Search results for: radar chart
Commenced in January 2007
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Edition: International
Paper Count: 522

Search results for: radar chart

42 MBES-CARIS Data Validation for the Bathymetric Mapping of Shallow Water in the Kingdom of Bahrain on the Arabian Gulf

Authors: Abderrazak Bannari, Ghadeer Kadhem

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The objectives of this paper are the validation and the evaluation of MBES-CARIS BASE surface data performance for bathymetric mapping of shallow water in the Kingdom of Bahrain. The latter is an archipelago with a total land area of about 765.30 km², approximately 126 km of coastline and 8,000 km² of marine area, located in the Arabian Gulf, east of Saudi Arabia and west of Qatar (26° 00’ N, 50° 33’ E). To achieve our objectives, bathymetric attributed grid files (X, Y, and depth) generated from the coverage of ship-track MBSE data with 300 x 300 m cells, processed with CARIS-HIPS, were downloaded from the General Bathymetric Chart of the Oceans (GEBCO). Then, brought into ArcGIS and converted into a raster format following five steps: Exportation of GEBCO BASE surface data to the ASCII file; conversion of ASCII file to a points shape file; extraction of the area points covering the water boundary of the Kingdom of Bahrain and multiplying the depth values by -1 to get the negative values. Then, the simple Kriging method was used in ArcMap environment to generate a new raster bathymetric grid surface of 30×30 m cells, which was the basis of the subsequent analysis. Finally, for validation purposes, 2200 bathymetric points were extracted from a medium scale nautical map (1:100 000) considering different depths over the Bahrain national water boundary. The nautical map was scanned, georeferenced and overlaid on the MBES-CARIS generated raster bathymetric grid surface (step 5 above), and then homologous depth points were selected. Statistical analysis, expressed as a linear error at the 95% confidence level, showed a strong correlation coefficient (R² = 0.96) and a low RMSE (± 0.57 m) between the nautical map and derived MBSE-CARIS depths if we consider only the shallow areas with depths of less than 10 m (about 800 validation points). When we consider only deeper areas (> 10 m) the correlation coefficient is equal to 0.73 and the RMSE is equal to ± 2.43 m while if we consider the totality of 2200 validation points including all depths, the correlation coefficient is still significant (R² = 0.81) with satisfactory RMSE (± 1.57 m). Certainly, this significant variation can be caused by the MBSE that did not completely cover the bottom in several of the deeper pockmarks because of the rapid change in depth. In addition, steep slopes and the rough seafloor probably affect the acquired MBSE raw data. In addition, the interpolation of missed area values between MBSE acquisition swaths-lines (ship-tracked sounding data) may not reflect the true depths of these missed areas. However, globally the results of the MBES-CARIS data are very appropriate for bathymetric mapping of shallow water areas.

Keywords: bathymetry mapping, multibeam echosounder systems, CARIS-HIPS, shallow water

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41 Simulating an Interprofessional Hospital Day Shift: A Student Interprofessional (IP) Collaborative Learning Activity

Authors: Fiona Jensen, Barb Goodwin, Nancy Kleiman, Rhonda Usunier

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Background: Clinical simulation is now a common component in many health profession curricula in preparation for clinical practice. In the Rady Faculty of Health Sciences (RFHS) college leads in simulation and interprofessional (IP) education, planned an eight hour simulated hospital day shift, where seventy students from six health professions across two campuses, learned with each other in a safe, realistic environment. Learning about interprofessional collaboration, an expected competency for many health professions upon graduation, was a primary focus of the simulation event. Method: Faculty representatives from the Colleges of Nursing, Medicine, Pharmacy and Rehabilitation Sciences (Physical Therapy, Occupation Therapy, Respiratory Therapy) and Pharmacy worked together to plan the IP event in a simulation facility in the College of Nursing. Each college provided a faculty mentor to guide the same profession students. Students were placed in interprofessional teams consisting of a nurse, physician, pharmacist, and then sharing respiratory, occupational, and physical therapists across the team depending on the needs of the patients. Eight patient scenarios were role played by health profession students, who had been provided with their patient’s story shortly before the event. Each team was guided by a facilitator. Results and Outcomes: On the morning of the event, all students gathered in a large group to meet mentors and facilitators and have a brief overview of the six competencies for effective collaboration and the session objectives. The students assuming their same profession roles were provided with their patient’s chart at the beginning of the shift, met with their team, and then completed professional specific assessments. Shortly into the shift, IP team rounds began, facilitated by the team facilitator. During the shift, each patient role-played a spontaneous health incident, which required collaboration between the IP team members for assessment and management. The afternoon concluded with team rounds, a collaborative management plan, and a facilitated de-brief. Conclusions: During the de-brief sessions, students responded to set questions related to the session learning objectives and expressed many positive learning moments. We believe that we have a sustainable simulation IP collaborative learning opportunity, which can be embedded into curricula, and has the capacity to grow to include more health profession faculties and students. Opportunities are being explored in the RFHS at the administrative level, to offer this event more frequently in the academic year to reach more students. In addition, a formally structured event evaluation tool would provide important feedback and inform the qualitative feedback to event organizers and the colleges about the significance of the simulation event to student learning.

