Search results for: emergency response

Authors: Manoj Parmar

Abstract:

The article uses reflexivity as a research method to investigate and propose an architectural theory plan for climate change. It hypothecates that to discuss or formulate discourse on "Architectural Thinking in a Time of Climate Emergency," firstly, we need to understand the modes of integration that enable architectural thinking with climate change. The study intends to study the various integration modes that have evolved historically and situate them in time. Subsequently, it analyses the integration pattern, challenges the existing model, and finds a way towards climate change as central to architectural thinking. The study is fundamental on-premises that ecology and climate change scholarship has consistently out lashed the asymmetrical and nonlinear knowledge and needs approaches for architecture that are less burden to climate change to people and minimize its impact on ecology.

Keywords: climate change, architectural theory, reflexivity, modernity

Procedia PDF Downloads 242

Authors: Rattanan Tippayaphalapholgul, Yasothorn Sapsathiarn

Abstract:

Composites of piezoelectric materials are widely use in practical applications such as nondestructive testing devices, smart adaptive structures and medical devices. A thorough understanding of coupled electro-elastic response and properties of piezocomposite are crucial for the development and design of piezoelectric composite materials used in advanced applications. The micromechanics analysis is employed in this paper to determine the response and engineering properties of the piezocomposite. A mechanical imperfect interface bonding between piezoelectric inclusion and polymer matrix is taken into consideration in the analysis. The micromechanics analysis is based on the Boundary Element Method (BEM) together with the periodic micro-field micromechanics theory. A selected set of numerical results is presented to investigate the influence of volume ratio and interface bonding condition on effective piezocomposite material coefficients and portray basic features of coupled electroelastic response within the domain of piezocomposite unit cell.

Keywords: effective engineering properties, electroelastic response, imperfect interface, piezocomposite

Procedia PDF Downloads 198

Authors: Jorge Iván Bañol-Betancur, Lina María Martínez-Sánchez, María de los Ángeles Rodríguez-Gázquez, Estefanía Bahamonde-Olaya, Ana María Gutiérrez-Tamayo, Laura Isabel Jaramillo-Jaramillo, Camilo Ruiz-Mejía, Natalia Morales-Quintero

Abstract:

Acute chest pain is a distressing sensation between the diaphragm and the base of the neck and it represents a diagnostic challenge for any physician in the emergency department. Objective: To establish the main clinical and epidemiological characteristics of patients who present with chest pain to the emergency department in a private clinic from the city of Medellin, during 2014-2015. Methods: Cross-sectional retrospective observational study. Population and sample were patients who consulted for chest pain in the emergency department who met the eligibility criteria. The information was analyzed in SPSS program vr.21; qualitative variables were described through relative frequencies, and the quantitative through mean and standard deviation ‬or medians according to their distribution in the study population. Results: A total of 231 patients were evaluated, the mean age was 49.5 ± 19.9 years, 56.7% were females. The most frequent pathological antecedents were hypertension 35.5%, diabetes 10,8%, dyslipidemia 10.4% and coronary disease 5.2%. Regarding pain features, in 40.3% of the patients the pain began abruptly, in 38.2% it had a precordial location, for 20% of the cases physical activity acted as a trigger, and 60.6% was oppressive. Costochondritis was the most common cause of chest pain among patients with an established etiologic diagnosis, representing the 18.2%. Conclusions: Although the clinical features of pain reported coincide with the clinical presentation of an acute coronary syndrome, the most common cause of chest pain in study population was costochondritis instead, indicating that it is a differential diagnostic in the approach of patients with pain acute chest.

Keywords: acute coronary syndrome, chest pain, epidemiology, osteochondritis

Procedia PDF Downloads 309

Authors: Getachew Demesa Bexa

Abstract:

Building resilience to withstand extreme weather events through reduction and mitigation measures towards predicted disasters with appropriate contingency plans complemented by timely and effective emergency response demands committed and integrated/coordinated efforts. The 2006 flood disaster that claimed more than 200 people in Dire Dawa town shifted the paradigm from reactive to proactive engagement among government, NGOs and communities to contain future disasters through resilience building. Dire Dawa CMDRR Association is a model community organization that demonstrated the basic minimum and turning adversity into opportunity by mobilizing vulnerable community members. Meanwhile the birth of African Centre for Disaster Risk Management is a milestone in changing the image of the country and beyond in resilience building while linking relief and development.

