Search results for: follow deer
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1777

Search results for: follow deer

367 Alveolar Ridge Preservation in Post-extraction Sockets Using Concentrated Growth Factors: A Split-Mouth, Randomized, Controlled Clinical Trial

Authors: Sadam Elayah

Abstract:

Background: One of the most critical competencies in advanced dentistry is alveolar ridge preservation after exodontia. The aim of this clinical trial was to assess the impact of autologous concentrated growth factor (CGF) as a socket-filling material and its ridge preservation properties following the lower third molar extraction. Materials and Methods: A total of 60 sides of 30 participants who had completely symmetrical bilateral impacted lower third molars were enrolled. The short-term outcome variables were wound healing, swelling and pain, clinically assessed at different time intervals (1st, 3rd & 7th days). While the long-term outcome variables were bone height & width, bone density and socket surface area in the coronal section. Cone beam computed tomography images were obtained immediately after surgery and three months after surgery as a temporal measure. Randomization was achieved by opaque, sealed envelopes. Follow-up data were compared to baseline using Paired & Unpaired t-tests. Results: The wound healing index was significantly better in the test sides (P =0.001). Regarding the facial swelling, the test sides had significantly fewer values than the control sides, particularly on the 1st (1.01±.57 vs 1.55 ±.56) and 3rd days (1.42±0.8 vs 2.63±1.2) postoperatively. Nonetheless, the swelling disappeared within the 7th day on both sides. The pain scores of the visual analog scale were not a statistically significant difference between both sides on the 1st day; meanwhile, the pain scores were significantly lower on the test sides compared with the control sides, especially on the 3rd (P=0.001) and 7th days (P˂0.001) postoperatively. Regarding long-term outcomes, CGF sites had higher values in height and width when compared to Control sites (Buccal wall 32.9±3.5 vs 29.4±4.3 mm, Lingual wall 25.4±3.5 vs 23.1±4 mm, and Alveolar bone width 21.07±1.55vs19.53±1.90 mm) respectively. Bone density showed significantly higher values in CGF sites than in control sites (Coronal half 200±127.3 vs -84.1±121.3, Apical half 406.5±103 vs 64.2±158.6) respectively. There was a significant difference between both sites in reducing periodontal pockets. Conclusion: CGF application following surgical extraction provides an easy, low-cost, and efficient option for alveolar ridge preservation. Thus, dentists may encourage using CGF during dental extractions, particularly when alveolar ridge preservation is required.

Keywords: platelet, extraction, impacted teeth, alveolar ridge, regeneration, CGF

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366 A Critical Discourse Analysis of ‘Youth Radicalisation’: A Case of the Daily Nation Kenya Online Newspaper

Authors: Miraji H. Mohamed

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The purpose of this study is to critique ‘radicalisation’ and more particularly ‘youth radicalisation’ by exploring its usage in online newspapers. ‘Radicalisation’ and ‘extremism’ have become the most common terms in terrorism studies since the 9/11 attacks. Regardless of the geographic location, when the word terrorism is used the terms ‘radicalisation’ and ‘extremism’ always follow to attempt to explore the journey of the perpetrators towards violence. These terms have come to represent a discourse of dominantly pejorative traits often used to describe spaces, groups, and processes identified as problematic. Even though ambiguously defined they feature widely in government documents, political statements, news articles, academic research, social media platforms, religious gatherings, and public discussions. Notably, ‘radicalisation’ and ‘extremism’ have been closely conflated with the term youth to form ‘youth radicalisation’ to refer to a discourse of ‘youth at risk’. The three terms largely continue to be used unquestioningly and interchangeably hence the reason why they are placed in single quotation marks to deliberately question their conventional usage. Albeit this comes timely in the Kenyan context where there has been a proliferation of academic and expert research on ‘youth radicalisation’ (used as a neutral label) without considering the political, cultural and socio-historical contexts that inform this label. This study seeks to draw these nuances by employing a genealogical approach that historicises and deconstructs ‘youth radicalisation’; and by applying a Discourse-Historical Approach (DHA) of Critical Discourse Analysis to analyse Kenyan online newspaper - The Daily Nation between 2015 and 2018. By applying the concept of representation to analyse written texts, the study reveals that the use of ‘youth radicalisation’ as a discursive strategy disproportionately affects young people especially those from cultural/ethnic/religious minority groups. Also, the ambiguous use of ‘radicalisation’ and ‘youth radicalisation’ by the media reinforces the discourse of ‘youth at risk’ which has become the major framework underpinning Countering Violent Extremism (CVE) interventions. Similarly, the findings indicate that the uncritical use of ‘youth radicalisation’ has been used to serve political interests; and has become an instrument of policing young people, thus contributing to their cultural shaping. From this, it is evident that the media could thwart rather than assist CVE efforts. By exposing the political nature of the three terms through evidence-based research, this study offers recommendations on how critical reflective reporting by the media could help to make CVE more nuanced.

Keywords: discourse, extremism, radicalisation, terrorism, youth

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365 Medical Complications in Diabetic Recipients after Kidney Transplantation

Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

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Diabetes mellitus is the most common etiology of end-stage renal disease (ESRD). Also, diabetic nephropathy is the etiology of ESRD in approximately 23% of kidney transplant recipients. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients. However, patients require close follow-up after transplantation due to medical complications. Diabetes mellitus can affect patient morbidity and mortality due to possible effects of immunosuppressive therapy on glucose metabolism. We compared the frequency of medical complications and the outcomes in diabetic and non-diabetic kidney transplant recipients. Materials and Methods: This retrospective study conducted in 498 patients who underwent kidney transplant surgery at our center in 10-year periods. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). The medical complications, graft functions, causes of graft loss and death were obtained from medical records. Results: There was no significant difference between recipient age, duration of dialysis, body mass index, gender, donor type, donor age, dialysis type, histories of HBV, HCV and coronary artery disease between two groups. The history of hypertension in diabetics was higher (69% vs. 36%, p < 0.001). The ratios of hypertension (50.1% vs. 57.1%), pneumonia (21.9% vs. 20%), urinary infection (16.9% vs. 20%), transaminase elevation (11.5% vs. 20%), hyperpotasemia (14.7% vs. 17.1%), hyponatremia (9.7% vs. 20%), hypotension (7.1% vs. 7.9%), hypocalcemia (1.4% vs. 0%), thrombocytopenia (8.6% vs. 8.6%), hypoglycemia (0.7% vs. 0%) and neutropenia (1.8% vs. 0%) were comparable in non-diabetic and diabetic groups, respectively. The frequency of hyperglycaemia in diabetics was higher (8.6% vs. 54.3%, p < 0.001). After transplantation, primary non-function (3.4% vs. 2.6%), delayed graft function (25.1% vs. 34.2%) and acute rejection (7.3% vs. 10.5%) ratios of in non-diabetic and diabetic groups were similar, respectively. Hospitalization durations in non-diabetics and diabetics were 22.5 ± 17.5 and 18.7 ± 13 day (p=0.094). Mean serum creatinine levels in non-diabetics and diabetics were 1.54 ± 0.74 and 1.52 ± 0.62 mg/dL at 6th month. Forty patients had graft loss. The ratios of graft loss and death in non-diabetic and diabetic groups were 8.2% vs. 7.1% and 7.1% vs. 2.6% (p > 0.05). There was no significant relationship between graft and patient survivals with the development of medical complication. Conclusion: As a result, medical complications are common in the early period. Hyperglycaemia was frequently seen following transplantation due to the effects of immunosuppressant regimens. However, the frequency of other medical complications in diabetic patients did not differ from non-diabetic one. The most important cause of death is still infections. The development of medical complications during the first 6 months did not significantly affect transplant outcomes.