Keywords: simulation, collaboration, teams, interprofessional

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40 On-Ice Force-Velocity Modeling Technical Considerations

Authors: Dan Geneau, Mary Claire Geneau, Seth Lenetsky, Ming -Chang Tsai, Marc Klimstra

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Introduction— Horizontal force-velocity profiling (HFVP) involves modeling an athletes linear sprint kinematics to estimate valuable maximum force and velocity metrics. This approach to performance modeling has been used in field-based team sports and has recently been introduced to ice-hockey as a forward skating performance assessment. While preliminary data has been collected on ice, distance constraints of the on-ice test restrict the ability of the athletes to reach their maximal velocity which result in limits of the model to effectively estimate athlete performance. This is especially true of more elite athletes. This report explores whether athletes on-ice are able to reach a velocity plateau similar to what has been seen in overground trials. Fourteen male Major Junior ice-hockey players (BW= 83.87 +/- 7.30 kg, height = 188 ± 3.4cm cm, age = 18 ± 1.2 years n = 14) were recruited. For on-ice sprints, participants completed a standardized warm-up consisting of skating and dynamic stretching and a progression of three skating efforts from 50% to 95%. Following the warm-up, participants completed three on ice 45m sprints, with three minutes of rest in between each trial. For overground sprints, participants completed a similar dynamic warm-up to that of on-ice trials. Following the warm-up participants completed three 40m overground sprint trials. For each trial (on-ice and overground), radar was used to collect instantaneous velocity (Stalker ATS II, Texas, USA) aimed at the participant’s waist. Sprint velocities were modelled using custom Python (version 3.2) script using a mono-exponential function, similar to previous work. To determine if on-ice tirals were achieving a maximum velocity (plateau), minimum acceleration values of the modeled data at the end of the sprint were compared (using paired t-test) between on-ice and overground trials. Significant differences (P<0.001) between overground and on-ice minimum accelerations were observed. It was found that on-ice trials consistently reported higher final acceleration values, indicating a maximum maintained velocity (plateau) had not been reached. Based on these preliminary findings, it is suggested that reliable HFVP metrics cannot yet be collected from all ice-hockey populations using current methods. Elite male populations were not able to achieve a velocity plateau similar to what has been seen in overground trials, indicating the absence of a maximum velocity measure. With current velocity and acceleration modeling techniques, including a dependency of a velocity plateau, these results indicate the potential for error in on-ice HFVP measures. Therefore, these findings suggest that a greater on-ice sprint distance may be required or the need for other velocity modeling techniques, where maximal velocity is not required for a complete profile.   

Keywords: ice-hockey, sprint, skating, power

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39 Clinical Audit on the Introduction of Apremilast into Ireland

Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

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38 Transition Dynamic Analysis of the Urban Disparity in Iran “Case Study: Iran Provinces Center”

Authors: Marzieh Ahmadi, Ruhullah Alikhan Gorgani

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The usual methods of measuring regional inequalities can not reflect the internal changes of the country in terms of their displacement in different development groups, and the indicators of inequalities are not effective in demonstrating the dynamics of the distribution of inequality. For this purpose, this paper examines the dynamics of the urban inertial transport in the country during the period of 2006-2016 using the CIRD multidimensional index and stochastic kernel density method. it firstly selects 25 indicators in five dimensions including macroeconomic conditions, science and innovation, environmental sustainability, human capital and public facilities, and two-stage Principal Component Analysis methodology are developed to create a composite index of inequality. Then, in the second stage, using a nonparametric analytical approach to internal distribution dynamics and a stochastic kernel density method, the convergence hypothesis of the CIRD index of the Iranian provinces center is tested, and then, based on the ergodic density, long-run equilibrium is shown. Also, at this stage, for the purpose of adopting accurate regional policies, the distribution dynamics and process of convergence or divergence of the Iranian provinces for each of the five. According to the results of the first Stage, in 2006 & 2016, the highest level of development is related to Tehran and zahedan is at the lowest level of development. The results show that the central cities of the country are at the highest level of development due to the effects of Tehran's knowledge spillover and the country's lower cities are at the lowest level of development. The main reason for this may be the lack of access to markets in the border provinces. Based on the results of the second stage, which examines the dynamics of regional inequality transmission in the country during 2006-2016, the first year (2006) is not multifaceted and according to the kernel density graph, the CIRD index of about 70% of the cities. The value is between -1.1 and -0.1. The rest of the sequence on the right is distributed at a level higher than -0.1. In the kernel distribution, a convergence process is observed and the graph points to a single peak. Tends to be a small peak at about 3 but the main peak at about-0.6. According to the chart in the final year (2016), the multidimensional pattern remains and there is no mobility in the lower level groups, but at the higher level, the CIRD index accounts for about 45% of the provinces at about -0.4 Take it. That this year clearly faces the twin density pattern, which indicates that the cities tend to be closely related to each other in terms of development, so that the cities are low in terms of development. Also, according to the distribution dynamics results, the provinces of Iran follow the single-density density pattern in 2006 and the double-peak density pattern in 2016 at low and moderate inequality index levels and also in the development index. The country diverges during the years 2006 to 2016.

Keywords: Urban Disparity, CIRD Index, Convergence, Distribution Dynamics, Random Kernel Density

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37 Ecosystem Modeling along the Western Bay of Bengal

Authors: A. D. Rao, Sachiko Mohanty, R. Gayathri, V. Ranga Rao

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Modeling on coupled physical and biogeochemical processes of coastal waters is vital to identify the primary production status under different natural and anthropogenic conditions. About 7, 500 km length of Indian coastline is occupied with number of semi enclosed coastal bodies such as estuaries, inlets, bays, lagoons, and other near shore, offshore shelf waters, etc. This coastline is also rich in wide varieties of ecosystem flora and fauna. Directly/indirectly extensive domestic and industrial sewage enter into these coastal water bodies affecting the ecosystem character and create environment problems such as water quality degradation, hypoxia, anoxia, harmful algal blooms, etc. lead to decline in fishery and other related biological production. The present study is focused on the southeast coast of India, starting from Pulicat to Gulf of Mannar, which is rich in marine diversity such as lagoon, mangrove and coral ecosystem. Three dimensional Massachusetts Institute of Technology general circulation model (MITgcm) along with Darwin biogeochemical module is configured for the western Bay of Bengal (BoB) to study the biogeochemistry over this region. The biogeochemical module resolves the cycling of carbon, phosphorous, nitrogen, silica, iron and oxygen through inorganic, living, dissolved and particulate organic phases. The model domain extends from 4°N-16.5°N and 77°E-86°E with a horizontal resolution of 1 km. The bathymetry is derived from General Bathymetric Chart of the Oceans (GEBCO), which has a resolution of 30 sec. The model is initialized by using the temperature, salinity filed from the World Ocean Atlas (WOA2013) of National Oceanographic Data Centre with a resolution of 0.25°. The model is forced by the surface wind stress from ASCAT and the photosynthetically active radiation from the MODIS-Aqua satellite. Seasonal climatology of nutrients (phosphate, nitrate and silicate) for the southwest BoB region are prepared using available National Institute of Oceanography (NIO) in-situ data sets and compared with the WOA2013 seasonal climatology data. The model simulations with the two different initial conditions viz., WOA2013 and the generated NIO climatology, showed evident changes in the concentration and the evolution of the nutrients in the study region. It is observed that the availability of nutrients is more in NIO data compared to WOA in the model domain. The model simulated primary productivity is compared with the spatially distributed satellite derived chlorophyll data and at various locations with the in-situ data. The seasonal variability of the model simulated primary productivity is also studied.

