for the trade routes of AS-NA (Asia to North America), EU-NA (Europe to North America), and SA-NA (South America to North America) is established by deploying Automatic Identification System (AIS) data and the financial results of a selected car carrier company. More specifically, Wallenius Wilhelmsen Logistics (WALWIL), the Norwegian Ro-Ro carrier listed on Oslo Stock Exchange, is selected as the case study company in this paper. AIS-based ton-mile datasets of WALWIL vessels that are sailing into North America region from three different origins (Asia, Europe, and South America), together with WALWIL’s quarterly freight revenues as reported in trade segments, will be investigated and compared for the past five years (2018-2022). Furthermore, ordinary‐least‐square (OLS) regression is utilized to construct the ton-mile demand and freight revenue forecasting. The determinants of trade pattern shifting, such as import tariffs following the China-US trade war and fuel prices following the 0.1% Emission Control Areas (ECA) zone requirement after IMO2020 will be set as key variable inputs to the machine learning model. The model will be tested on another newly listed Norwegian Car Carrier, Hoegh Autoliner, to forecast its 2022 financial results and to validate the accuracy based on its actual results. GHG emissions on the three routes will be compared and discussed based on a constant emission per mile assumption and voyage distances. Our findings will provide important insights about 1) the trade-off evaluation between revenue reduction and energy saving with the new ton-mile pattern and 2) how the trade flow shifting would influence the future need for the vessel and fleet size.

Keywords: AIS, automobile exports, maritime big data, trade flows

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203 The Quality of Life, Situations and Emerging Concerns of Parents of Children with Neurodevelopmental Disorders in Philippine Children's Medical Center during the Covid-19 Pandemic

Authors: Annelyn Fatima Lopez, Ermenilda Avendano, Aileen Marie Vargas, Lara Baylon, Rorilee Angeles

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BACKGROUND: The COVID-19 resulted in a public health emergency and quarantine measures which may negatively impact psychosocial and environmental aspects of vulnerable populations. OBJECTIVES: This study intended to determine the quality of life, situations and emerging concerns of parents of children with neurodevelopmental disorders during the ongoing coronavirus pandemic. METHODOLOGY: Parents of patients seen in the PCMC Neurodevelopmental Pediatrics OPD clinic were recruited to fill out questionnaires on parent and child characteristics, survey on situations and emerging concerns during the coronavirus pandemic and WHOQOL-BREF (Filipino version) for parental quality of life. RESULTS: Data from 115 respondents showed a lower score in the environmental domain. The child characteristics that are statistically comparable with the QoL scores include sex, severity of ID and ADHD while the parent characteristics that are statistically comparable with the QoL scores include educational attainment, monthly family income, father’s employment status and family structure (P-value <0.05). Most respondents reported physical distancing (82.61%) and curfew (80.87%) as measures implemented due to the pandemic. Inability to access essential services (43.48-74.48%) were further compounded by limited financial resources (51.30%) and public transport (60%). Government responses received include quarantine pass (90.43%), food allowance or relief package (86.09%), disinfection (60.87%), DSWD-SAP (42.61%) and cash distribution (41.74%). Concerns encountered include socio-environmental issues (i.e. no available transportation, effect on the ability to earn, inadequate food/medicine rations, disruptions in basic social services) and patient concerns (i.e. access to education, medical, developmental and behavioral services, nutrition and sleep). RECOMMENDATIONS: Programs and policies should be planned accordingly to provide improvement of quality of life for both parents and the child with a neurodevelopmental disorder.

Keywords: covid-19, neurodevelopmental disorder, parental quality of life, whoqol-bref

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202 Lipid Emulsion versus DigiFab in a Rat Model of Acute Digoxin Toxicity

Authors: Cansu Arslan Turan, Tuba Cimilli Ozturk, Ebru Unal Akoglu, Kemal Aygun, Ecem Deniz Kırkpantur, Ozge Ecmel Onur