Keywords: Dire Dawa, disaster, resilience, risk management

Procedia PDF Downloads 346

Authors: P. O. Ughachukwu, P. O. Okonkwo, P. C. Unekwe, J. O. Ogamba

Abstract:

Background: The prevalence of hepatitis B viral infection is high worldwide with liver cirrhosis and hepatocellular carcinoma as important complications. Cases of poor antibody response to hepatitis B vaccination abound. Immunosuppression, especially from glucocorticoids, is often cited as a cause of poor antibody response and there are documented evidences of irrational administration of glucocorticoids to children and adults. The study was, therefore, designed to find out if administration of glucocorticoids affects immune response to vaccination against hepatitis B in mice. Methods: Mice of both sexes were randomly divided into 2 groups. Daily intramuscular methylprednisolone injections, (15 mg kg-1), were given to the test group while sterile deionized water (0.1ml) was given to control mice for 30 days. On day 6 all mice were given 2 μg (0.1ml) hepatitis B vaccine and a booster dose on day 27. On day 34, blood samples were collected and analyzed for anti-HBs titres using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was done using Graph Pad Prism 5.0 and the results taken as statistically significant at p value < 0.05. Results: There were positive serum anti-HBs responses in all mice groups but the differences in titres were not statistically significant. Conclusions: At the dosages and length of exposure used in this study, methylprednisolone injection did not significantly inhibit anti-HBs response in mice following immunization against hepatitis B virus. By extrapolation, methylprednisolone, when used in the usual clinical doses and duration of therapy, is not likely to inhibit immune response to hepatitis B vaccinations in man.

Keywords: anti-HBs, hepatitis B vaccine, immune response, methylprednisolone, mice

Procedia PDF Downloads 289

Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

Abstract:

We experience the autopsy cases that the deceased was alive in emergency room on arrival. Bleeding is the leading cause of preventable death after injury. This retrospective study aimed to characterize opportunities for performance improvement identified in patients who died from traffic trauma and were considered by the quality improvement of education system. The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. We focused the abdominal traffic trauma injury. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 41 post-mortems of road traffic accident between April 1999 and March 2014 subjected to medico-legal autopsy at the department of Forensic Medicine, Shiga University of Medical Science. 16 patients (39.0%) were abdominal trauma injury. The mean period of survival after meet with accident was 13.5 hours, compared abdominal trauma death was 27.4 hours longer. In road traffic accidents, the most injured abdominal organs were liver followed by mesentery. We thought delayed treatment was associated with immediate diagnostic imaging, and so expected to expand trauma management examination.

Keywords: abdominal traffic trauma, preventable death, autopsy, emergency medicine

Procedia PDF Downloads 418

Authors: Lotfi O. Gargab, Ruichong R. Zhang

Abstract:

A wave-based framework is presented for modeling seismic motion in multistory buildings and using measured response for system identification which can be utilized to extract important information regarding structure integrity. With one pair of building response at two locations, a generalized model response is formulated based on wave propagation features and expressed as frequency and time response functions denoted, respectively, as GFRF and GIRF. In particular, GIRF is fundamental in tracking arrival times of impulsive wave motion initiated at response level which is dependent on local model properties. Matching model and measured-structure responses can help in identifying model parameters and infer building properties. To show the effectiveness of this approach, the Millikan Library in Pasadena, California is identified with recordings of the Yorba Linda earthquake of September 3, 2002.

Keywords: system identification, continuous-discrete mass modeling, damage detection, post-earthquake

Procedia PDF Downloads 343

Authors: Hyuk-Hoon Kim, Young Gi Min

Abstract:

Background: Acute poisoning is the common cause of morbidity and mortality. Characteristics of acute poisoning differ between countries. While other countries operate the database system for poisoning, Korea has not collected the database for acute poisoning. Distribution of incidence of acute poisoning depending on the types of materials have also not studied in Korea. Our aims are to evaluate the etiologic and demographic characteristics of acute poisoning cases and to obtain up-to-date information on acute poisonings. Method: We retrospectively recorded cases of acute poisoning from eight emergency departments of second level or university hospitals from different cities in Gyeonggi province in Korea from April 2006 and March 2015. The distributions of incidence of acute poisoning depending on the types of materials are mapped by geographic information system. Result: A total of 3,449 poisoned cases were analyzed. Mean estimated age of patients was 39.56 ± 22.40 years. Mean male to female ratio of patients was 1:1.4. Mean proportion of intentional poisoning was 57.9%. Common materials are benzodiazepine (16.6%), carbon monoxide (10.5%), pesticide (8.1%) and zolpidem (7.1%) Common route of exposure is ingestion (79.5%) and followed by inhalation (16.5%). Common treatment methods are gastric lavage (20%) and activated charcoal (30%). Most cases had uneventful recovery; 61.4% were treated as outpatients and 0.1% of the poisoning resulted in death in ER. Conclusion: Even though the cases enrolled in our study is not the overall cases of acute poisoning in Korea, our study could be the basis of countermeasures for analysis and prevention of acute poisoning in Korea.