Keywords: Bay of Bengal, Massachusetts Institute of Technology general circulation model, MITgcm, biogeochemistry, primary productivity

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36 Geoinformation Technology of Agricultural Monitoring Using Multi-Temporal Satellite Imagery

Authors: Olena Kavats, Dmitry Khramov, Kateryna Sergieieva, Vladimir Vasyliev, Iurii Kavats

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Geoinformation technologies of space agromonitoring are a means of operative decision making support in the tasks of managing the agricultural sector of the economy. Existing technologies use satellite images in the optical range of electromagnetic spectrum. Time series of optical images often contain gaps due to the presence of clouds and haze. A geoinformation technology is created. It allows to fill gaps in time series of optical images (Sentinel-2, Landsat-8, PROBA-V, MODIS) with radar survey data (Sentinel-1) and use information about agrometeorological conditions of the growing season for individual monitoring years. The technology allows to perform crop classification and mapping for spring-summer (winter and spring crops) and autumn-winter (winter crops) periods of vegetation, monitoring the dynamics of crop state seasonal changes, crop yield forecasting. Crop classification is based on supervised classification algorithms, takes into account the peculiarities of crop growth at different vegetation stages (dates of sowing, emergence, active vegetation, and harvesting) and agriculture land state characteristics (row spacing, seedling density, etc.). A catalog of samples of the main agricultural crops (Ukraine) is created and crop spectral signatures are calculated with the preliminary removal of row spacing, cloud cover, and cloud shadows in order to construct time series of crop growth characteristics. The obtained data is used in grain crop growth tracking and in timely detection of growth trends deviations from reference samples of a given crop for a selected date. Statistical models of crop yield forecast are created in the forms of linear and nonlinear interconnections between crop yield indicators and crop state characteristics (temperature, precipitation, vegetation indices, etc.). Predicted values of grain crop yield are evaluated with an accuracy up to 95%. The developed technology was used for agricultural areas monitoring in a number of Great Britain and Ukraine regions using EOS Crop Monitoring Platform (https://crop-monitoring.eos.com). The obtained results allow to conclude that joint use of Sentinel-1 and Sentinel-2 images improve separation of winter crops (rapeseed, wheat, barley) in the early stages of vegetation (October-December). It allows to separate successfully the soybean, corn, and sunflower sowing areas that are quite similar in their spectral characteristics.

Keywords: geoinformation technology, crop classification, crop yield prediction, agricultural monitoring, EOS Crop Monitoring Platform

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35 The International Prohibition of Religiously-Motivated 'Incitement' to Violence

Authors: J. D. Temperman

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Introduction: In particular, in relation to religion, the meaning and scope of freedom of expression have been tested in recent times. This paper investigates the legal justifications for restrictions that have been suggested in this area and asks whether they are sustainable from an international human rights perspective. The universal human rights instruments, particularly the UN International Covenant on Civil and Political Rights (ICCPR), are increasingly geared towards eradicating ‘incitement’ to contingent harms like violence or discrimination, whilst forms of extreme speech that fall short of such incitement are to be protected rather than countered by states. Human Rights Committee’s draft-General Comment on freedom of expression, adopted in 2011, provides another strong indication that this is the envisaged way forward: repealing anti-blasphemy and anti-religious defamation laws, whilst simultaneously increasing efforts to combat ‘incitement’. Within regional human rights frameworks, notably the European Convention system, judgments have in fact supported legal restrictions on both hate speech, holocaust denial, and blasphemy or religious defamation. Major contributions to scholarship: This paper proposes an actus reus for the offense of ‘advocacy of religious hatred that constitutes incitement to discrimination or violence’, as enshrined in Article 20(2) of the UN ICCPR. In underscoring the high threshold of ‘incitement’, the author distinguishes this offense from such notions as ‘blasphemy’ or ‘defamation of religions’. In addition to treating the said provision as a sui generis prohibition, the question is addresses whether a ‘right to be protected against incitement’ may be distilled from the ICCPR. Furthermore, the author will discuss the question of how to judge incitement; notably, is mens rea required to convict someone of incitement, and if so, what degree of mens rea? This analysis also includes the question how to balance content and context factors when addressing alleged instances of incitement, notably what factors make provide for a likelihood that imminent acts of violence or discrimination will ensue from an inciteful speech act? Methodology: This paper takes a double comparative approach: (i) it endeavours to compare and contrast monitoring bodies’ approach to incitement (notably, the UN Human Rights Committee, but also the UN Committee on the Elimination of Racial Discrimination which monitors states’ compliance with Article 4 of ICERD on incitement); and (ii) it endeavours to chart and compare and analyse from an international human rights perspective recent forms of state practice in the field of dealing with incitement (i.e. a comparative legal analysis and vertical human rights analysis of newly emerging incitement legislation in the light of the said international standards). Conclusion: This paper conceptualizes a legal notion – ‘incitement’ – encapsulated in international human rights law that may have a profound bearing on contemporary challenges of radicalization and religious strife.