Keywords: kidney transplantation, diabetes mellitus, complication, graft function

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364 Effect of Lullabies on Babies Stress and Relaxation Symptoms in the Neonatal Intensive Care Units

Authors: Meltem Kürtüncü, Işın Alkan

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Objective: This study was carried out with an experimental design in order to determine whether the lullaby, which was listened from mother’s voice and a stranger’s voice to the babies born at term and hospitalized in neonatal intensive care unit, had an effect on stress and relaxation symptoms of the infants. Method: Data from the study were obtained from 90 newborn babies who were hospitalized in Neonatal Intensive Care Unit of Zonguldak Maternity And Children Hospital between September 2015-January 2016 and who met the eligibility criteria. Lullaby concert was performed by choosing one of the suitable care hours. Stress and relaxation symptoms were recorded by the researcher on “Newborn response follow-up form” at pre-care and post-care. Results: After lullaby concert when stress symptoms compared to infants in the experimental and control groups before the care was not detected statistically significant difference between crying, contraction, facial grimacing, flushing, cyanosis and the rates of increase in temperature. After care, crying, contractions, facial grimacing, flushing, and restlessness revealed a statistically significant difference between the groups, but as the cyanosis and temperature increased stress responses did not result in a significant difference between the groups. In the control group babies the crying, contraction, facial grimacing, flushing, and restlessness behaviors rates were found to be significantly higher than experimental group babies. After lullaby concert when relaxation symptoms compared to infants in the experimental and control groups before the care, eye contact rates who listen to lullaby from mother’s voice was found to be significantly higher than infants who listen to lullaby from stranger’s voice and infants in the control group. After care as eye contact, smiling, sucking/searching, yawning, non-crying and sleep behaviors relaxation symptoms revealed statistically significant results. In the control group, these behaviors were found statistically lower degree than the experimental groups. Conclusion: Lullaby concerts as masking the ambient noise, reducing the stress symptoms and increasing the relaxation symptoms, and also for soothing and stimulant affects, due to ease the transition to the sleep state should be preferred in the neonatal intensive care units.

Keywords: lullaby, mother voice, relaxation, stress

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363 A Rare Case of Myometrial Ectopic

Authors: Madeleine Cox

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Objective: Discussion of diagnosis and management options for myometrial ectopic pregnancy Case: A 30 yo G1P0 presented to the emergency department with vaginal bleeding for the last 4 days. She had a positive home urine pregnancy test, confirmed with a serum HCG. When she presented for an ultrasound, there was no intrauterine pregnancy, no evidence of adnexal pregnancy, however, the anterior myometrium of the uterus was noted to be markedly abnormal. When she presented to the emergency department of a busy tertiary hospital in Queensland, she had a small amount of vaginal bleeding, was anxious but well, observations normal. Repeat blood testes demonstrated a serum HCG of 9246 IU/L, haemoglobin of 143g/L. The patient had an interesting history of a right oophorectomy and open myomectomy in another country. A repeat ultrasound again showed an abnormality within the myometrium of the uterus, which was initially reported as concerning for an AVM, or potentially invasive gestational trophoblastic disease. An MRI was organised 2 days later, which demonstrated a intramural/subserosal irregularity in the right lateral body measuring 35x38x42mm with peripheral enhancement and central cystic components, favouring a myometrial ectopic most likely at the site of previous myomectomy. Alternative diagnosis of AVM, GTD were considered less likely. After discussion with the patient, IV methotrexate was administered as an in patient 4 days after her initial presentation to emergency. After this, her HCG fell to 1236 IU/L on day 6 post treatment. Weekly reviews showed stable ultrasound appearances with a steadily dropping HCG level. A repeat MRI was performed 3 weeks after methotrexate administration which confirmed involution of the myometrial ectopic, however, showed ongoing progression of vascularity surrounding the site. Despite resolution of HCG, the patient persisted to have ongoing bleeding associated with this and went to have uterine artery embolisation. Follow up ultrasound showed resolution of abnormal vascularity and negative HCG levels. Conclusion: Myometrial ectopic pregnancies are a rare occurrence and require a multidisciplinary approach to achieve timely management for these patients. This patient was in a very well resourced setting with excellent access to Interventional Radiology and specialist Radiologists who could work together with the Obstetrics, Gynaecology, and Maternal Fetal Medicine team to provide multiple options of management which preserved her fertility. This case has a very good outcome, with the patient being referred back to our service 12 months later with an early intrauterine pregnancy.

Keywords: ectopic, pregnancy, miscarriage, gynaecology

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362 Audit on Antibiotic Prophylaxis and Post-Procedure Complication Rate for Patients Undergoing Transperineal Template Biopsies of the Prostate

Authors: W. Hajuthman, R. Warner, S. Rahman, M. Abraham, H. Helliwell, D. Bodiwala

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Context: Prostate cancer is a prevalent cancer in males in Europe and the US, with diagnosis primarily relying on PSA testing, mpMRI, and subsequent biopsies. However, this diagnostic strategy may lead to complications for patients. Research Aim: The aim of this study is to assess compliance with trust guidelines for antibiotic prophylaxis in patients undergoing transperineal template biopsies of the prostate and evaluate the rate of post-procedure complications. Methodology: This study is conducted retrospectively over an 8-month period. Data collection includes patient demographics, compliance with trust guidelines, associated risk factors, and post-procedure complications such as infection, haematuria, and urinary retention. Findings: The audit includes 100 patients with a median age of 66.11. The compliance with pre-procedure antibiotics was 98%, while compliance with antibiotic prophylaxis recommended by trust guidelines was 68%. Among the patients, 3% developed post-procedure sepsis, with 2 requiring admission for intravenous antibiotics. No evident risk factors were identified in these cases. Additionally, post-procedure urinary retention occurred in 3% of patients and post-procedure haematuria in 2%. Theoretical Importance: This study highlights the increasing use of transperineal template biopsies across UK centres and suggests that having a standardized protocol and compliance with guidelines can reduce confusion, ensure appropriate administration of antibiotics, and mitigate post-procedure complications. Data Collection and Analysis Procedures: Data for this study is collected retrospectively, involving the extraction and analysis of relevant information from patient records over the specified 8-month period. Question Addressed: This study addresses the following research questions: (1) What is the compliance rate with trust guidelines for antibiotic prophylaxis in transperineal template biopsies of the prostate? (2) What is the rate of post-procedure complications, such as infection, haematuria, and urinary retention? Conclusion: Transperineal template biopsies are becoming increasingly prevalent in the UK. Implementing a standardized protocol and ensuring compliance with guidelines can reduce confusion, ensure proper administration of antibiotics, and potentially minimize post-procedure complications. Additionally, considering that studies show no difference in outcomes when prophylactic antibiotics are not used, the reminder to follow trust guidelines may prompt a re-evaluation of antibiotic prescribing practices.