Keywords: acute poisoning, emergency department, epidemiology, Korea

Procedia PDF Downloads 370

Authors: A. Benyahia, M. Zergoug, M. Amir, M. Fodil

Abstract:

The main objective of this work is to enhance the Pulsed Eddy Current (PEC) response from the aluminum structure using signal processing. Cracks and metal loss in different structures cause changes in PEC response measurements. In this paper, time-frequency analysis is used to represent PEC response, which generates a large quantity of data and reduce the noise due to measurement. Power Spectral Density (PSD) after Wavelet Decomposition (PSD-WD) is proposed for defect detection. The experimental results demonstrate that the cracks in the surface can be extracted satisfactorily by the proposed methods. The validity of the proposed method is discussed.

Keywords: DT, pulsed eddy current, continuous wavelet transform, Mexican hat wavelet mother, defect detection, power spectral density.

Procedia PDF Downloads 199

Authors: S. Mohamadi, T. Boudina, A. Rouabeh, A. Seridi

Abstract:

Equivalent linear and non-linear ground response analyses are conducted at many representative sites at the mosque of Algeria, to compare the free field acceleration spectra with local code of practice. Spectral Analysis of Surface Waves (SASW) technique was adopted to measure the in-situ shear wave velocity profile at the representative sites. The seismic movement imposed on the rock is the NS component of Keddara station recorded during the earthquake in Boumerdes 21 May 2003. The site-specific elastic design spectra for each site are determined to further obtain site specific non-linear acceleration spectra. As a case study, the results of site-specific evaluations are presented for two building sites (site of minaret and site of the prayer hall) to demonstrate the influence of local geological conditions on ground response at Algerian sites. A comparison of computed response with the standard code of practice being used currently in Algeria for the seismic zone of Algiers indicated that the design spectra is not able to capture site amplification due to local geological conditions.

Keywords: equivalent linear, non-linear, ground response analysis, design response spectrum

Procedia PDF Downloads 412

Authors: Germán Gálvez-García, Marta Lavin, Javiera Peña, Javier Albayay, Claudio Bascour, Jesus Fernandez-Gomez, Alicia Pérez-Gálvez

Abstract:

We studied the effectiveness of response inhibition in movements with different degrees of motor complexity when they were executed in isolation and alternately. Sixteen participants performed the Stroop task which was used as a measure of response inhibition. Participants responded by lifting the index finger and reaching the screen with the same finger. Both actions were performed separately and alternately in different experimental blocks. Repeated measures ANOVAs were used to compare reaction time, movement time, kinematic errors and Movement errors across conditions (experimental block, movement, and congruency). Delta plots were constructed to perform distributional analyses of response inhibition and accuracy rate. The effectiveness of response inhibition did not show difference when the movements were performed in separated blocks. Nevertheless, it showed differences when they were performed alternately in the same experimental block, being more effective for the lifting action. This could be due to a competition of the available resources during a more complex scenario which also demands to adopt some strategy to avoid errors.

Keywords: response inhibition, motor complexity, Stroop task, delta plots

Procedia PDF Downloads 365

Authors: Zheni S. Stefanova, Kandethody M. Ramachandran

Abstract:

With the increasing dependency on our computer devices, we face the necessity of adequate, efficient and effective mechanisms, for protecting our network. There are two main problems that Intrusion Detection Systems (IDS) attempt to solve. 1) To detect the attack, by analyzing the incoming traffic and inspect the network (intrusion detection). 2) To produce a prompt response when the attack occurs (intrusion prevention). It is critical creating an Intrusion detection model that will detect a breach in the system on time and also challenging making it provide an automatic and with an acceptable delay response at every single stage of the monitoring process. We cannot afford to adopt security measures with a high exploiting computational power, and we are not able to accept a mechanism that will react with a delay. In this paper, we will propose an intrusion response mechanism that is based on artificial intelligence, and more precisely, reinforcement learning techniques (RLT). The RLT will help us to create a decision agent, who will control the process of interacting with the undetermined environment. The goal is to find an optimal policy, which will represent the intrusion response, therefore, to solve the Reinforcement learning problem, using a Q-learning approach. Our agent will produce an optimal immediate response, in the process of evaluating the network traffic.This Q-learning approach will establish the balance between exploration and exploitation and provide a unique, self-learning and strategic artificial intelligence response mechanism for IDS.