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Although the mechanism of action is not well known, Intravenous Lipid Emulsion (ILE) has been shown to be effective in the treatment of lipophilic drug intoxications. It is thought that ILE probably separate the lipophilic drugs from target tissue by creating a lipid-rich compartment in the plasma. The second theory is that ILE provides energy to myocardium with high dose free fatty acids activating the voltage gated calcium channels in the myocytes. In this study, the effects of ILE treatment on digoxin overdose which are frequently observed in emergency departments was searched in an animal model in terms of cardiac side effects and survival. The study was carried out at Yeditepe University, Faculty of Medicine-Experimental Animals Research Center Labs in December 2015. 40 Sprague-Dawley rats weighing 300-400 g were divided into 5 groups randomly. As the pre-treatment, the first group received saline, the second group received lipid, the third group received DigiFab, and the fourth group received DigiFab and lipid. Following that, digoxin was infused to all groups until death except the control group. First arrhythmia and cardiac arrest occurrence times were recorded. As no medication causing arrhythmia was infused, Group 5 was excluded from the statistical analysis performed for the comparisons of first arrhythmia and death time. According to the results although there was no significant difference in the statistical analysis comparing the four groups, as the rats, only exposed to digoxin intoxication were compared with the rats pre-treated with ILE in terms of first arrhythmia time and cardiac arrest occurrence times, significant difference was observed between the groups. According to our results, using DigiFab treatment, intralipid treatment, intralipid and DigiFab treatment for the rats exposed to digoxin intoxication makes no significant difference in terms of the first arrhythmia and death occurrence time. However, it is not possible to say that at the doses we use in the study, ILE treatment might be successful at least as a known antidote. The fact that the statistical significance between the two groups is not observed in the inter-comparisons of all the groups, the study should be repeated in the larger groups.

Keywords: arrhytmia, cardiac arrest, DigiFab, digoxin intoxication

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201 Cadmium Accumulation and Depuration Characteristics through Food Source of Cage-Cultivated Fish after Accidental Pollution in Longjiang River

Authors: Qianli Ma, Xuemin Zhao, Lingai Yao, Zhencheng Xu, Li Wang

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Heavy metal pollution accidents, frequently happened in this decade in China, severely threaten aquatic ecosystem and economy. In January 2012, a basin-scale accidental Cd pollution happened in Longjiang River in southwest China. Although water quality was recovered in short period by emergency treatment with flocculants, a large amount of contaminated cage-cultivated fish were left with the task of preventing or mitigating Cd contamination of fish. In this study, unpolluted Ctenopharyngodon idellus were fed by Cd-contaminated macrophytes for assessing the effect of Cd accumulation through food exposure, and the contaminated C. idellus were fed with Cd-free macrophytes for assessing the ability of Cd depuration. The on-site cultivation experiments were done in two sites of Lalang (S1, accidental Cd pollution originated) and Sancha (S2, a large amount of flocculants were added to accelerate Cd precipitation) in Longjiang river. Results showed that Cd content in fish muscle presented an increasing trend in the accumulation experiment. In S1, Cd content of fish muscle rose sharply from day 8 to day 18 with higher average Cd content in macrophytes and sediment, and kept in the range of 0.208-0.308 mg/kg afterward. In S2, Cd content of fish muscle rose gradually throughout the experiment and reached the maximum level of 0.285 mg/kg on day 76. The results of the depuration experiment showed that Cd content in fish muscle decreased and significant changes were observed in the first half time of the experiment. Meanwhile, fish with lower initial Cd content presented higher elimination constant. In S1, Cd content of fish significantly decreased from 0.713 to 0.304 mg/kg in 18 days and kept decreasing to 0.110 mg/kg in the end, and 84.6% of Cd content was eliminated. While in S2, there was a sharp decrease of Cd content of fish in 0-8 days from 0.355 mg/kg to 0.069 mg/kg. The total elimination percentage was 93.8% and 80.6% of which appeared in day 0-8. The elimination constant of fish in S2 was 0.03 which was higher than 0.02 in S1. Collectively, our results showed Cd could be absorbed through food exposure and accumulate in fish muscle, and the accumulated Cd in fish muscle can be excreted after isolated from the polluted food sources. This knowledge allows managers to assess health risk of Cd contaminated fish and minimize aquaculture loss when considering fish cultivation after accidental pollution.

Keywords: accidental pollution, cadmium accumulation and depuration, cage-cultivated fish, environmental management, river

Procedia PDF Downloads 234
200 The Flood Disaster Management of Communities in Ubon Ratchathani Province, Thailand