Keywords: prostate, transperineal template biopsies of prostate, antibiotics, complications, microbiology, guidelines

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361 Preferences of Electric Buses in Public Transport; Conclusions from Real Life Testing in Eight Swedish Municipalities

Authors: Sven Borén, Lisiana Nurhadi, Henrik Ny

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From a theoretical perspective, electric buses can be more sustainable and can be cheaper than fossil fuelled buses in city traffic. The authors have not found other studies based on actual urban public transport in Swedish winter climate. Further on, noise measurements from buses for the European market were found old. The aims of this follow-up study was therefore to test and possibly verify in a real-life environment how energy efficient and silent electric buses are, and then conclude on if electric buses are preferable to use in public transport. The Ebusco 2.0 electric bus, fitted with a 311 kWh battery pack, was used and the tests were carried out during November 2014-April 2015 in eight municipalities in the south of Sweden. Six tests took place in urban traffic and two took place in more of a rural traffic setting. The energy use for propulsion was measured via logging of the internal system in the bus and via an external charging meter. The average energy use turned out to be 8% less (0,96 kWh/km) than assumed in the earlier theoretical study. This rate allows for a 320 km range in public urban traffic. The interior of the bus was kept warm by a diesel heater (biodiesel will probably be used in a future operational traffic situation), which used 0,67 kWh/km in January. This verified that electric buses can be up to 25% cheaper when used in public transport in cities for about eight years. The noise was found to be lower, primarily during acceleration, than for buses with combustion engines in urban bus traffic. According to our surveys, most passengers and drivers appreciated the silent and comfortable ride and preferred electric buses rather than combustion engine buses. Bus operators and passenger transport executives were also positive to start using electric buses for public transport. The operators did however point out that procurement processes need to account for eventual risks regarding this new technology, along with personnel education. The study revealed that it is possible to establish a charging infrastructure for almost all studied bus lines. However, design of a charging infrastructure for each municipality requires further investigations, including electric grid capacity analysis, smart location of charging points, and tailored schedules to allow fast charging. In conclusion, electric buses proved to be a preferable alternative for all stakeholders involved in public bus transport in the studied municipalities. However, in order to electric buses to be a prominent support for sustainable development, they need to be charged either by stand-alone units or via an expansion of the electric grid, and the electricity should be made from new renewable sources.

Keywords: sustainability, electric, bus, noise, greencharge

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360 Risk of Mortality and Spectrum of Second Primary Malignancies in Mantle Cell Lymphoma before and after Ibrutinib Approval: A Population-Based Study

Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari

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Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.

Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers

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359 Mini-Open Repair Using Ring Forceps Show Similar Results to Repair Using Achillon Device in Acute Achilles Tendon Rupture

Authors: Chul Hyun Park

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Background:Repair using the Achillon deviceis a representative mini-open repair technique;however, the limitations of this technique includethe need for special instruments and decreasedrepair strength.A modifiedmini-open repair using ring forcepsmight overcome these limitations. Purpose:This study was performed to compare the Achillon device with ring forceps in mini-open repairsof acute Achilles tendon rupture. Study Design:This was a retrospective cohort study, and the level of evidence was3. Methods:Fifty patients (41 men and 9 women), withacute Achilles tendon rupture on one foot, were consecutively treated using mini-open repair techniques. The first 20 patients were treated using the Achillon device (Achillon group) and the subsequent 30 patients were treated using a ring forceps (Forcep group). Clinical, functional, and isokinetic results,and postoperative complications were compared between the two groups at the last follow-up. Clinical evaluations wereperformed using the American Orthopedic Foot and Ankle Society (AOFAS) score, Achilles tendon Total Rupture Score (ATRS), length of incision, and operation time. Functional evaluationsincludedactive range of motion (ROM) of the ankle joint, maximum calf circumference (MCC), hopping test, and single limb heel-rise (SLHR) test. Isokinetic evaluations were performed using the isokinetic test for ankle plantar flexion. Results:The AOFAS score (p=0.669), ATRS (p=0.753), and length of incision (p=0.305) were not significantly different between the groups. Operative times in the Achillon group were significantly shorter than that in the Forcep group (p<0.001).The maximum height of SLHR (p=0.023) and number of SLHRs (p=0.045) in the Forcep group were significantly greater than that in the Achillon group. No significant differences in the mean peak torques for plantar flexion at angular speeds of 30°/s (p=0.219) and 120°/s (p=0.656) were detected between the groups. There was no significant difference in the occurrence of postoperative complications between the groups (p=0.093). Conclusion:The ring forceps technique is comparable with the Achillon technique with respect to clinical, functional, and isokinetic results and the postoperative complications. Given that no special instrument is required, the ring forceps technique could be a better option for acute Achilles tendon rupture repair.

Keywords: achilles tendon, acute rupture, repair, mini-open

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358 Spontaneous Rupture of Splenic Artery Pseudoaneurysm; A Rare Presentation of Acute Abdominal Pain in the Emergency Department: Case Report

Authors: Zainab Elazab, Azhar Aziz

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Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

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357 The Morphogenesis of an Informal Settlement: An Examination of Street Networks through the Informal Development Stages Framework

Authors: Judith Margaret Tymon

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As cities struggle to incorporate informal settlements into the fabric of urban areas, the focus has often been on the provision of housing. This study explores the underlying structure of street networks, with the goal of understanding the morphogenesis of informal settlements through the lens of the access network. As the stages of development progress from infill to consolidation and eventually, to a planned in-situ settlement, the access networks retain the form of the core segments; however, a majority of street patterns are adapted to a grid design to support infrastructure in the final upgraded phase. A case study is presented to examine the street network in the informal settlement of Gobabis Namibia as it progresses from its initial stages to a planned, in-situ, and permanently upgraded development. The Informal Development Stages framework of foundation, infill, and consolidation, as developed by Dr. Jota Samper, is utilized to examine the evolution of street networks. Data is gathered from historical Google Earth satellite images for the time period between 2003 and 2022. The results demonstrate that during the foundation through infill stages, incremental changes follow similar patterns, with pathways extended, lengthened, and densified as housing is created and the settlement grows. In the final stage of consolidation, the resulting street layout is transformed to support the installation of infrastructure; however, some elements of the original street patterns remain. The core pathways remain intact to accommodate the installation of infrastructure and the creation of housing plots, defining the shape of the settlement and providing the basis of the urban form. The adaptations, growth, and consolidation of the street network are critical to the eventual formation of the spatial layout of the settlement. This study will include a comparative analysis of findings with those of recent research performed by Kamalipour, Dovey, and others regarding incremental urbanism within informal settlements. Further comparisons will also include studies of street networks of well-established urban centers that have shown links between the morphogenesis of access networks and the eventual spatial layout of the city. The findings of the study can be used to guide and inform strategies for in-situ upgrading and can contribute to the sustainable development of informal settlements.