Keywords: cyber security, intrusion prevention, optimal policy, Q-learning

Procedia PDF Downloads 201

Authors: Khaoula Azraiel, Mohamed Mehdi Abassi, Amel Sadraoui, Walid Hammami, Azouz Msaddek, Imed Cheikh, Maria Mancebo, Elisabet Perez-Navarro, Antonio Caruz, Henda Triki, Ahlem Djebbi

Abstract:

IL28B rs12979860 genotype is confirmed as an important predictor of response to peginterferon/ribavirin therapy in patients with chronic hepatitis C (CHC). IFNL4 ss469415590 is a newly discovered polymorphism that could also affect the sustained virological response (SVR). The aim of this study was to evaluate the association of IL28B and IFNL4 genotypes with peginterferon/ribavirin treatment response in Tunisians patients with CHC and to determine which of these SNPs, was the stronger marker. A total of 120 patients were genotyped for both rs12979860 and ss469415590 polymorphisms. The association of each genetic marker with SVR was analyzed and comparison between the two SNPs was calculated by logistic regression models. For rs12979860, 69.6% of patients with CC, 41.8% with CT and 42.8% with TT achieved SVR (p = 0.003). Regarding ss469415590, 70.4% of patients with TT/TT genotype achieved SVR compared to 42.8% with TT/ΔG and 37.5% with ΔG /ΔG (p = 0.002). The presence of CC and TT/TT genotypes was independently associated with treatment response with an OR of 3.86 for each. In conclusion, both IL28B rs12979860 and IFNL4 ss469415590 variants were associated with response to pegIFN/RBV in Tunisian patients, without any additional benefit in performance for IFNL4. Our results are different from those detected in Sub-Saharan Africa countries.

Keywords: Hepatitis C virus, IFNL4, IL28B, Peginterferon/ribavirin, polymorphism

Procedia PDF Downloads 314

Authors: Vivian A. Panes, Raymond John S. Rebong, Miel Q. Diaz

Abstract:

Moringa oleifera Lam. is known mainly for its high nutritional value and medicinal properties contributing to its popular reputation as a 'miracle plant' in the tropical climates where it usually grows. The main objective of this study is to discover the genes and gene products involved in abiotic stress-induced activity that may impact the M. oleifera Lam. mature seeds as well as their corresponding functions. In this study, RNA-sequencing and de novo transcriptome assembly were performed using two assemblers, Trinity and Oases, which produced 177,417 and 120,818 contigs respectively. These transcripts were then subjected to various bioinformatics tools such as Blast2GO, UniProt, KEGG, and COG for gene annotation and the analysis of relevant metabolic pathways. Furthermore, FPKM analysis was performed to identify gene expression levels. The sequences were filtered according to the 'response to stress' GO term since this study dealt with stress response. Clustered Orthologous Groups (COG) showed that the highest frequencies of stress response gene functions were those of cytoskeleton which make up approximately 14% and 23% of stress-related sequences under Trinity and Oases respectively, recombination, repair and replication at 11% and 14% respectively, carbohydrate transport and metabolism at 23% and 9% respectively and defense mechanisms 16% and 12% respectively. KEGG pathway analysis determined the most abundant stress-response genes in the phenylpropanoid biosynthesis at counts of 187 and 166 pathways for Oases and Trinity respectively, purine metabolism at 123 and 230 pathways, and biosynthesis of antibiotics at 105 and 102. Unique and cumulative GO term counts revealed that majority of the stress response genes belonged to the category of cellular response to stress at cumulative counts of 1,487 to 2,187 for Oases and Trinity respectively, defense response at 754 and 1,255, and response to heat at 213 and 208, response to water deprivation at 229 and 228, and oxidative stress at 508 and 488. Lastly, FPKM was used to determine the levels of expression of each stress response gene. The most upregulated gene encodes for thiamine thiazole synthase chloroplastic-like enzyme which plays a significant role in DNA damage tolerance. Data analysis implies that M. oleifera stress response genes are directed towards the effects of climate change more than other stresses indicating the potential of M. oleifera for cultivation in harsh environments because it is resistant to climate change, pathogens, and foreign invaders.