Keywords: incitement, international human rights law, religious hatred, violence

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34 Predictors of Motor and Cognitive Domains of Functional Performance after Rehabilitation of Individuals with Acute Stroke

Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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33 Improving Patient Outcomes for Aspiration Pneumonia

Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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32 The Role of Social Media in the Rise of Islamic State in India: An Analytical Overview

Authors: Yasmeen Cheema, Parvinder Singh

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The evolution of Islamic State (acronym IS) has an ultimate goal of restoring the caliphate. IS threat to the global security is main concern of international community but has also raised a factual concern for India about the regular radicalization of IS ideology among Indian youth. The incident of joining Arif Ejaz Majeed, an Indian as ‘jihadist’ in IS has set strident alarm in law & enforcement agencies. On 07.03.2017, many people were injured in an Improvised Explosive Device (IED) blast on-board of Bhopal Ujjain Express. One perpetrator of this incident was killed in encounter with police. But, the biggest shock is that the conspiracy was pre-planned and the assailants who carried out the blast were influenced by the ideology perpetrated by the Islamic State. This is the first time name of IS has cropped up in a terror attack in India. It is a red indicator of violent presence of IS in India, which is spreading through social media. The IS have the capacity to influence the younger Muslim generation in India through its brutal and aggressive propaganda videos, social media apps and hatred speeches. It is a well known fact that India is on the radar of IS, as well on its ‘Caliphate Map’. IS uses Twitter, Facebook and other social media platforms constantly. Islamic State has used enticing videos, graphics, and articles on social media and try to influence persons from India & globally that their jihad is worthy. According to arrested perpetrator of IS in different cases in India, the most of Indian youths are victims to the daydreams which are fondly shown by IS. The dreams that the Muslim empire as it was before 1920 can come back with all its power and also that the Caliph and its caliphate can be re-established are shown by the IS. Indian Muslim Youth gets attracted towards these euphemistic ideologies. Islamic State has used social media for disseminating its poisonous ideology, recruitment, operational activities and for future direction of attacks. IS through social media inspired its recruits & lone wolfs to continue to rely on local networks to identify targets and access weaponry and explosives. Recently, a pro-IS media group on its Telegram platform shows Taj Mahal as the target and suggested mode of attack as a Vehicle Born Improvised Explosive Attack (VBIED). Islamic State definitely has the potential to destroy the Indian national security & peace, if timely steps are not taken. No doubt, IS has used social media as a critical mechanism for recruitment, planning and executing of terror attacks. This paper will therefore examine the specific characteristics of social media that have made it such a successful weapon for Islamic State. The rise of IS in India should be viewed as a national crisis and handled at the central level with efficient use of modern technology.

Keywords: ideology, India, Islamic State, national security, recruitment, social media, terror attack

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31 Evaluation of Trabectedin Safety and Effectiveness at a Tertiary Cancer Center at Qatar: A Retrospective Analysis

Authors: Nabil Omar, Farah Jibril, Oraib Amjad

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Purpose: Trabecatine is a is a potent marine-derived antineoplastic drug which binds to the minor groove of the DNA, bending DNA towards the major groove resulting in a changed conformation that interferes with several DNA transcription factors, repair pathways and cell proliferation. Trabectedin was approved by the European Medicines Agency (EMA; London, UK) for the treatment of adult patients with advanced stage soft tissue sarcomas in whom treatment with anthracyclines and ifosfamide has failed, or for those who are not candidates for these therapies. The recommended dosing regimen is 1.5 mg/m2 IV over 24 hours every 3 weeks. The purpose of this study was to comprehensively review available data on the safety and efficacy of trabectedin used as indicated for patients at a Tertiary Cancer Center at Qatar. Methods: A medication administration report generated in the electronic health record identified all patients who received trabectedin between November 1, 2015 and November 1, 2017. This retrospective chart review evaluated the indication of trabectedin use, compliance to administration protocol and the recommended monitoring parameters, number of patients improved on the drug and continued treatment, number of patients discontinued treatment due to side-effects and the reported side effects. Progress and discharged notes were utilized to report experienced side effects during trabectedin therapy. A total of 3 patients were reviewed. Results: Total of 2 out of 3 patients who received trabectedin were receiving it for non-FDA and non-EMA, approved indications; metastatic rhabdomyosarcoma and ovarian cancer stage IV with poor prognosis. And only one patient received it as indicated for leiomyosarcoma of left ureter with metastases to liver, lungs and bone. None of the patients has continued the therapy due to development of serious side effects. One patient had stopped the medication after one cycle due to disease progression and transient hepatic toxicity, the other one had disease progression and developed 12 % reduction in LVEF after 12 cycles of trabectedin, and the third patient deceased, had disease progression on trabectedin after the 10th cycle that was received through peripheral line which resulted in developing extravasation and left arm cellulitis requiring debridement. Regarding monitoring parameters, at baseline the three patients had ECHO, and Creatine Phosphokinase (CPK) but it was not monitored during treatment as recommended. Conclusion: Utilizing this medication as indicated with performing the appropriate monitoring parameters as recommended can benefit patients who are receiving it. It is important to reinforce the intravenous administration via central intravenous line, the re-assessment of left ventricular ejection fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan at 2- to 3-month intervals thereafter until therapy is discontinued, and CPK and LFTs levels prior to each administration of trabectedin.

Keywords: trabectedin, drug-use evaluation, safety, effectiveness, adverse drug reaction, monitoring

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30 Application of Unstructured Mesh Modeling in Evolving SGE of an Airport at the Confluence of Multiple Rivers in a Macro Tidal Region