Keywords: Gobabis Namibia, incremental urbanism, informal development stages, informal settlements, street networks

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356 The Epistemology of Human Rights Cherished in Islamic Law and Its Compatibility with International Law

Authors: Malik Imtiaz Ahmad

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Human beings are the super organism granted the gift of consciousness of life by the Almighty God and endowed with an intrinsic legal value to their humanity that shall be guarded and protected respecting dignity regardless of your cultural, religious, race, or physical background; you want to be treated equally for a reason for being human. Islam graces the essential integrity of humanity and confirms the freedom and accountability impact on individuality and the open societal sphere, including the moral, economic, and political aspects. Human Rights allow people to live with dignity, equality, justice, freedom, and peace. The Kantian approach to morality expresses that ethical actions follow universal moral laws. Hence, human rights are based upon the normative approaches setting the international standards to promote, guard, and protect the fundamental rights of the people. Islam is a divine religion commanding human rights based upon the principles of social justice and regulates all facets of the moral and spiritual ethics of Muslims besides bringing balance abreast in the non-Muslims to respect their lives with safety and security and property. The Canon law manifests the faith and equality amongst Christianity, regulating the communal dignity to build and promote the sanctity of Holy life (can. 208 to 223). This concept of the community is developed after the insight of the Islamic 'canon law', which is the code of revelation itself and inseparable from the natural part of the salvation of mankind. The etymology and history of human rights is a polemical debate in a preview of Islamic and Western culture. On the other hand, international law is meticulous about the fundamental part of Conon law that focuses on the communal political, social and economic relationship. The evolving process of human rights is considered to be an exclusive universal thought regarding an open society that forms a legal base for the constituent of international instruments of the protection of Human Rights, viz. UDHR. On the other side, Muslim scholars emphasize that human rights are devolving around Islamic law. Both traditions need a dire explanation of contemporary openness for bringing the harmonious universal law acceptable and applicable to the international communities concerning the anthropology of political, economic, and social aspects of a human being.

Keywords: human rights-based approach (HRBA), human rights in Islam, evolution of universal human rights, conflict in western, Islamic human rights

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355 Investigation a New Approach "AGM" to Solve of Complicate Nonlinear Partial Differential Equations at All Engineering Field and Basic Science

Authors: Mohammadreza Akbari, Pooya Soleimani Besheli, Reza Khalili, Davood Domiri Danji

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In this conference, our aims are accuracy, capabilities and power at solving of the complicated non-linear partial differential. Our purpose is to enhance the ability to solve the mentioned nonlinear differential equations at basic science and engineering field and similar issues with a simple and innovative approach. As we know most of engineering system behavior in practical are nonlinear process (especially basic science and engineering field, etc.) and analytical solving (no numeric) these problems are difficult, complex, and sometimes impossible like (Fluids and Gas wave, these problems can't solve with numeric method, because of no have boundary condition) accordingly in this symposium we are going to exposure an innovative approach which we have named it Akbari-Ganji's Method or AGM in engineering, that can solve sets of coupled nonlinear differential equations (ODE, PDE) with high accuracy and simple solution and so this issue will emerge after comparing the achieved solutions by Numerical method (Runge-Kutta 4th). Eventually, AGM method will be proved that could be created huge evolution for researchers, professors and students in whole over the world, because of AGM coding system, so by using this software we can analytically solve all complicated linear and nonlinear partial differential equations, with help of that there is no difficulty for solving all nonlinear differential equations. Advantages and ability of this method (AGM) as follow: (a) Non-linear Differential equations (ODE, PDE) are directly solvable by this method. (b) In this method (AGM), most of the time, without any dimensionless procedure, we can solve equation(s) by any boundary or initial condition number. (c) AGM method always is convergent in boundary or initial condition. (d) Parameters of exponential, Trigonometric and Logarithmic of the existent in the non-linear differential equation with AGM method no needs Taylor expand which are caused high solve precision. (e) AGM method is very flexible in the coding system, and can solve easily varieties of the non-linear differential equation at high acceptable accuracy. (f) One of the important advantages of this method is analytical solving with high accuracy such as partial differential equation in vibration in solids, waves in water and gas, with minimum initial and boundary condition capable to solve problem. (g) It is very important to present a general and simple approach for solving most problems of the differential equations with high non-linearity in engineering sciences especially at civil engineering, and compare output with numerical method (Runge-Kutta 4th) and Exact solutions.

Keywords: new approach, AGM, sets of coupled nonlinear differential equation, exact solutions, numerical

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354 Change of Bone Density with Treatments of Intravenous Zoledronic Acid in Patients with Osteoporotic Distal Radial Fractures

Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

Procedia PDF Downloads 96
353 Efficient Estimation of Maximum Theoretical Productivity from Batch Cultures via Dynamic Optimization of Flux Balance Models

Authors: Peter C. St. John, Michael F. Crowley, Yannick J. Bomble

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Production of chemicals from engineered organisms in a batch culture typically involves a trade-off between productivity, yield, and titer. However, strategies for strain design typically involve designing mutations to achieve the highest yield possible while maintaining growth viability. Such approaches tend to follow the principle of designing static networks with minimum metabolic functionality to achieve desired yields. While these methods are computationally tractable, optimum productivity is likely achieved by a dynamic strategy, in which intracellular fluxes change their distribution over time. One can use multi-stage fermentations to increase either productivity or yield. Such strategies would range from simple manipulations (aerobic growth phase, anaerobic production phase), to more complex genetic toggle switches. Additionally, some computational methods can also be developed to aid in optimizing two-stage fermentation systems. One can assume an initial control strategy (i.e., a single reaction target) in maximizing productivity - but it is unclear how close this productivity would come to a global optimum. The calculation of maximum theoretical yield in metabolic engineering can help guide strain and pathway selection for static strain design efforts. Here, we present a method for the calculation of a maximum theoretical productivity of a batch culture system. This method follows the traditional assumptions of dynamic flux balance analysis: that internal metabolite fluxes are governed by a pseudo-steady state and external metabolite fluxes are represented by dynamic system including Michealis-Menten or hill-type regulation. The productivity optimization is achieved via dynamic programming, and accounts explicitly for an arbitrary number of fermentation stages and flux variable changes. We have applied our method to succinate production in two common microbial hosts: E. coli and A. succinogenes. The method can be further extended to calculate the complete productivity versus yield Pareto surface. Our results demonstrate that nearly optimal yields and productivities can indeed be achieved with only two discrete flux stages.