Keywords: stress response, genes, Moringa oleifera, transcriptomics

Procedia PDF Downloads 114

Authors: Akhil Raj Pushparajan, Ranjit Ramachandran, Jijimole Gopi Reji, Ajay Kumar Ramakrishnan

Abstract:

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is one of the leading causes of death by an infectious disease. In spite of the availability of effective drugs and a vaccine, TB is a major health concern and was declared a global emergency by the World Health Organization (WHO). The success of intracellular pathogens like Mtb depends on its ability to overcome the challenging environment in the host. Gene regulation controlled by transcriptional regulators (TRs) plays a crucial role for the bacteria to adapt to the host environment. In vitro studies on gene regulatory mechanisms during dormancy and reactivation have provided insights into the adaptations employed by Mtb to survive in the host. Here we present our efforts to functionally characterize Rv1019, a putative TR of Mtb H37Rv which was found to be present at significantly varying levels during dormancy and reactivation in vitro. The expression of this protein in the dormancy-reactivation model was validated by qRT-PCR and western blot. By DNA- protein interaction studies and reporter assays we found that under normal laboratory conditions of growth this protein behaves as an auto-repressor and tetracycline was found to abrogate this repression by interfering with its ability to bind DNA. Further, by cDNA analysis, we found that this TR is co-transcribed with its downstream genes Rv1020 (mfd) and Rv1021 (mazG) which are involved in DNA damage response in Mtb. Constitutive expression of this regulator in the surrogate host M. smegmatis showed downregulation of the orthologues of downstream genes suggested that Rv1019 could negatively regulate these genes. Our finds also show that M. smegmatis expressing Rv1019 is sensitive to DNA damage suggests the role of this protein in regulating DNA damage response induced by oxidative stress. Because of its role in regulating DNA damage response which may help in the persistence of Mtb, Rv1019 could be used as a prospective target for therapeutic intervention to fight TB.

Keywords: auto-repressor, DNA repair, mycobacterium smegmatis, mycobacterium tuberculosis, tuberculosis

Procedia PDF Downloads 103

Authors: Geetha Jayapathy, Lakshmi Muthukrishnan, Manoj Kumar Reddy Pulim , Radhika Raman

Abstract:

Introduction: Ketones are the end products of fatty acid metabolism and a source of energy for vital organs such as the brain, heart and skeletal muscles. Ketones are produced in excess when glucose is not available as a source of energy or it cannot be utilized as in diabetic ketoacidosis. Children admitted in the emergency department often have starvation ketosis which is not clinically manifested. Decision on admission of children to the emergency room with subtle signs can be difficult at times. Point of care blood ketone testing can be done at the bedside even in a primary level care setting to supplement and guide us in our management decisions. Hence this study was done to explore the utility of this simple bedside parameter as a supplement in assessing pediatric patients presenting to the emergency department. Objectives: To estimate blood ketones of children admitted in the emergency department. To analyze the significance of blood ketones in various disease conditions. Methods: Blood ketones using point of care testing instrument (ABOTTprecision Xceed Pro meters) was done in patients getting admitted in emergency room and in out-patients (through sample collection centre). Study population: Children aged 1 month to 18 years were included in the study. 250 cases (In-patients) and 250 controls (out-patients) were collected. Study design: Prospective observational study. Data on details of illness and physiological status were documented. Blood ketones were compared between the two groups and all in patients were categorized into various system groups and analysed. Results: Mean blood ketones were high in in-patients ranging from 0 to 7.2, with a mean of 1.28 compared to out-patients ranging from 0 to 1.9 with a mean of 0.35. This difference was statistically significant with a p value < 0.001. In-patients with shock (mean of 4.15) and diarrheal dehydration (mean of 1.85) had a significantly higher blood ketone values compared to patients with other system involvement. Conclusion: Blood ketones were significantly high (above the normal range) in pediatric patients who are sick requiring admission. Patients with various forms of shock had very high blood ketone values as found in diabetic ketoacidosis. Ketone values in diarrheal dehydration were moderately high correlating to the degree of dehydration.

Keywords: admission, blood ketones, paediatric emergencies, point of care testing

Procedia PDF Downloads 180

Authors: Nelson Bii, Christopher Ouma, John Odhiambo

Abstract:

Non-response is a potential source of errors in sample surveys. It introduces bias and large variance in the estimation of finite population parameters. Regression models have been recognized as one of the techniques of reducing bias and variance due to random non-response using auxiliary data. In this study, it is assumed that random non-response occurs in the survey variable in the second stage of cluster sampling, assuming full auxiliary information is available throughout. Auxiliary information is used at the estimation stage via a regression model to address the problem of random non-response. In particular, the auxiliary information is used via an improved Nadaraya-Watson kernel regression technique to compensate for random non-response. The asymptotic bias and mean squared error of the estimator proposed are derived. Besides, a simulation study conducted indicates that the proposed estimator has smaller values of the bias and smaller mean squared error values compared to existing estimators of finite population mean. The proposed estimator is also shown to have tighter confidence interval lengths at a 95% coverage rate. The results obtained in this study are useful, for instance, in choosing efficient estimators of the finite population mean in demographic sample surveys.