Authors: A. A. Purohit, M. M. Vaidya, M. D. Kudale

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Among the various developing countries in the world like China, Malaysia, Korea etc., India is also developing its infrastructures in the form of Road/Rail/Airports and Waterborne facilities at an exponential rate. Mumbai, the financial epicenter of India is overcrowded and to relieve the pressure of congestion, Navi Mumbai suburb is being developed on the east bank of Thane creek near Mumbai. The government due to limited space at existing Mumbai Airports (domestic and international) to cater for the future demand of airborne traffic, proposes to build a new international airport near Panvel at Navi Mumbai. Considering the precedence of extreme rainfall on 26th July 2005 and nearby townships being in a low-lying area, wherein new airport is proposed, it is inevitable to study this complex confluence area from a hydrodynamic consideration under both tidal and extreme events (predicted discharge hydrographs), to avoid inundation of the surrounding due to the proposed airport reclamation (1160 hectares) and to determine the safe grade elevation (SGE). The model studies conducted using the application of unstructured mesh to simulate the Panvel estuarine area (93 km2), calibration, validation of a model for hydraulic field measurements and determine the maxima water levels around the airport for various extreme hydrodynamic events, namely the simultaneous occurrence of highest tide from the Arabian Sea and peak flood discharges (Probable Maximum Precipitation and 26th July 2005) from five rivers, the Gadhi, Kalundri, Taloja, Kasadi and Ulwe, meeting at the proposed airport area revealed that: (a) The Ulwe River flowing beneath the proposed airport needs to be diverted. The 120m wide proposed Ulwe diversion channel having a wider base width of 200 m at SH-54 Bridge on the Ulwe River along with the removal of the existing bund in Moha Creek is inevitable to keep the SGE of the airport to a minimum. (b) The clear waterway of 80 m at SH-54 Bridge (Ulwe River) and 120 m at Amra Marg Bridge near Moha Creek is also essential for the Ulwe diversion and (c) The river bank protection works on the right bank of Gadhi River between the NH-4B and SH-54 bridges as well as upstream of the Ulwe River diversion channel are essential to avoid inundation of low lying areas. The maxima water levels predicted around the airport keeps SGE to a minimum of 11m with respect to Chart datum of Ulwe Bundar and thus development is not only technologically-economically feasible but also sustainable. The unstructured mesh modeling is a promising tool to simulate complex extreme hydrodynamic events and provides a reliable solution to evolve optimal SGE of airport.

Keywords: airport, hydrodynamics, safe grade elevation, tides

Procedia PDF Downloads 240
29 Combined Pneumomediastinum and Pneumothorax Due to Hyperemesis Gravidarum

Authors: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

Procedia PDF Downloads 64
28 Midterm Clinical and Functional Outcomes After Treatment with Ponseti Method for Idiopathic Clubfeet: A Prospective Cohort Study

Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur

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Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

Procedia PDF Downloads 52
27 Verification of Geophysical Investigation during Subsea Tunnelling in Qatar

Authors: Gary Peach, Furqan Hameed

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Musaimeer outfall tunnel is one of the longest storm water tunnels in the world, with a total length of 10.15 km. The tunnel will accommodate surface and rain water received from the drainage networks from 270 km of urban areas in southern Doha with a pumping capacity of 19.7m³/sec. The tunnel is excavated by Tunnel Boring Machine (TBM) through Rus Formation, Midra Shales, and Simsima Limestone. Water inflows at high pressure, complex mixed ground, and weaker ground strata prone to karstification with the presence of vertical and lateral fractures connected to the sea bed were also encountered during mining. In addition to pre-tender geotechnical investigations, the Contractor carried out a supplementary offshore geophysical investigation in order to fine-tune the existing results of geophysical and geotechnical investigations. Electric resistivity tomography (ERT) and Seismic Reflection survey was carried out. Offshore geophysical survey was performed, and interpretations of rock mass conditions were made to provide an overall picture of underground conditions along the tunnel alignment. This allowed the critical tunnelling area and cutter head intervention to be planned accordingly. Karstification was monitored with a non-intrusive radar system facility installed on the TBM. The Boring Electric Ahead Monitoring(BEAM) was installed at the cutter head and was able to predict the rock mass up to 3 tunnel diameters ahead of the cutter head. BEAM system was provided with an online system for real time monitoring of rock mass condition and then correlated with the rock mass conditions predicted during the interpretation phase of offshore geophysical surveys. The further correlation was carried by Samples of the rock mass taken from tunnel face inspections and excavated material produced by the TBM. The BEAM data was continuously monitored to check the variations in resistivity and percentage frequency effect (PFE) of the ground. This system provided information about rock mass condition, potential karst risk, and potential of water inflow. BEAM system was found to be more than 50% accurate in picking up the difficult ground conditions and faults as predicted in the geotechnical interpretative report before the start of tunnelling operations. Upon completion of the project, it was concluded that the combined use of different geophysical investigation results can make the execution stage be carried out in a more confident way with the less geotechnical risk involved. The approach used for the prediction of rock mass condition in Geotechnical Interpretative Report (GIR) and Geophysical Reflection and electric resistivity tomography survey (ERT) Geophysical Reflection surveys were concluded to be reliable as the same rock mass conditions were encountered during tunnelling operations.

Keywords: tunnel boring machine (TBM), subsea, karstification, seismic reflection survey

Procedia PDF Downloads 198
26 Geomorphology and Flood Analysis Using Light Detection and Ranging

Authors: George R. Puno, Eric N. Bruno

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The natural landscape of the Philippine archipelago plus the current realities of climate change make the country vulnerable to flood hazards. Flooding becomes the recurring natural disaster in the country resulting to lose of lives and properties. Musimusi is among the rivers which exhibited inundation particularly at the inhabited floodplain portion of its watershed. During the event, rescue operations and distribution of relief goods become a problem due to lack of high resolution flood maps to aid local government unit identify the most affected areas. In the attempt of minimizing impact of flooding, hydrologic modelling with high resolution mapping is becoming more challenging and important. This study focused on the analysis of flood extent as a function of different geomorphologic characteristics of Musimusi watershed. The methods include the delineation of morphometric parameters in the Musimusi watershed using Geographic Information System (GIS) and geometric calculations tools. Digital Terrain Model (DTM) as one of the derivatives of Light Detection and Ranging (LiDAR) technology was used to determine the extent of river inundation involving the application of Hydrologic Engineering Center-River Analysis System (HEC-RAS) and Hydrology Modelling System (HEC-HMS) models. The digital elevation model (DEM) from synthetic Aperture Radar (SAR) was used to delineate watershed boundary and river network. Datasets like mean sea level, river cross section, river stage, discharge and rainfall were also used as input parameters. Curve number (CN), vegetation, and soil properties were calibrated based on the existing condition of the site. Results showed that the drainage density value of the watershed is low which indicates that the basin is highly permeable subsoil and thick vegetative cover. The watershed’s elongation ratio value of 0.9 implies that the floodplain portion of the watershed is susceptible to flooding. The bifurcation ratio value of 2.1 indicates higher risk of flooding in localized areas of the watershed. The circularity ratio value (1.20) indicates that the basin is circular in shape, high discharge of runoff and low permeability of the subsoil condition. The heavy rainfall of 167 mm brought by Typhoon Seniang last December 29, 2014 was characterized as high intensity and long duration, with a return period of 100 years produced 316 m3s-1 outflows. Portion of the floodplain zone (1.52%) suffered inundation with 2.76 m depth at the maximum. The information generated in this study is helpful to the local disaster risk reduction management council in monitoring the affected sites for more appropriate decisions so that cost of rescue operations and relief goods distribution is minimized.