Authors: Eakarat Boonreang, Anothai Harasarn

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The objectives of this study are to investigate the flood disaster management capacity of communities in Ubon Ratchathani province, Thailand, and to recommend the sustainable flood management approaches of communities in Ubon Ratchathani province, Thailand. The selected population consisted of the community leaders and committees, the executives of local administrative organizations, and the head of Ubon Ratchathani provincial office of disaster prevention and mitigation. The data was collected by in-depth interview, focus group, and observation. The data was analyzed and classified in order to determine the communities’ capacity in flood disaster management. The results revealed that communities’ capacity were as follows, before flood disaster, the community leaders held a meeting with the community committees in order to plan disaster response and determined evacuation routes, and the villagers moved their belongings to higher places and prepared vehicles for evacuation. During flood disaster, the communities arranged motorboats for transportation and villagers evacuated to a temporary evacuation center. Moreover, the communities asked for survival bags, motorboats, emergency toilets, and drinking water from the local administrative organizations and the 22nd Military Circle. After flood disaster, the villagers cleaned and fixed their houses and also collaborated in cleaning the temple, school, and other places in the community. The recommendation approaches for sustainable flood disaster management consisted of structural measures, such as the establishment of reservoirs and building higher houses, and non-structural measures such as raising awareness and fostering self-reliance, establishing disaster management plans, rehearsal of disaster response procedures every year, and transferring disaster knowledge among younger generations. Moreover, local administrative organizations should formulate strategic plans that focus on disaster management capacity building at the community level, particularly regarding non-structural measures. Ubon Ratchathani provincial offices of disaster prevention and mitigation should continually monitor and evaluate the outcomes of community based disaster risk management program, including allocating more flood disaster management-related resources among local administrative organizations and communities.

Keywords: capacity building, community based disaster risk management, flood disaster management, Thailand

Procedia PDF Downloads 144
199 Establishing a Communication Framework in Response to the COVID-19 Pandemic in a Tertiary Government Hospital in the Philippines

Authors: Nicole Marella G. Tan, Al Joseph R. Molina, Raisa Celine R. Rosete, Soraya Elisse E. Escandor, Blythe N. Ke, Veronica Marie E. Ramos, Apolinario Ericson B. Berberabe, Jose Jonas D. del Rosario, Regina Pascua-Berba, Eileen Liesl A. Cubillan, Winlove P. Mojica

Abstract:

Emergency risk and health communications play a vital role in any pandemic response. However, the Philippine General Hospital (PGH) lacked a system of information delivery that could effectively fulfill the hospital’s communication needs as a COVID-19 referral hospital. This study aimed to describe the establishment of a communication framework for information dissemination within a tertiary government hospital during the COVID-19 pandemic and evaluated the perceived usefulness of its outputs. This is a mixed quantitative-qualitative study with two phases. Phase 1 documented the formation and responsibilities of the Information Education Communication (IEC) Committee. Phase 2 evaluated its output and outcomes through a hospital-wide survey of 528 healthcare workers (HCWs) using a pre-tested questionnaire. In-depth explanations were obtained from five focused group discussions (FGD) amongst various HCW subgroups. Descriptive analysis was done using STATA 16 while qualitative data were synthesized thematically. Communication practices in PGH were loosely structured at the beginning of the pandemic until the establishment of the IEC Committee. The IEC Committee was well-represented by concerned stakeholders. Nine types of infographics tackled different aspects of the hospital’s health operations after thorough inputs from concerned offices. Internal and external feedback mechanisms ensured accurate infographics. Majority of the survey respondents (98.67%) perceived these as useful in their work or daily lives. FGD participants cited the relevance of infographics to their occupations, suggested improvements, and hoped that these efforts would be continued in the future. Sustainability and comprehensive reach were the main concerns in this undertaking. The PGH COVID-19 IEC framework was developed through trial and testing as there were no existing formal structures to communicate health risks and to properly direct the HCWs in the chaotic time of a pandemic. It is a continuously evolving framework which is perceived as useful by HCWs and is hoped to be sustained in the future.

Keywords: COVID-19, pandemic, health communication, infographics, social media

Procedia PDF Downloads 98
198 The Relationship between Proximity to Sources of Industrial-Related Outdoor Air Pollution and Children Emergency Department Visits for Asthma in the Census Metropolitan Area of Edmonton, Canada, 2004/2005 to 2009/2010

Authors: Laura A. Rodriguez-Villamizar, Alvaro Osornio-Vargas, Brian H. Rowe, Rhonda J. Rosychuk

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Introduction/Objectives: The Census Metropolitan Area of Edmonton (CMAE) has important industrial emissions to the air from the Industrial Heartland Alberta (IHA) at the Northeast and the coal-fired power plants (CFPP) at the West. The objective of the study was to explore the presence of clusters of children asthma ED visits in the areas around the IHA and the CFPP. Methods: Retrospective data on children asthma ED visits was collected at the dissemination area (DA) level for children between 2 and 14 years of age, living in the CMAE between April 1, 2004, and March 31, 2010. We conducted a spatial analysis of disease clusters around putative sources with count (ecological) data using descriptive, hypothesis testing, and multivariable modeling analysis. Results: The mean crude rate of asthma ED visits was 9.3/1,000 children population per year during the study period. Circular spatial scan test for cases and events identified a cluster of children asthma ED visits in the DA where the CFPP are located in the Wabamum area. No clusters were identified around the IHA area. The multivariable models suggest that there is a significant decline in risk for children asthma ED visits as distance increases around the CFPP area this effect is modified at the SE direction with mean angle 125.58 degrees, where the risk increases with distance. In contrast, the regression models for IHA suggest that there is a significant increase in risk for children asthma ED visits as distance increases around the IHA area and this effect is modified at SW direction with mean angle 216.52 degrees, where the risk increases at shorter distances. Conclusions: Different methods for detecting clusters of disease consistently suggested the existence of a cluster of children asthma ED visits around the CFPP but not around the IHA within the CMAE. These results are probably explained by the direction of the air pollutants dispersion caused by the predominant and subdominant wind direction at each point. The use of different approaches to detect clusters of disease is valuable to have a better understanding of the presence, shape, direction and size of clusters of disease around pollution sources.