Keywords: mean squared error, random non-response, two-stage cluster sampling, confidence interval lengths

Procedia PDF Downloads 105

Authors: Peter Antwi Buah, Yingbin Zhang, Jianxian He, Chenlin Xiang, Delali Atsu Y. Bakah

Abstract:

Near-fault ground motions with velocity pulses are considered to cause significant damage to structures or slopes compared to ordinary ground motions without velocity pulses. The double pulsed pulse-like ground motion is as well known to be stronger than the single pulse. This study has numerically justified this perspective by studying the dynamic response of a homogeneous rock slope subjected to four pulse-like and two non-pulse-like ground motions using the Fast Lagrangian Analysis of Continua in 3 Dimensions (FLAC3D) software. Two of the pulse-like ground motions just have a single pulse. The results show that near-fault ground motions with velocity pulses can cause a higher dynamic response than regular ground motions. The amplification of the peak ground acceleration (PGA) in horizontal direction increases with the increase of the slope elevation. The seismic response of the slope under double pulse ground motion is stronger than that of the single pulse ground motion. The PGV amplification factor under the effect of the non-pulse-like records is also smaller than those under the pulse-like records. The velocity pulse strengthens the earthquake damage to the slope, which results in producing a more strong dynamic response.

Keywords: velocity pulses, dynamic response, PGV magnification effect, elevation effect, double pulse

Procedia PDF Downloads 120

Authors: Martha Wilson

Abstract:

With the peak of Computer-Assisted Language Learning slowly coming to pass and Mobile-Assisted Language Learning, at times, a bit lacking in the communicative department, we are now faced with a challenging question: How can we engage the interest of our digital native students and, most importantly, sustain it? As previously mentioned, our classrooms are now experiencing an influx of “digital natives” – people who have grown up using and having unlimited access to technology. While modernizing our curriculum and digitalizing our classrooms are necessary in order to accommodate this new learning style, it is a huge financial burden and a massive undertaking for language institutes. Instead, opting for a more compact, simple, yet multidimensional pedagogical tool may be the solution to the issue at hand. This paper aims to give a brief overview into an existing device referred to as Student Response Systems (SRS) and to expand on this notion to include a new prototype of response system that will be designed as a mobile application to eliminate the need for costly hardware and software. Additionally, an analysis into recent attempts by other institutes to develop the Mobile Response System (MRS) and customer reviews of the existing MRSs will be provided, as well as the lessons learned from those projects. Finally, while the new model of MRS is still in its infancy stage, this paper will discuss the implications of incorporating such an application as a tool to support and to enrich traditional techniques and also offer practical classroom applications with the existing response systems that are immediately available on the market.

Keywords: app, clickers, mobile app, mobile response system, student response system

Procedia PDF Downloads 345

Authors: Orsolya Kegyes-Brassai, Zsolt Szilvágyi, Ákos Wolf, Richard P. Ray

Abstract:

Local ground conditions have a substantial influence on the seismic response of structures. Their inclusion in seismic hazard assessment and structural design can be realized at different levels of sophistication. However, response results based on more advanced calculation methods e.g. nonlinear or equivalent linear site analysis tend to show significant discrepancies when compared to simpler approaches. This project's main objective was to compare results from several 1-D response programs to Eurocode 8 design spectra. Data from in-situ site investigations were used for assessing local ground conditions at several locations in Hungary. After discussion of the in-situ measurements and calculation methods used, a comprehensive evaluation of all major contributing factors for site response is given. While the Eurocode spectra should account for local ground conditions based on soil classification, there is a wide variation in peak ground acceleration determined from 1-D analyses versus Eurocode. Results show that current Eurocode 8 design spectra may not be conservative enough to account for local ground conditions typical for Hungary.