Keywords: flooding, geomorphology, mapping, watershed

Procedia PDF Downloads 202
25 Seafloor and Sea Surface Modelling in the East Coast Region of North America

Authors: Magdalena Idzikowska, Katarzyna Pająk, Kamil Kowalczyk

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Seafloor topography is a fundamental issue in geological, geophysical, and oceanographic studies. Single-beam or multibeam sonars attached to the hulls of ships are used to emit a hydroacoustic signal from transducers and reproduce the topography of the seabed. This solution provides relevant accuracy and spatial resolution. Bathymetric data from ships surveys provides National Centers for Environmental Information – National Oceanic and Atmospheric Administration. Unfortunately, most of the seabed is still unidentified, as there are still many gaps to be explored between ship survey tracks. Moreover, such measurements are very expensive and time-consuming. The solution is raster bathymetric models shared by The General Bathymetric Chart of the Oceans. The offered products are a compilation of different sets of data - raw or processed. Indirect data for the development of bathymetric models are also measurements of gravity anomalies. Some forms of seafloor relief (e.g. seamounts) increase the force of the Earth's pull, leading to changes in the sea surface. Based on satellite altimetry data, Sea Surface Height and marine gravity anomalies can be estimated, and based on the anomalies, it’s possible to infer the structure of the seabed. The main goal of the work is to create regional bathymetric models and models of the sea surface in the area of the east coast of North America – a region of seamounts and undulating seafloor. The research includes an analysis of the methods and techniques used, an evaluation of the interpolation algorithms used, model thickening, and the creation of grid models. Obtained data are raster bathymetric models in NetCDF format, survey data from multibeam soundings in MB-System format, and satellite altimetry data from Copernicus Marine Environment Monitoring Service. The methodology includes data extraction, processing, mapping, and spatial analysis. Visualization of the obtained results was carried out with Geographic Information System tools. The result is an extension of the state of the knowledge of the quality and usefulness of the data used for seabed and sea surface modeling and knowledge of the accuracy of the generated models. Sea level is averaged over time and space (excluding waves, tides, etc.). Its changes, along with knowledge of the topography of the ocean floor - inform us indirectly about the volume of the entire water ocean. The true shape of the ocean surface is further varied by such phenomena as tides, differences in atmospheric pressure, wind systems, thermal expansion of water, or phases of ocean circulation. Depending on the location of the point, the higher the depth, the lower the trend of sea level change. Studies show that combining data sets, from different sources, with different accuracies can affect the quality of sea surface and seafloor topography models.

Keywords: seafloor, sea surface height, bathymetry, satellite altimetry

Procedia PDF Downloads 49
24 Factors Affecting Early Antibiotic Delivery in Open Tibial Shaft Fractures

Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

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Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

Procedia PDF Downloads 29
23 Establishment of Precision System for Underground Facilities Based on 3D Absolute Positioning Technology

Authors: Yonggu Jang, Jisong Ryu, Woosik Lee

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The study aims to address the limitations of existing underground facility exploration equipment in terms of exploration depth range, relative depth measurement, data processing time, and human-centered ground penetrating radar image interpretation. The study proposed the use of 3D absolute positioning technology to develop a precision underground facility exploration system. The aim of this study is to establish a precise exploration system for underground facilities based on 3D absolute positioning technology, which can accurately survey up to a depth of 5m and measure the 3D absolute location of precise underground facilities. The study developed software and hardware technologies to build the precision exploration system. The software technologies developed include absolute positioning technology, ground surface location synchronization technology of GPR exploration equipment, GPR exploration image AI interpretation technology, and integrated underground space map-based composite data processing technology. The hardware systems developed include a vehicle-type exploration system and a cart-type exploration system. The data was collected using the developed exploration system, which employs 3D absolute positioning technology. The GPR exploration images were analyzed using AI technology, and the three-dimensional location information of the explored precise underground facilities was compared to the integrated underground space map. The study successfully developed a precision underground facility exploration system based on 3D absolute positioning technology. The developed exploration system can accurately survey up to a depth of 5m and measure the 3D absolute location of precise underground facilities. The system comprises software technologies that build a 3D precise DEM, synchronize the GPR sensor's ground surface 3D location coordinates, automatically analyze and detect underground facility information in GPR exploration images and improve accuracy through comparative analysis of the three-dimensional location information, and hardware systems, including a vehicle-type exploration system and a cart-type exploration system. The study's findings and technological advancements are essential for underground safety management in Korea. The proposed precision exploration system significantly contributes to establishing precise location information of underground facility information, which is crucial for underground safety management and improves the accuracy and efficiency of exploration. The study addressed the limitations of existing equipment in exploring underground facilities, proposed 3D absolute positioning technology-based precision exploration system, developed software and hardware systems for the exploration system, and contributed to underground safety management by providing precise location information. The developed precision underground facility exploration system based on 3D absolute positioning technology has the potential to provide accurate and efficient exploration of underground facilities up to a depth of 5m. The system's technological advancements contribute to the establishment of precise location information of underground facility information, which is essential for underground safety management in Korea.