Keywords: A. succinogenes, E. coli, metabolic engineering, metabolite fluxes, multi-stage fermentations, succinate

Procedia PDF Downloads 190
352 Intensity Modulated Radiotherapy of Nasopharyngeal Carcinomas: Patterns of Loco Regional Relapse

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

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Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

Procedia PDF Downloads 103
351 Co-Creational Model for Blended Learning in a Flipped Classroom Environment Focusing on the Combination of Coding and Drone-Building

Authors: A. Schuchter, M. Promegger

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The outbreak of the COVID-19 pandemic has shown us that online education is so much more than just a cool feature for teachers – it is an essential part of modern teaching. In online math teaching, it is common to use tools to share screens, compute and calculate mathematical examples, while the students can watch the process. On the other hand, flipped classroom models are on the rise, with their focus on how students can gather knowledge by watching videos and on the teacher’s use of technological tools for information transfer. This paper proposes a co-educational teaching approach for coding and engineering subjects with the help of drone-building to spark interest in technology and create a platform for knowledge transfer. The project combines aspects from mathematics (matrices, vectors, shaders, trigonometry), physics (force, pressure and rotation) and coding (computational thinking, block-based programming, JavaScript and Python) and makes use of collaborative-shared 3D Modeling with clara.io, where students create mathematics knowhow. The instructor follows a problem-based learning approach and encourages their students to find solutions in their own time and in their own way, which will help them develop new skills intuitively and boost logically structured thinking. The collaborative aspect of working in groups will help the students develop communication skills as well as structural and computational thinking. Students are not just listeners as in traditional classroom settings, but play an active part in creating content together by compiling a Handbook of Knowledge (called “open book”) with examples and solutions. Before students start calculating, they have to write down all their ideas and working steps in full sentences so other students can easily follow their train of thought. Therefore, students will learn to formulate goals, solve problems, and create a ready-to use product with the help of “reverse engineering”, cross-referencing and creative thinking. The work on drones gives the students the opportunity to create a real-life application with a practical purpose, while going through all stages of product development.

Keywords: flipped classroom, co-creational education, coding, making, drones, co-education, ARCS-model, problem-based learning

Procedia PDF Downloads 98
350 The Effectiveness of a Self-Efficacy Psychoeducational Programme to Enhance Outcomes of Patients with End-Stage Renal Disease

Authors: H. C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological well-being, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes and it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 286
349 Digital Image Correlation: Metrological Characterization in Mechanical Analysis

Authors: D. Signore, M. Ferraiuolo, P. Caramuta, O. Petrella, C. Toscano

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The Digital Image Correlation (DIC) is a newly developed optical technique that is spreading in all engineering sectors because it allows the non-destructive estimation of the entire surface deformation without any contact with the component under analysis. These characteristics make the DIC very appealing in all the cases the global deformation state is to be known without using strain gages, which are the most used measuring device. The DIC is applicable to any material subjected to distortion caused by either thermal or mechanical load, allowing to obtain high-definition mapping of displacements and deformations. That is why in the civil and the transportation industry, DIC is very useful for studying the behavior of metallic materials as well as of composite materials. DIC is also used in the medical field for the characterization of the local strain field of the vascular tissues surface subjected to uniaxial tensile loading. DIC can be carried out in the two dimension mode (2D DIC) if a single camera is used or in a three dimension mode (3D DIC) if two cameras are involved. Each point of the test surface framed by the cameras can be associated with a specific pixel of the image, and the coordinates of each point are calculated knowing the relative distance between the two cameras together with their orientation. In both arrangements, when a component is subjected to a load, several images related to different deformation states can be are acquired through the cameras. A specific software analyzes the images via the mutual correlation between the reference image (obtained without any applied load) and those acquired during the deformation giving the relative displacements. In this paper, a metrological characterization of the digital image correlation is performed on aluminum and composite targets both in static and dynamic loading conditions by comparison between DIC and strain gauges measures. In the static test, interesting results have been obtained thanks to an excellent agreement between the two measuring techniques. In addition, the deformation detected by the DIC is compliant with the result of a FEM simulation. In the dynamic test, the DIC was able to follow with a good accuracy the periodic deformation of the specimen giving results coherent with the ones given by FEM simulation. In both situations, it was seen that the DIC measurement accuracy depends on several parameters such as the optical focusing, the parameters chosen to perform the mutual correlation between the images and, finally, the reference points on image to be analyzed. In the future, the influence of these parameters will be studied, and a method to increase the accuracy of the measurements will be developed in accordance with the requirements of the industries especially of the aerospace one.

Keywords: accuracy, deformation, image correlation, mechanical analysis

Procedia PDF Downloads 289
348 A Pilot Randomized Controlled Trial of a Physical Activity Intervention in a Low Socioeconomic Population: Focus on Mental Contrasting with Implementation Intentions

Authors: Shaun G. Abbott, Rebecca C. Reynolds, John B. F. de Wit

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Low physical activity (PA) levels are a major public health concern in Australia. There is some evidence that PA interventions can increase PA levels via various methods, including online delivery. Low Socioeconomic Status (SES) people participate in less PA than the rest of the population, partly due to poor self-regulation behaviors associated with socioeconomic characteristics. Interventions that involve a particular method of self-regulation, Mental Contrasting with Implementation Intentions (MCII), has regularly achieved healthy behavior change, but few studies focus on PA behavior outcomes and no studies examining the effect of MCII on the PA behaviors of low SES people has been done. In this study, a pilot randomized controlled trial (RCT) will deliver MCII for PA behavior change to individuals of relative disadvantage for the first time. The current pilot study will predict sample size for a future full RCT and test the hypothesis that sedentary participants from areas of relative socioeconomic disadvantage of Sydney, who learn the MCII technique will be more physically active, have improved anthropometry and psychological indicators at the completion of a 12-week intervention compared to baseline and control. Eligible participants of relative socioeconomic disadvantage will be randomly assigned to either the ‘PA Information Plus MCII Intervention Group’ or a ‘PA Information-Only Control Group’. Both groups will attend a baseline and 12-week face-to-face consultation; where PA, anthropometric and psychological data will be gathered. The intervention group will be guided through an MCII session at the baseline appointment to establish a PA goal to aim to achieve over 12 weeks. Other than these baseline and 12-week consultations, all participant interaction will occur online. All participants will receive a ‘Fitbit’ accelerometer to record objectively. PA as a daily step count, along with a PA diary for the duration of the study. PA data will be recorded on a personalized online spreadsheet. Both groups will receive a standard PA information email at weeks 2, 4, and 8. The intervention group will also receive scripted follow-up online appointments to discuss goal progress. The current pilot study is in recruitment stage with findings to be presented at the conference in December if selected.