Keywords: 1-D site response analysis, multichannel analysis of surface waves (MASW), seismic CPT, seismic hazard assessment

Procedia PDF Downloads 222

Authors: Morteza Gharibi, Abdolghader Pakniat, Somayeh Bahrampouri

Abstract:

Introduction: Emergency department (E.R.) crowding is a serious widespread problem in hospitals that leads to irregularities, a slower rate of delivery of services to patients, and a long-term stay. In addition, the long-term stay in the E.D. reduces the possibility of providing services with appropriate quality to other patients who are undergoing medical emergencies, which leads to dissatisfaction among patients. This study aimed to determine the relationship between ED-crowding and the mortality rate of the patients referred to the E.D. In a retrospective cohort study, all patients who expired in first 24 hours of admission were enrolled in the study. Crowding index at the moment of admission was calculated using Edwin Score. The data including history and physical examination, time of arrival in the E.D., diagnosis (using ICD 10 code), time of death, cause of death, demographic information was recoded based on triage forms on admission and patients’ medical files. Data analysis was performed by using descriptive statistics and chi square test, ANOVA tests using SPSS ver. 19. The time of arrival in E.D. to death in crowded E.D. conditions, with an average of five hours and 25 minutes, was significantly higher than the average admission Time of arrival in E.D. to death in active and crowded E.D. conditions. More physicians and nurses can be employed during crowded times to reduce staff fatigue and improve their performance during these hours.

Keywords: mortality, emergency, department, crowding

Procedia PDF Downloads 66

Authors: B. Adini, M. Oren

Abstract:

Introduction: Communicable diseases and pandemics pose a growing threat to the well-being of the global population. A vital component of protecting the public health is the creation and sustenance of a continuous preparedness for such hazards. A joint Israeli-German task force was deployed in order to develop an advanced tool for self-evaluation of emergency preparedness for variable types of biological threats. Methods: Based on a comprehensive literature review and interviews with leading content experts, an evaluation tool was developed based on quantitative and qualitative parameters and indicators. A modified Delphi process was used to achieve consensus among over 225 experts from both Germany and Israel concerning items to be included in the evaluation tool. Validity and applicability of the tool for medical institutions was examined in a series of simulation and field exercises. Results: Over 115 German and Israeli experts reviewed and examined the proposed parameters as part of the modified Delphi cycles. A consensus of over 75% of experts was attained for 183 out of 188 items. The relative importance of each parameter was rated as part of the Delphi process, in order to define its impact on the overall emergency preparedness. The parameters were integrated in computerized web-based software that enables to calculate scores of emergency preparedness for biological events. Conclusions: The parameters developed in the joint German-Israeli project serve as benchmarks that delineate actions to be implemented in order to create and maintain an ongoing preparedness for biological events. The computerized evaluation tool enables to continuously monitor the level of readiness and thus strengths and gaps can be identified and corrected appropriately. Adoption of such a tool is recommended as an integral component of quality assurance of public health and safety.

Keywords: biological events, emergency preparedness, bioterrorism, natural biological events

Procedia PDF Downloads 392

Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

Abstract:

Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

Procedia PDF Downloads 67

Authors: A. Baqqal, O. Abduhamid, H. Abdul-Hameed, T. Messager, G. Ayoub

Abstract:

In this contribution, the effect of crystal content on the cyclic response of semi-crystalline polyethylene is studied over a large strain range. Experimental observations on a high-density polyethylene with 72% crystal content and an ultralow density polyethylene with 15% crystal content are reported. The cyclic stretching does appear a thermoplastic-like response for high crystallinity and an elastomeric-like response for low crystallinity, both characterized by a stress-softening, a hysteresis and a residual strain, whose amount depends on the crystallinity and the applied strain. Based on the experimental observations, a unified viscoelastic-viscoplastic constitutive model capturing the polyethylene cyclic response features is proposed. A two-phase representation of the polyethylene microstructure allows taking into consideration the effective contribution of the crystalline and amorphous phases to the intermolecular resistance to deformation which is coupled, to capture the strain hardening, to a resistance to molecular orientation. The polyethylene cyclic response features are captured by introducing evolution laws for the model parameters affected by the microstructure alteration due to the cyclic stretching.