Keywords: 3D absolute positioning, AI interpretation of GPR exploration images, complex data processing, integrated underground space maps, precision exploration system for underground facilities

Procedia PDF Downloads 34
22 Compass Bar: A Visualization Technique for Out-of-View-Objects in Head-Mounted Displays

Authors: Alessandro Evangelista, Vito M. Manghisi, Michele Gattullo, Enricoandrea Laviola

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In this work, we propose a custom visualization technique for Out-Of-View-Objects in Virtual and Augmented Reality applications using Head Mounted Displays. In the last two decades, Augmented Reality (AR) and Virtual Reality (VR) technologies experienced a remarkable growth of applications for navigation, interaction, and collaboration in different types of environments, real or virtual. Both environments can be potentially very complex, as they can include many virtual objects located in different places. Given the natural limitation of the human Field of View (about 210° horizontal and 150° vertical), humans cannot perceive objects outside this angular range. Moreover, despite recent technological advances in AR e VR Head-Mounted Displays (HMDs), these devices still suffer from a limited Field of View, especially regarding Optical See-Through displays, thus greatly amplifying the challenge of visualizing out-of-view objects. This problem is not negligible when the user needs to be aware of the number and the position of the out-of-view objects in the environment. For instance, during a maintenance operation on a construction site where virtual objects serve to improve the dangers' awareness. Providing such information can enhance the comprehension of the scene, enable fast navigation and focused search, and improve users' safety. In our research, we investigated how to represent out-of-view-objects in HMD User Interfaces (UI). Inspired by commercial video games such as Call of Duty Modern Warfare, we designed a customized Compass. By exploiting the Unity 3D graphics engine, we implemented our custom solution that can be used both in AR and VR environments. The Compass Bar consists of a graduated bar (in degrees) at the top center of the UI. The values of the bar range from -180 (far left) to +180 (far right), the zero is placed in front of the user. Two vertical lines on the bar show the amplitude of the user's field of view. Every virtual object within the scene is represented onto the compass bar as a specific color-coded proxy icon (a circular ring with a colored dot at its center). To provide the user with information about the distance, we implemented a specific algorithm that increases the size of the inner dot as the user approaches the virtual object (i.e., when the user reaches the object, the dot fills the ring). This visualization technique for out-of-view objects has some advantages. It allows users to be quickly aware of the number and the position of the virtual objects in the environment. For instance, if the compass bar displays the proxy icon at about +90, users will immediately know that the virtual object is to their right and so on. Furthermore, by having qualitative information about the distance, users can optimize their speed, thus gaining effectiveness in their work. Given the small size and position of the Compass Bar, our solution also helps lessening the occlusion problem thus increasing user acceptance and engagement. As soon as the lockdown measures will allow, we will carry out user-tests comparing this solution with other state-of-the-art existing ones such as 3D Radar, SidebARs and EyeSee360.

Keywords: augmented reality, situation awareness, virtual reality, visualization design

Procedia PDF Downloads 98
21 Developing an Innovative General Foundation Programme (GFP) and an IELTS Centre in a New Military College

Authors: Jessica Peart, Sarim Al Zubaidy

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This paper examines the main dialogic and reformative aspects that have constituted the developing implementation of an English language module in a common pre-sessional program in Oman, the General Foundation Program (GFP), at the new Military Technological College (MTC), in Oman’s capital, muscat. The MTC is the first of its kind in the country to merge military with academic training and has been running programs since September 2013 over five trimesters to date, receiving external validation and accreditation from the University of Portsmouth (UoP), UK. From this starting point, We will provide context on the parameters that necessitated delivery of this common but specially tailored pre-sessional program at the MTC and outline in detail how the English module with integrated key study skills and personal tutoring support was initially conceived before operations commenced and cooperation between all stakeholders took practical shape. This enquiry traces how stakeholders from students to faculty, college boards and collaborative university partners have considered and redefined the in part static and dynamic boundaries of their larger and smaller scale stakes. With regard to the widely held recognition that pre-sessional students require training in transferable study skills in order to succeed at university, we will chart the subsequent and ongoing adjustments made to the generic, pastoral and integrated elements of that program. Driving this concerted effort has been at base the need for a GFP concerned with three criteria for incoming MTC students cadets, namely to develop candidate’s rounded capacity for intellectual, technical and physical skill as both students and cadets, to generate linguistic proficiency and discerning use of appropriate language registers and to allow personal and collective time for adjustment to a multilayered, brand new environment, while also working within a regulated timeline for academic progression to the MTC diploma or degree levels. The English Department teaching staff’s facilitation of the initial program’s methodologies and timeframe for the GFP English module has garnered a keen and diverse sense of the holistic student cadet experience, which a range of alterations to the program demonstrate. These include alterations to the class types and overall program duration as well as greater multiplicity of exposure within learning environments. In surveying the impact of these composite maneuvers and challenges within a proactive and evolving context of teaching and learning, it is finally demonstrated how student cadet levels of productivity and self-reliance on the one hand and retention issues on the other are being gainfully steered towards progression within a framework for inclusive reciprocal dialogue, gathering thereby civilian and military backgrounds toward uniquely united ends.

Keywords: English module transferable skills, faculty dialogue, governance structure, overarching regulatory agencies

Procedia PDF Downloads 255
20 Modelling the Art Historical Canon: The Use of Dynamic Computer Models in Deconstructing the Canon