Keywords: air pollution, asthma, disease cluster, industry

Procedia PDF Downloads 254
197 Seismic Perimeter Surveillance System (Virtual Fence) for Threat Detection and Characterization Using Multiple ML Based Trained Models in Weighted Ensemble Voting

Authors: Vivek Mahadev, Manoj Kumar, Neelu Mathur, Brahm Dutt Pandey

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Perimeter guarding and protection of critical installations require prompt intrusion detection and assessment to take effective countermeasures. Currently, visual and electronic surveillance are the primary methods used for perimeter guarding. These methods can be costly and complicated, requiring careful planning according to the location and terrain. Moreover, these methods often struggle to detect stealthy and camouflaged insurgents. The object of the present work is to devise a surveillance technique using seismic sensors that overcomes the limitations of existing systems. The aim is to improve intrusion detection, assessment, and characterization by utilizing seismic sensors. Most of the similar systems have only two types of intrusion detection capability viz., human or vehicle. In our work we could even categorize further to identify types of intrusion activity such as walking, running, group walking, fence jumping, tunnel digging and vehicular movements. A virtual fence of 60 meters at GCNEP, Bahadurgarh, Haryana, India, was created by installing four underground geophones at a distance of 15 meters each. The signals received from these geophones are then processed to find unique seismic signatures called features. Various feature optimization and selection methodologies, such as LightGBM, Boruta, Random Forest, Logistics, Recursive Feature Elimination, Chi-2 and Pearson Ratio were used to identify the best features for training the machine learning models. The trained models were developed using algorithms such as supervised support vector machine (SVM) classifier, kNN, Decision Tree, Logistic Regression, Naïve Bayes, and Artificial Neural Networks. These models were then used to predict the category of events, employing weighted ensemble voting to analyze and combine their results. The models were trained with 1940 training events and results were evaluated with 831 test events. It was observed that using the weighted ensemble voting increased the efficiency of predictions. In this study we successfully developed and deployed the virtual fence using geophones. Since these sensors are passive, do not radiate any energy and are installed underground, it is impossible for intruders to locate and nullify them. Their flexibility, quick and easy installation, low costs, hidden deployment and unattended surveillance make such systems especially suitable for critical installations and remote facilities with difficult terrain. This work demonstrates the potential of utilizing seismic sensors for creating better perimeter guarding and protection systems using multiple machine learning models in weighted ensemble voting. In this study the virtual fence achieved an intruder detection efficiency of over 97%.

Keywords: geophone, seismic perimeter surveillance, machine learning, weighted ensemble method

Procedia PDF Downloads 42
196 Development of a Fire Analysis Drone for Smoke Toxicity Measurement for Fire Prediction and Management

Authors: Gabrielle Peck, Ryan Hayes

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This research presents the design and creation of a drone gas analyser, aimed at addressing the need for independent data collection and analysis of gas emissions during large-scale fires, particularly wasteland fires. The analyser drone, comprising a lightweight gas analysis system attached to a remote-controlled drone, enables the real-time assessment of smoke toxicity and the monitoring of gases released into the atmosphere during such incidents. The key components of the analyser unit included two gas line inlets connected to glass wool filters, a pump with regulated flow controlled by a mass flow controller, and electrochemical cells for detecting nitrogen oxides, hydrogen cyanide, and oxygen levels. Additionally, a non-dispersive infrared (NDIR) analyser is employed to monitor carbon monoxide (CO), carbon dioxide (CO₂), and hydrocarbon concentrations. Thermocouples can be attached to the analyser to monitor temperature, as well as McCaffrey probes combined with pressure transducers to monitor air velocity and wind direction. These additions allow for monitoring of the large fire and can be used for predictions of fire spread. The innovative system not only provides crucial data for assessing smoke toxicity but also contributes to fire prediction and management. The remote-controlled drone's mobility allows for safe and efficient data collection in proximity to the fire source, reducing the need for human exposure to hazardous conditions. The data obtained from the gas analyser unit facilitates informed decision-making by emergency responders, aiding in the protection of both human health and the environment. This abstract highlights the successful development of a drone gas analyser, illustrating its potential for enhancing smoke toxicity analysis and fire prediction capabilities. The integration of this technology into fire management strategies offers a promising solution for addressing the challenges associated with wildfires and other large-scale fire incidents. The project's methodology and results contribute to the growing body of knowledge in the field of environmental monitoring and safety, emphasizing the practical utility of drones for critical applications.