Keywords: implementation intentions, mental contrasting, motivation, pedometer, physical activity, socioeconomic

Procedia PDF Downloads 272
347 Characterization of Aerosol Droplet in Absorption Columns to Avoid Amine Emissions

Authors: Hammad Majeed, Hanna Knuutila, Magne Hilestad, Hallvard Svendsen

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Formation of aerosols can cause serious complications in industrial exhaust gas CO2 capture processes. SO3 present in the flue gas can cause aerosol formation in an absorption based capture process. Small mist droplets and fog formed can normally not be removed in conventional demisting equipment because their submicron size allows the particles or droplets to follow the gas flow. As a consequence of this aerosol based emissions in the order of grams per Nm3 have been identified from PCCC plants. In absorption processes aerosols are generated by spontaneous condensation or desublimation processes in supersaturated gas phases. Undesired aerosol development may lead to amine emissions many times larger than what would be encountered in a mist free gas phase in PCCC development. It is thus of crucial importance to understand the formation and build-up of these aerosols in order to mitigate the problem.Rigorous modelling of aerosol dynamics leads to a system of partial differential equations. In order to understand mechanics of a particle entering an absorber an implementation of the model is created in Matlab. The model predicts the droplet size, the droplet internal variable profiles and the mass transfer fluxes as function of position in the absorber. The Matlab model is based on a subclass method of weighted residuals for boundary value problems named, orthogonal collocation method. The model comprises a set of mass transfer equations for transferring components and the essential diffusion reaction equations to describe the droplet internal profiles for all relevant constituents. Also included is heat transfer across the interface and inside the droplet. This paper presents results describing the basic simulation tool for the characterization of aerosols formed in CO2 absorption columns and gives examples as to how various entering droplets grow or shrink through an absorber and how their composition changes with respect to time. Below are given some preliminary simulation results for an aerosol droplet composition and temperature profiles. Results: As an example a droplet of initial size of 3 microns, initially containing a 5M MEA, solution is exposed to an atmosphere free of MEA. Composition of the gas phase and temperature is changing with respect to time throughout the absorber.

Keywords: amine solvents, emissions, global climate change, simulation and modelling, aerosol generation

Procedia PDF Downloads 238
346 Cultural Heritage Resources for Tourism, Two Countries – Two Approaches: A Comparative Analysis of Cultural Tourism Products in Turkey and Austria

Authors: Irfan Arikan, George Christian Steckenbauer

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Turkey and Austria are examples for highly developed tourism destinations, where tourism providers use cultural heritage and regional natural resources to develop modern tourism products in order to be successful on increasingly competitive international tourism markets. The use and exploitation of these resources follow on the one hand international standards of tourism marketing (as ‘sustainability’). Therefore, we find highly comparable internationalized products in these destinations (like hotel products, museums, spas etc.). On the other hand, development standards and processes strongly depend on local, regional and national cultures, which influence the way how people work, cooperate, think and create. Thus, cultural factors also influence the attitude towards cultural heritage and natural resources and the way, how these resources are used for the creation of tourism products. This leads to differences in the development of tourism products on several levels: 1. In the selection of cultural heritage and natural resources for the product development process 2. In the processes, how tourism products are created 3. In the way, how providers and marketing organisations work with tourism products based on cultural heritage or natural resources. Aim of this paper is to discover differences in these dimensions by analysing and comparing examples of tourism products in Turkey and Austria, both countries with a highly developed, high professional tourism industry and rich experience of stakeholders in tourism industry in the field of product development and marketing. The cases are selected from the following fields: + Cultural tourism / heritage tourism + City tourism + Industrial heritage tourism + Nature and outdoor tourism + Health tourism The cases are analysed based on available secondary data (as several cases are scientifically described) and expert interviews with local and regional stakeholders of tourism industry and tourism experts. The available primary and secondary data will be analysed and displayed in a comparative structure that allows to derive answers to the above stated research question. The result of the project therefore will be a more precise picture about the influence of cultural differences on the use and exploitation of resources in the field of tourism that allows developing recommendations for tourism industry, which must be taken into consideration to assure cultural and natural resources are treated in a sustainable and responsible way. The authors will edit these culture-cross recommendations in form of a ‘check-list’ that can be used as a ‘guideline’ for tourism professionals in the field of product development and marketing and therefore connects theoretical research to the field of practical application and closes the gap between academic research and the field of tourism practice.

Keywords: cultural heritage, natural resources, Austria, Turkey

Procedia PDF Downloads 456
345 Unity and Diversity Under Islam: A 21st Century Sufi Master’s Perspective

Authors: Ayşe Büşra Yakut Kubaş

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This paper addresses a long-standing theological conflict within the “Abrahamic religions” by presenting the views of the 21st century Sufi master Haji Galip Hasan Kuşçuoğlu (1919-2013). The orthodox theological viewpoints share a confessional salvation concept in which only the followers of their prophet will be redeemed and rewarded while the rest of the world will be banished to hell. The conveyed commandments, sharīʿahs have been regarded as separate religions each claiming none will enter Paradise except those of their own faith. In contrast to this orthodox hierarchal conception, an interconfessional universalism manifests itself within the works of various Sufi masters such as Yunus Emre and Maulana Jalaluddin Rumi (13th century) and more recently the founder of Galibi Order Haji Galip H. Kuşçuoğlu who supports a peaceful coexistence and respect for multiplicity under the religion of Allah. Bringing evidence from a number of ayahs in the Qur’an (e.g. 2:62, 111-112, 131-133, 136, 285; 3:113-114; 4:123-125, 5:43-44, 47-48, 51, 66-69, 112), Kuşçuoğlu argues that whoever submits themselves to Allah, meaning the One and Indivisible who has no partners (112:1) is called a Muslim. There are no Abrahamic “religions” but Abraham’s “religion” which is Islam, literally translating to total devotion to Allah. Starting from the very first prophet, Adam, all the prophets sent upon the earth as mentors to humanity revealed that there is no god but Allah and thus in the proper meaning of the word, they were Muslims. When it comes to those who follow the shariah of Moses, Jesus or Muhammed are called Judaic Muslims, Christian Muslims and Muhammadian Muslims respectively and as such they are brothers and sisters, which is why Islam cannot be a property of Muhammadian Muslims only. Kuşçuoğlu underscores the ayahs which show that the Qur’an does not abrogate other scriptures but completes them and Allah does not banish the People of the Book to hell but gives good tidings to the believers who do good (17:9). He points out a number of intellectuals such as Goethe and Prof. Dr. Süleyman Ateş (1933-) who understood the true meaning of Islam. Goethe states that if Islam means devotion to Allah then “In Islam, we live and die all.” Kuşçuoğlu underscores the fatal consequences of this terminological misinterpretation throughout the history and emphasizes the significance of the unity of religion for the believers of Allah. His perspective provides a significant contribution to the religious conflict resolution and provides a solid basis for sustainable dialogue among the people belonging to different confessions.