Keywords: cyclic loading unloading, polyethylene, semi-crystalline polymer, viscoelastic-viscoplastic constitutive model

Procedia PDF Downloads 184

Authors: J. D. Ho, D. M. Dawes, B. Driver

Abstract:

Introduction: TASER Conducted Electrical Weapons (CEWs) are the dominant CEWs in use and have been used in modern police and military operations since the late 1990s as a form of non-lethal weaponry. The 3rd generation of CEWs has been recently introduced and is known as The TASER 7. This new CEW will be replacing current CEW technology and has a new dart design that is important for emergency medical professionals to be familiar with because it requires a different method of removal and will leave a different marking pattern in human tissue than they may have been previously familiar with. features of this new dart design include: higher velocity impact, larger impact surface area, break away dart body segment, dual back-barb retention, newly designed removal process. As the TASER 7 begins to be deployed by the police and military personnel, these new features make it imperative that emergency medical professionals become familiar with the signature markings that this new dart design will make on human tissue and how to remove them. Methods: Multiple observational studies using high speed photography were used to record impact patterns of the new dart design on fresh tissue and also the newly recommended dart removal process. Both animal and human subjects were used to test this dart design prior to production release. Results: Data presented will include dart design overview, flight pattern accuracy, impact analysis, and dart removal example. Tissue photographs will be presented to demonstrate examples of signature TASER 7 dart markings that emergency medical professionals can expect to see. Conclusion: This work will provide the reader with an understanding of this newest generation CEW dart design, its key features, its signature marking pattern that can be expected and a recommendation of how to remove it from human tissue.

Keywords: TASER 7, conducted electrical weapon, dart mark, dart removal

Procedia PDF Downloads 124

Authors: Adeniran Adetunji, Babalola M. Florence, Akande Ademola

Abstract:

In this paper, we made an overview on the concept of adaptive e-Learning system, enumerates the elements of adaptive learning concepts e.g. A pedagogical framework, multiple learning strategies and pathways, continuous monitoring and feedback on student performance, statistical inference to reach final learning strategy that works for an individual learner by “mass-customization”. Briefly highlights the motivation of this new system proposed for effective learning teaching. E-Review literature on the concept of adaptive e-learning system and emphasises on the Item Response Calibration, which is an important approach to developing an adaptive e-Learning system. This paper write-up is concluded on the justification of item response calibration/estimation towards designing a successful and effective adaptive e-Learning system.

Keywords: adaptive e-learning system, pedagogical framework, item response, computer applications

Procedia PDF Downloads 559

Authors: Sen-Yung Lee, Li-Kuo Chou, Chao-Kuang Chen

Abstract:

In this study, the problem of temperature transient response of a spiral fin, with its end insulated, is analyzed with base end subjected to a variation of fluid temperature. The hybrid method of Laplace transforms/Adomian decomposed method-Padé, is applied to the temperature transient response of the fin, the result of the temperature distribution and the heat flux at the base of the spiral fin are obtained, show a good agreement in the physical phenomenon.

Keywords: Laplace transforms, Adomian decomposed method- Padé, transient response, heat transfer

Procedia PDF Downloads 392

Authors: Jonathan D. Recchi

Abstract:

Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

Procedia PDF Downloads 72

Authors: A. Latif Karimi, M. K. Shrimali

Abstract:

Seismic design is a critical stage in the process of design and construction of a building. It includes strategies for designing earthquake-resistant buildings to ensure health, safety, and security of the building occupants and assets. Hence, it becomes very important to understand the behavior of structural members precisely, for construction of buildings that can yield a better response to seismic forces. This paper investigates the behavior of a typical structure when subjected to ground motion. The corresponding mode shapes and modal frequencies are studied to interpret the response of an actual structure using different fabricated models and 3D visual models. In this study, three different structural configurations are subjected to horizontal ground motion, and the effect of “stiffness eccentricity” and placement of infill walls are checked to determine how each parameter contributes in a building’s response to dynamic forces. The deformation data from lab experiments and the analysis on SAP2000 software are reviewed to obtain the results. This study revealed that seismic response in a building can be improved by introducing higher deformation capacity in the building. Also, proper design of infill walls and maintaining a symmetrical configuration in a building are the key factors in building stability during the earthquake.

Keywords: eccentricity, seismic response, mode shape, building configuration, building dynamics

Procedia PDF Downloads 166

Authors: Alok Kumar, Raviraj Patil

Abstract:

The ability to respond to an incident of a disastrous event in a vulnerable area is very crucial an aspect of emergency management. The ability to constantly predict the likelihood of an event along with its severity in an area and react to those significant events which are likely to have a high impact allows the authorities to respond by allocating resources optimally in a timely manner. It provides for measuring, monitoring, and modeling facilities that integrate underlying systems into one solution to improve operational efficiency, planning, and coordination. We were particularly involved in this innovative incubation work on the current state of research and development in collaboration. technologies & systems for a disaster.

Keywords: predictive analytics, advanced analytics, area flood likelihood model, area flood severity model, level of impact model, mortality score, economic loss score, resource allocation, crew allocation

Procedia PDF Downloads 286