Keywords: fire prediction, drone, smoke toxicity, analyser, fire management

Procedia PDF Downloads 57
195 Arterial Line Use for Acute Type 2 Respiratory Failure

Authors: C. Scurr, J. Jeans, S. Srivastava

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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

Procedia PDF Downloads 399
194 Shaping of World-Class Delhi: Politics of Marginalization and Inclusion

Authors: Aparajita Santra

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In the context of the government's vision of turning Delhi into a green, privatized and slum free city, giving it a world-class image at par with the global cities of the world, this paper investigates into the various processes and politics of things that went behind defining spaces in the city and attributing an aesthetic image to it. The paper will explore two cases that were forged primarily through the forces of one particular type of power relation. One would be to look at the modernist movement adopted by the Nehruvian government post-independence and the next case will look at special periods like Emergency and Commonwealth games. The study of these cases will help understand the ambivalence embedded in the different rationales of the Government and different powerful agencies adopted in order to build world-classness. Through the study, it will be easier to discern how city spaces were reconfigured in the name of 'good governance'. In this process, it also became important to analyze the double nature of law, both as a protector of people’s rights and as a threat to people. What was interesting to note through the study was that in the process of nation building and creating an image for the city, the government’s policies and programs were mostly aimed at the richer sections of the society and the poorer sections and people from lower income groups kept getting marginalized, subdued, and pushed further away (These marginalized people were pushed away even geographically!). The reconfiguration of city space and attributing an aesthetic character to it, led to an alteration not only in the way in which citizens perceived and engaged with these spaces, but also brought about changes in the way they envisioned their place in the city. Ironically, it was found that every attempt to build any kind of facility for the city’s elite in turn led to an inevitable removal of the marginalized sections of the society as a necessary step to achieve a clean, green and world-class city. The paper questions the claim made by the government for creating a just, equitable city and granting rights to all. An argument is put forth that in the politics of redistribution of space, the city that has been designed is meant for the aspirational middle-class and elite only, who are ideally primed to live in world-class cities. Thus, the aim is to study city spaces, urban form, the associated politics and power plays involved within and understand whether segmented cities are being built in the name of creating sensible, inclusive cities.

Keywords: aesthetics, ambivalence, governmentality, power, World-class

Procedia PDF Downloads 92
193 Engineering Economic Analysis of Implementing a Materials Recovery Facility in Jamaica: A Green Industry Approach towards a Sustainable Developing Economy

Authors: Damian Graham, Ashleigh H. Hall, Damani R. Sulph, Michael A. James, Shawn B. Vassell

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This paper assesses the design and feasibility of a Materials Recovery Facility (MRF) in Jamaica as a possible green industry approach to the nation’s economic and solid waste management problems. Jamaica is a developing nation that is vulnerable to climate change that can affect its blue economy and tourism on which it is heavily reliant. Jamaica’s National Solid Waste Management Authority (NSWMA) collects only a fraction of all the solid waste produced annually which is then transported to dumpsites. The remainder is either burnt by the population or disposed of illegally. These practices negatively impact the environment, threaten the sustainability of economic growth from blue economy and tourism and its waste management system is predominantly a cost centre. The implementation of an MRF could boost the manufacturing sector, contribute to economic growth, and be a catalyst in creating a green industry with multiple downstream value chains with supply chain linkages. Globally, there is a trend to reuse and recycle that created an international market for recycled solid waste. MRFs enable the efficient sorting of solid waste into desired recoverable materials thus providing a gateway for entrance to the international trading of recycled waste. Research into the current state and effort to improve waste management in Jamaica in contrast with the similar and more advanced territories are outlined. The study explores the concept of green industrialization and its applicability to vulnerable small state economies like Jamaica. The study highlights the possible contributions and benefits derived from MRFs as a seeding factory that can anchor the reverse and forward logistics of other green industries as part of a logistic-cantered economy. Further, the study showcases an engineering economic analysis that assesses the viability of the implementation of an MRF in Jamaica. This research outlines the potential cost of constructing and operating an MRF and provides a realistic cash flow estimate to establish a baseline for profitability. The approach considers quantitative and qualitative data, assumptions, and modelling using industrial engineering tools and techniques that are outlined. Techniques of facility planning, system analysis and operations research with a focus on linear programming techniques are expressed. Approaches to overcome some implementation challenges including policy, technology and public education are detailed. The results of this study present a reasonable judgment of the prospects of incorporating an MRF to improve Jamaica’s solid waste management and contribute to socioeconomic and environmental benefits and an alternate pathway for economic sustainability.