Keywords: interfaith dialogue, Islam, religious conflict resolution, Sufism

Procedia PDF Downloads 56
344 Left Atrial Appendage Occlusion vs Oral Anticoagulants in Atrial Fibrillation and Coronary Stenting. The DESAFIO Registry

Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

Abstract:

Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

Procedia PDF Downloads 28
343 The Application of Animal Welfare Certification System for Farm Animal in South Korea

Authors: Ahlyum Mun, Ji-Young Moon, Moon-Seok Yoon, Dong-Jin Baek, Doo-Seok Seo, Oun-Kyong Moon

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There is a growing public concern over the standards of farm animal welfare, with higher standards of food safety. In addition, the recent low incidence of Avian Influenza in laying hens among certificated farms is receiving attention. In this study, we introduce animal welfare systems covering the rearing, transport and slaughter of farm animals in South Korea. The concepts of animal welfare farm certification are based on ensuring the five freedoms of animal. The animal welfare is also achieved by observing the condition of environment including shelter and resting area, feeding and water and the care for the animal health. The certification of farm animal welfare is handled by the Animal Protection & Welfare Division of Animal and Plant Quarantine Agency (APQA). Following the full amendment of Animal Protection Law in 2011, animal welfare farm certification program has been implemented since 2012. The certification system has expanded to cover laying hen, swine, broiler, beef cattle and dairy cow, goat and duck farms. Livestock farmers who want to be certified must apply for certification at the APQA. Upon receipt of the application, the APQA notifies the applicant of the detailed schedule of the on-site examination after reviewing the document and conducts the on-site inspection according to the evaluation criteria of the welfare standard. If the on-site audit results meet the certification criteria, APQA issues a certificate. The production process of certified farms is inspected at least once a year for follow-up management. As of 2017, a total of 145 farms have been certified (95 laying hen farms, 12 swine farms, 30 broiler farms and 8 dairy cow farms). In addition, animal welfare transportation vehicles and slaughterhouses have been designated since 2013 and currently 6 slaughterhouses have been certified. Animal Protection Law has been amended so that animal welfare certification marks can be affixed only to livestock products produced by animal welfare farms, transported through animal welfare vehicles and slaughtered at animal welfare slaughterhouses. The whole process including rearing–transportation- slaughtering completes the farm animal welfare system. APQA established its second 5-year animal welfare plan (2014-2019) that includes setting a minimum standard of animal welfare applicable to all livestock farms, transportation vehicles and slaughterhouses. In accordance with this plan, we will promote the farm animal welfare policy in order to truly advance the Korean livestock industry.

Keywords: animal welfare, farm animal, certification system, South Korea

Procedia PDF Downloads 371
342 Comparative Study on Fire Safety Evaluation Methods for External Cladding Systems: ISO 13785-2 and BS 8414

Authors: Kyungsuk Cho, H. Y. Kim, S. U. Chae, J. H. Choi

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Technological development has led to the construction of super-tall buildings and insulators are increasingly used as exterior finishing materials to save energy. However, insulators are usually combustible and vulnerable to fire. Fires like that at Wooshin Golden Suite Building in Busan, Korea in 2010 and that at CCTV Building in Beijing, China are the major examples of fire spread accelerated by combustible insulators. The exterior finishing materials of a high-rise building are not made of insulators only, but they are integrated with the building’s external cladding system. There is a limit in evaluating the fire safety of a cladding system with a single small-unit material such as a cone calorimeter. Therefore, countries provide codes to evaluate the fire safety of exterior finishing materials using full-scale tests. This study compares and to examine the applicability of the methods to Korea. Standard analysis showed differences in the type and size of fire sources and duration and exterior finishing materials also differed in size. In order to confirm the differences, fire tests were conducted on identical external cladding systems to compare fire safety. Although the exterior finishing materials were identical, varying degrees of fire spread were observed, which could be considered as differences in the type and size of the fire sources and duration. Therefore, it is deduced that extended studies should be conducted before the evaluation methods and standards are employed in Korea. The two standards for evaluating fire safety provided different results. Peak heat release rate was 5.5MW in ISO method and 3.0±0.5MW in BS method. Peak heat release rate in ISO method continued for 15 minutes. Fire ignition, growth, full development and decay evolved for 30 minutes in BS method where wood cribs were used as fire sources. Therefore, follow-up studies should be conducted to determine which of the two standards provides fire sources that approximate the size of flames coming out from the openings or those spreading to the outside when a fire occurs at a high-rise building.

Keywords: external cladding systems, fire safety evaluation, ISO 13785-2, BS 8414

Procedia PDF Downloads 221
341 Revolutionizing Healthcare Facility Maintenance: A Groundbreaking AI, BIM, and IoT Integration Framework

Authors: Mina Sadat Orooje, Mohammad Mehdi Latifi, Behnam Fereydooni Eftekhari

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The integration of cutting-edge Internet of Things (IoT) technologies with advanced Artificial Intelligence (AI) systems is revolutionizing healthcare facility management. However, the current landscape of hospital building maintenance suffers from slow, repetitive, and disjointed processes, leading to significant financial, resource, and time losses. Additionally, the potential of Building Information Modeling (BIM) in facility maintenance is hindered by a lack of data within digital models of built environments, necessitating a more streamlined data collection process. This paper presents a robust framework that harmonizes AI with BIM-IoT technology to elevate healthcare Facility Maintenance Management (FMM) and address these pressing challenges. The methodology begins with a thorough literature review and requirements analysis, providing insights into existing technological landscapes and associated obstacles. Extensive data collection and analysis efforts follow to deepen understanding of hospital infrastructure and maintenance records. Critical AI algorithms are identified to address predictive maintenance, anomaly detection, and optimization needs alongside integration strategies for BIM and IoT technologies, enabling real-time data collection and analysis. The framework outlines protocols for data processing, analysis, and decision-making. A prototype implementation is executed to showcase the framework's functionality, followed by a rigorous validation process to evaluate its efficacy and gather user feedback. Refinement and optimization steps are then undertaken based on evaluation outcomes. Emphasis is placed on the scalability of the framework in real-world scenarios and its potential applications across diverse healthcare facility contexts. Finally, the findings are meticulously documented and shared within the healthcare and facility management communities. This framework aims to significantly boost maintenance efficiency, cut costs, provide decision support, enable real-time monitoring, offer data-driven insights, and ultimately enhance patient safety and satisfaction. By tackling current challenges in healthcare facility maintenance management it paves the way for the adoption of smarter and more efficient maintenance practices in healthcare facilities.