Keywords: engineering-economic analysis, facility design, green industry, MRF, manufacturing, plant layout, solid-waste management, sustainability, waste disposal

Procedia PDF Downloads 190
192 Utility of Thromboelastography Derived Maximum Amplitude and R-Time (MA-R) Ratio as a Predictor of Mortality in Trauma Patients

Authors: Arulselvi Subramanian, Albert Venencia, Sanjeev Bhoi

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Coagulopathy of trauma is an early endogenous coagulation abnormality that occurs shortly resulting in high mortality. In emergency trauma situations, viscoelastic tests may be better in identifying the various phenotypes of coagulopathy and demonstrate the contribution of platelet function to coagulation. We aimed to determine thrombin generation and clot strength, by estimating a ratio of Maximum amplitude and R-time (MA-R ratio) for identifying trauma coagulopathy and predicting subsequent mortality. Methods: We conducted a prospective cohort analysis of acutely injured trauma patients of the adult age groups (18- 50 years), admitted within 24hrs of injury, for one year at a Level I trauma center and followed up on 3rd day and 5th day of injury. Patients with h/o coagulation abnormalities, liver disease, renal impairment, with h/o intake of drugs were excluded. Thromboelastography was done and a ratio was calculated by dividing the MA by the R-time (MA-R). Patients were further stratified into sub groups based on the calculated MA-R quartiles. First sampling was done within 24 hours of injury; follow up on 3rd and 5thday of injury. Mortality was the primary outcome. Results: 100 acutely injured patients [average, 36.6±14.3 years; 94% male; injury severity score 12.2(9-32)] were included in the study. Median (min-max) on admission MA-R ratio was 15.01(0.4-88.4) which declined 11.7(2.2-61.8) on day three and slightly rose on day 5 13.1(0.06-68). There were no significant differences between sub groups in regard to age, or gender. In the lowest MA-R ratios subgroup; MA-R1 (<8.90; n = 27), injury severity score was significantly elevated. MA-R2 (8.91-15.0; n = 23), MA-R3 (15.01-19.30; n = 24) and MA-R4 (>19.3; n = 26) had no difference between their admission laboratory investigations, however slight decline was observed in hemoglobin, red blood cell count and platelet counts compared to the other subgroups. Also significantly prolonged R time, shortened alpha angle and MA were seen in MA-R1. Elevated incidence of mortality also significantly correlated with on admission low MA-R ratios (p 0.003). Temporal changes in the MA-R ratio did not correlated with mortality. Conclusion: The MA-R ratio provides a snapshot of early clot function, focusing specifically on thrombin burst and clot strength. In our observation, patients with the lowest MA-R time ratio (MA-R1) had significantly increased mortality compared with all other groups (45.5% MA-R1 compared with <25% in MA-R2 to MA-R3, and 9.1% in MA-R4; p < 0.003). Maximum amplitude and R-time may prove highly useful to predict at-risk patients early, when other physiologic indicators are absent.

Keywords: coagulopathy, trauma, thromboelastography, mortality

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191 Floodnet: Classification for Post Flood Scene with a High-Resolution Aerial Imaginary Dataset

Authors: Molakala Mourya Vardhan Reddy, Kandimala Revanth, Koduru Sumanth, Beena B. M.

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Emergency response and recovery operations are severely hampered by natural catastrophes, especially floods. Understanding post-flood scenarios is essential to disaster management because it facilitates quick evaluation and decision-making. To this end, we introduce FloodNet, a brand-new high-resolution aerial picture collection created especially for comprehending post-flood scenes. A varied collection of excellent aerial photos taken during and after flood occurrences make up FloodNet, which offers comprehensive representations of flooded landscapes, damaged infrastructure, and changed topographies. The dataset provides a thorough resource for training and assessing computer vision models designed to handle the complexity of post-flood scenarios, including a variety of environmental conditions and geographic regions. Pixel-level semantic segmentation masks are used to label the pictures in FloodNet, allowing for a more detailed examination of flood-related characteristics, including debris, water bodies, and damaged structures. Furthermore, temporal and positional metadata improve the dataset's usefulness for longitudinal research and spatiotemporal analysis. For activities like flood extent mapping, damage assessment, and infrastructure recovery projection, we provide baseline standards and evaluation metrics to promote research and development in the field of post-flood scene comprehension. By integrating FloodNet into machine learning pipelines, it will be easier to create reliable algorithms that will help politicians, urban planners, and first responders make choices both before and after floods. The goal of the FloodNet dataset is to support advances in computer vision, remote sensing, and disaster response technologies by providing a useful resource for researchers. FloodNet helps to create creative solutions for boosting communities' resilience in the face of natural catastrophes by tackling the particular problems presented by post-flood situations.