Keywords: artificial intelligence, building information modeling, healthcare facility maintenance, internet of things integration, maintenance efficiency

Procedia PDF Downloads 24
340 The Development of Cultural Routes: The Case of Greece

Authors: Elissavet Kosta

Abstract:

Introduction: In this research, we will propose the methodology, which is required for the planning of the cultural route in order to prepare substantiated proposals for the development and planning of cultural routes in Greece in the near future. Our research has started at 2016. Methodology in our research: Α combination of primary and secondary research will be used as project methodology. Furthermore, this study aims to follow a multidisciplinary approach, using dimensions of qualitative and quantitative data analysis models. Regarding the documentation of the theoretical part of the project, the method of secondary research will be mainly used, yet in combination with bibliographic sources. However, the data collection regarding the research topic will be conducted exclusively through primary research (questionnaires and interviews). Cultural Routes: The cultural route is defined as a brand name touristic product, that is a product of cultural tourism, which is shaped according to a specific connecting element. Given its potential, the cultural route is an important ‘tool’ for the management and development of cultural heritage. Currently, a constant development concerning the cultural routes is observed in an international level during the last decades, as it is widely accepted that cultural tourism has an important role in the world touristic industry. Cultural Routes in Greece: Especially for Greece, we believe, actions have not been taken to the systematic development of the cultural routes yet. The cultural routes that include Greece and have been design in a world scale as well as the cultural routes, which have been design in Greek ground up to this moment are initiations of the Council of Europe, World Tourism Organization UNWTO and ‘Diazoma’ association. Regarding the study of cultural routes in Greece as a multidimensional concept, the following concerns have arisen: Firstly, we are concerned about the general impact of cultural routes at local and national level and specifically in the economic sector. Moreover, we deal with the concerns regarding the natural environment and we delve into the educational aspect of cultural routes in Greece. In addition, the audience we aim at is both specific and broad and we put forward the institutional framework of the study. Finally, we conduct the development and planning of new cultural routes, having in mind the museums as both the starting and ending point of a route. Conclusion: The contribution of our work is twofold and lies firstly on the fact that we attempt to create cultural routes in Greece and secondly on the fact that an interdisciplinary approach is engaged towards realizing our study objective. In particular, our aim is to take advantage of all the ways in which the promotion of a cultural route can have a positive influence on the way of life of society. As a result, we intend to analyze how a cultural route can turn into a well-organized activity that can be used as social intervention to develop tourism, strengthen the economy and improve access to cultural goods in Greece during the economic crisis.

Keywords: cultural heritage, cultural routes, cultural tourism, Greece

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339 Case Study on the Effects of Early Mobilization in the Post-Surgical Recovery of Athletes with Open Triangular Fibrocartilage Complex Repair

Authors: Blair Arthur Agero Jr., Lucia Garcia Heras

Abstract:

The triangular fibrocartilage complex (TFCC) is one of the crucial stabilizing ligaments of the wrist. The TFCC is also subject to excessive stress amongst performance athletes and enthusiasts. The excessive loading of the TFCC may lead to a partial or complete rupture that requires surgery. The recovery from an open TFCC surgical repair may take several months. Immobilization of the repaired wrist for a given period is part of all the current protocols in the post-surgical treatment. The immobilization to prevent the rotation of the forearm can last from six weeks to eight weeks with the wrist held in a neutral position. In all protocols reviewed, the pronosupination is only initiated between the 6th week and 8th week or even later after the cast is removed. The prolonged immobilization can cause stiffness of the wrist and hand. Furthermore, the entire period of post-surgical hand therapy has its economic impact, especially for performing athletes. However, delayed mobilization, specifically rotation of the wrist, is necessary to allow ligament healing. This study aims to report the effects of early mobilization of the wrist in athletes who had an open surgical repair of the TFCC. The surgery was done by the co-author, and the hand therapy was implemented by the main author. The cases documented spans from 2014 to 2019 and were all performed in Dubai, United Arab Emirates. All selected participants in this case study were provided with a follow-up questionnaire to ascertain their current condition since their surgery. The respondents reported high satisfaction in the results of their treatment and have verified zero re-rupture of their TFCC despite mobilizing and rotating the wrist at the third-week post-surgery during their hand therapy. There is also a negligible number of respondents who reported a limitation in their ranges of pronosupination. This case study suggests that early mobilization of the wrist after an open TFCC surgical repair can be more beneficial to the patient as opposed to the traditional treatment of prolonged immobilization. However, it should be considered that the patients selected in this case study are professional performance athletes and advanced fitness enthusiasts. Athletes are known to withstand vigorous physical stress in their training that may correlate to their ability to better cope with the progressive stress that was implemented during their hand therapy. Nevertheless, this approach has its merits, and application of it may be adjusted for patients with a similar injury and surgical procedure.

Keywords: hand therapy, performance athlete, TFCC repair, wrist ligament

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338 Dyadic Effect of Emotional Focused Psycho Educational Intervention on Spousal Emotional Abuse and Marital Satisfaction among Elderly Couples

Authors: Maryam Hazrati, Tengku Aizan Hamid, Rahimah Ibrahim, Siti Aishah Hassan, Farkhondeh Sharif, Zahra Bagheri

Abstract:

Background: Emotional abuse is the most common type of spousal abuse. In a long-term marriage which lasts several decades, the couple will be faced with greater vulnerability due to illness, disability, and dependence. Emotional abuse can have a devastating impact on victims, leading to low self-esteem, depression, anxiety, and post-traumatic stress disorder. Research Aim: The aim of this study was to investigate the effects of an emotional-focused psychoeducational intervention (EFPEI) on emotional abuse and marital satisfaction among older adults couples and also to examine the dyadic effects of each partner’s emotional abuse behaviors (EAB) on his/her marital satisfaction (MS) in Shiraz-Iran. Methodology: The study was a randomized controlled trial (RCT). A total of 57 eligible couples were randomly assigned to either the experimental group or the control group. The experimental group received EFPEI, which consisted of 12 sessions, each lasting 90 minutes. The control group did not receive any intervention. Data were collected using demographic questionnaire, Multidimensional Measure of Emotional Abuse (MMEAQ), and Marital Satisfaction Questionnaire for Older People (MSQFOP). The data was analyzed using a variety of statistical methods, including repeated measures ANOVA, path analysis, and correlational analyses. Findings: The results of the study showed that the EFPEI was effective in reducing emotional abuse and increasing marital satisfaction among older adults couples. Specifically, the mean scores for emotional abuse and marital satisfaction were significantly lower in the experimental group than in the control group at the end of the intervention. These effects were maintained at a 3-month follow-up. Moreover, the dyadic analysis revealed that husbands’ EAB had no significant effects on his own marital satisfaction but a significant negative partner effect, while wives’ EAB had significant negative actor and partner effects. Conclusion: The findings of this study provide support for the use of EFPEI as an effective intervention for decreasing emotional abuse and improving marital dissatisfaction among older adults. EFPEI is a short-term, evidence-based intervention that can be delivered by trained professionals. The intervention focuses on helping couples to improve their communication skills, resolve conflict, and build a stronger emotional connection.

Keywords: spouse abuse, emotion, aged, satisfaction, dyadic effect

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