Keywords: image classification, segmentation, computer vision, nature disaster, unmanned arial vehicle(UAV), machine learning.

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190 The Impact of Supply Chain Strategy and Integration on Supply Chain Performance: Supply Chain Vulnerability as a Moderator

Authors: Yi-Chun Kuo, Jo-Chieh Lin

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The objective of a supply chain strategy is to reduce waste and increase efficiency to attain cost benefits, and to guarantee supply chain flexibility when facing the ever-changing market environment in order to meet customer requirements. Strategy implementation aims to fulfill common goals and attain benefits by integrating upstream and downstream enterprises, sharing information, conducting common planning, and taking part in decision making, so as to enhance the overall performance of the supply chain. With the rise of outsourcing and globalization, the increasing dependence on suppliers and customers and the rapid development of information technology, the complexity and uncertainty of the supply chain have intensified, and supply chain vulnerability has surged, resulting in adverse effects on supply chain performance. Thus, this study aims to use supply chain vulnerability as a moderating variable and apply structural equation modeling (SEM) to determine the relationships among supply chain strategy, supply chain integration, and supply chain performance, as well as the moderating effect of supply chain vulnerability on supply chain performance. The data investigation of this study was questionnaires which were collected from the management level of enterprises in Taiwan and China, 149 questionnaires were received. The result of confirmatory factor analysis shows that the path coefficients of supply chain strategy on supply chain integration and supply chain performance are positive (0.497, t= 4.914; 0.748, t= 5.919), having a significantly positive effect. Supply chain integration is also significantly positively correlated to supply chain performance (0.192, t = 2.273). The moderating effects of supply chain vulnerability on supply chain strategy and supply chain integration to supply chain performance are significant (7.407; 4.687). In Taiwan, 97.73% of enterprises are small- and medium-sized enterprises (SMEs) focusing on receiving original equipment manufacturer (OEM) and original design manufacturer (ODM) orders. In order to meet the needs of customers and to respond to market changes, these enterprises especially focus on supply chain flexibility and their integration with the upstream and downstream enterprises. According to the observation of this research, the effect of supply chain vulnerability on supply chain performance is significant, and so enterprises need to attach great importance to the management of supply chain risk and conduct risk analysis on their suppliers in order to formulate response strategies when facing emergency situations. At the same time, risk management is incorporated into the supply chain so as to reduce the effect of supply chain vulnerability on the overall supply chain performance.

Keywords: supply chain integration, supply chain performance, supply chain vulnerability, structural equation modeling

Procedia PDF Downloads 289
189 A Multi-Role Oriented Collaboration Platform for Distributed Disaster Reduction in China

Authors: Linyao Qiu, Zhiqiang Du

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As the rapid development of urbanization, economic developments, and steady population growth in China, the widespread devastation, economic damages, and loss of human lives caused by numerous forms of natural disasters are becoming increasingly serious every year. Disaster management requires available and effective cooperation of different roles and organizations in whole process including mitigation, preparedness, response and recovery. Due to the imbalance of regional development in China, the disaster management capabilities of national and provincial disaster reduction centers are uneven. When an undeveloped area suffers from disaster, neither local reduction department could get first-hand information like high-resolution remote sensing images from satellites and aircrafts independently, nor sharing mechanism is provided for the department to access to data resources deployed in other place directly. Most existing disaster management systems operate in a typical passive data-centric mode and work for single department, where resources cannot be fully shared. The impediment blocks local department and group from quick emergency response and decision-making. In this paper, we introduce a collaborative platform for distributed disaster reduction. To address the issues of imbalance of sharing data sources and technology in the process of disaster reduction, we propose a multi-role oriented collaboration business mechanism, which is capable of scheduling and allocating for optimum utilization of multiple resources, to link various roles for collaborative reduction business in different place. The platform fully considers the difference of equipment conditions in different provinces and provide several service modes to satisfy technology need in disaster reduction. An integrated collaboration system based on focusing services mechanism is designed and implemented for resource scheduling, functional integration, data processing, task management, collaborative mapping, and visualization. Actual applications illustrate that the platform can well support data sharing and business collaboration between national and provincial department. It could significantly improve the capability of disaster reduction in China.

Keywords: business collaboration, data sharing, distributed disaster reduction, focusing service

Procedia PDF Downloads 273
188 Factors Determining the Vulnerability to Occupational Health Risk and Safety of Call Center Agents in the Philippines

Authors: Lito M. Amit, Venecio U. Ultra, Young-Woong Song

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The business process outsourcing (BPO) in the Philippines is expanding rapidly attracting more than 2% of total employment. Currently, the BPO industry is confronted with several issues pertaining to sustainable productivity such as meeting the staffing gap, high rate of employees’ turnover and workforce retention, and the occupational health and safety (OHS) of call center agents. We conducted a survey of OHS programs and health concerns among call center agents in the Philippines and determined the sociocultural factors that affect the vulnerability of call center agents to occupational health risks and hazards. The majority of the agents affirmed that OHS are implemented and OHS orientation and emergency procedures were conducted at employment initiations, perceived favorable and convenient working environment except for occasional noise disturbances and acoustic shock, visual, and voice fatigues. Male agents can easily adjust to the demands and changes in their work environment and flexible work schedules than female agents. Female agents have a higher tendency to be pressured and humiliated by low work performance, experience a higher incidence of emotional abuse, psychological abuse, and experience more physical stress than male agents. The majority of the call center agents had a night-shift schedule and regardless of other factors, night shift work brings higher stress to agents. While working in a call center, higher incidence of headaches and insomnia, burnout, suppressed anger, anxiety, and depressions were experienced by female, younger (21-25 years old) and those at night shift than their counterpart. Most common musculoskeletal disorders include body pain in the neck, shoulders and back; and hand and wrist disorders and these are commonly experienced by female and younger workers. About 30% experienced symptoms of cardiovascular and gastrointestinal disorders and weakened immune systems. Overall, these findings have shown the variable vulnerability by a different subpopulation of call center agents and are important in the occupational health risk prevention and management towards a sustainable human resource for BPO industry in the Philippines.

Keywords: business process outsourcing industry, health risk of call center agents, socio-cultural determinants, Philippines

Procedia PDF Downloads 466
187 Mediating Role of 'Investment Recovery' and 'Competitiveness' on the Impact of Green Supply Chain Management Practices over Firm Performance: An Empirical Study Based on Textile Industry of Pakistan

Authors: Mehwish Jawaad

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Purpose: The concept of GrSCM (Green Supply Chain Management) in the academic and research field is still thought to be in the development stage especially in Asian Emerging Economies. The purpose of this paper is to contribute significantly to the first wave of empirical investigation on GrSCM Practices and Firm Performance measures in Pakistan. The aim of this research is to develop a more holistic approach towards investigating the impact of Green Supply Chain Management Practices (Ecodesign, Internal Environmental Management systems, Green Distribution, Green Purchasing and Cooperation with Customers) on multiple dimensions of Firm Performance Measures (Economic Performance, Environmental Performance and Operational Performance) with a mediating role of Investment Recovery and Competitiveness. This paper also serves as an initiative to identify if the relationship between Investment Recovery and Firm Performance Measures is mediated by Competitiveness. Design/ Methodology/Approach: This study is based on survey Data collected from 272, ISO (14001) Certified Textile Firms Based in Lahore, Faisalabad, and Karachi which are involved in Spinning, Dyeing, Printing or Bleaching. A Theoretical model was developed incorporating the constructs representing Green Activities and Firm Performance Measures of a firm. The data was analyzed using Partial Least Square Structural Equation Modeling. Senior and Mid-level managers provided the data reflecting the degree to which their organizations deal with both internal and external stakeholders to improve the environmental sustainability of their supply chain. Findings: Of the 36 proposed Hypothesis, 20 are considered valid and significant. The statistics result reveal that GrSCM practices positively impact Environmental Performance followed by Economic and Operational Performance. Investment Recovery acts as a strong mediator between Intra organizational Green activities and performance outcomes. The relationship of Reverse Logistics influencing outcomes is significantly mediated by Competitiveness. The pressure originating from customers exert significant positive influence on the firm to adopt Green Practices consequently leading to higher outcomes. Research Contribution/Originality: Underpinning the Resource dependence theory and as a first wave of investigating the impact of Green Supply chain on performance outcomes in Pakistan, this study intends to make a prominent mark in the field of research. Investment and Competitiveness together are tested as a mediator for the first time in this arena. Managerial implications: Practitioner is provided with a framework for assessing the synergistic impact of GrSCM practices on performance. Upgradation of Accreditations and Audit Programs on regular basis are the need of the hour. Making the processes leaner with the sale of excess inventories and scrap helps the firm to work more efficiently and productively.

Keywords: economic performance, environmental performance, green supply chain management practices, operational performance, sustainability, a textile sector of Pakistan

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

Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

Abstract:

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

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

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