Authors: Laura M. F. Bertens

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There is a long tradition of visually representing the art historical canon, in schematic overviews and diagrams. This is indicative of the desire for scientific, ‘objective’ knowledge of the kind (seemingly) produced in the natural sciences. These diagrams will, however, always retain an element of subjectivity and the modelling methods colour our perception of the represented information. In recent decades visualisations of art historical data, such as hand-drawn diagrams in textbooks, have been extended to include digital, computational tools. These tools significantly increase modelling strength and functionality. As such, they might be used to deconstruct and amend the very problem caused by traditional visualisations of the canon. In this paper, the use of digital tools for modelling the art historical canon is studied, in order to draw attention to the artificial nature of the static models that art historians are presented with in textbooks and lectures, as well as to explore the potential of digital, dynamic tools in creating new models. To study the way diagrams of the canon mediate the represented information, two modelling methods have been used on two case studies of existing diagrams. The tree diagram Stammbaum der neudeutschen Kunst (1823) by Ferdinand Olivier has been translated to a social network using the program Visone, and the famous flow chart Cubism and Abstract Art (1936) by Alfred Barr has been translated to an ontological model using Protégé Ontology Editor. The implications of the modelling decisions have been analysed in an art historical context. The aim of this project has been twofold. On the one hand the translation process makes explicit the design choices in the original diagrams, which reflect hidden assumptions about the Western canon. Ways of organizing data (for instance ordering art according to artist) have come to feel natural and neutral and implicit biases and the historically uneven distribution of power have resulted in underrepresentation of groups of artists. Over the last decades, scholars from fields such as Feminist Studies, Postcolonial Studies and Gender Studies have considered this problem and tried to remedy it. The translation presented here adds to this deconstruction by defamiliarizing the traditional models and analysing the process of reconstructing new models, step by step, taking into account theoretical critiques of the canon, such as the feminist perspective discussed by Griselda Pollock, amongst others. On the other hand, the project has served as a pilot study for the use of digital modelling tools in creating dynamic visualisations of the canon for education and museum purposes. Dynamic computer models introduce functionalities that allow new ways of ordering and visualising the artworks in the canon. As such, they could form a powerful tool in the training of new art historians, introducing a broader and more diverse view on the traditional canon. Although modelling will always imply a simplification and therefore a distortion of reality, new modelling techniques can help us get a better sense of the limitations of earlier models and can provide new perspectives on already established knowledge.

Keywords: canon, ontological modelling, Protege Ontology Editor, social network modelling, Visone

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19 Electromagnetic Modeling of a MESFET Transistor Using the Moments Method Combined with Generalised Equivalent Circuit Method

Authors: Takoua Soltani, Imen Soltani, Taoufik Aguili

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The communications' and radar systems' demands give rise to new developments in the domain of active integrated antennas (AIA) and arrays. The main advantages of AIA arrays are the simplicity of fabrication, low cost of manufacturing, and the combination between free space power and the scanner without a phase shifter. The integrated active antenna modeling is the coupling between the electromagnetic model and the transport model that will be affected in the high frequencies. Global modeling of active circuits is important for simulating EM coupling, interaction between active devices and the EM waves, and the effects of EM radiation on active and passive components. The current review focuses on the modeling of the active element which is a MESFET transistor immersed in a rectangular waveguide. The proposed EM analysis is based on the Method of Moments combined with the Generalised Equivalent Circuit method (MOM-GEC). The Method of Moments which is the most common and powerful software as numerical techniques have been used in resolving the electromagnetic problems. In the class of numerical techniques, MOM is the dominant technique in solving of Maxwell and Transport’s integral equations for an active integrated antenna. In this situation, the equivalent circuit is introduced to the development of an integral method formulation based on the transposition of field problems in a Generalised equivalent circuit that is simpler to treat. The method of Generalised Equivalent Circuit (MGEC) was suggested in order to represent integral equations circuits that describe the unknown electromagnetic boundary conditions. The equivalent circuit presents a true electric image of the studied structures for describing the discontinuity and its environment. The aim of our developed method is to investigate the antenna parameters such as the input impedance and the current density distribution and the electric field distribution. In this work, we propose a global EM modeling of the MESFET AsGa transistor using an integral method. We will begin by describing the modeling structure that allows defining an equivalent EM scheme translating the electromagnetic equations considered. Secondly, the projection of these equations on common-type test functions leads to a linear matrix equation where the unknown variable represents the amplitudes of the current density. Solving this equation resulted in providing the input impedance, the distribution of the current density and the electric field distribution. From electromagnetic calculations, we were able to present the convergence of input impedance for different test function number as a function of the guide mode numbers. This paper presents a pilot study to find the answer to map out the variation of the existing current evaluated by the MOM-GEC. The essential improvement of our method is reducing computing time and memory requirements in order to provide a sufficient global model of the MESFET transistor.

Keywords: active integrated antenna, current density, input impedance, MESFET transistor, MOM-GEC method

Procedia PDF Downloads 168
18 Robots for the Elderly at Home: For Men Only

Authors: Christa Fricke, Sibylle Meyer, Gert G. Wagner

Abstract:

Our research focuses on the question of whether assistive and social robotics could pose a promising strategy to support the independent living of elderly people and potentially relieve relatives of any anxieties. To answer the question of how elderly people perceive the potential of robotics, we analysed the data from the Berlin Aging Study BASE-II (https://www.base2.mpg.de/de) (N=1463) and data from the German SYMPARTNER study (http://www.sympartner.de) (N=120) and compared those to a control group made up of people younger than 30 years (BASE II: N=241; SYMPARTNER: N=30). BASE-II is a cohort study of people living in Berlin, Germany. The sample covers more than 2200 cases; a questionnaire on the use and acceptance of assistive and social robots was carried out with a sub-sample of 1463 respondents in 2015. The SYMPARTNER study was done by SIBIS institute of Social Research, Berlin and included a total of 120 persons between the ages of 60 and 87 in Berlin and the rural German federal state of Thuringia. Both studies included a control group of persons between the ages of 20 and 35 (BASE II: N=241; SYMPARTNER: N=30). Additional data, representative for the whole population in Germany, will be surveyed in fall 2017 (Survey “Technikradar” [technology radar] by the National Academy of Science and Engineering). Since this survey is including some identical questions as BASE-II/SYMPARTNER, comparative results can be presented at 20th International Conference on Social Robotics in New York 2018. The complexity of the data gathered in BASE-II and SYMPARTNER, encompassing detailed socio-economic background characteristics as well as personality traits such as the personal attitude to risk taking, locus of control and Big Five, proves highly valuable and beneficial. Results show that participants’ expressions of resentment against robots are comparatively low. Participants’ personality traits play a role, however the effect sizes are small. Only 15 percent of participants received domestic robots with great scepticism. Participants aged older than 70 years expressed greatest rejection of the robotic assistant. The effect sizes however account for only a few percentage points. Overall, participants were surprisingly open to the robot and its usefulness. The analysis also shows that men’s acceptance of the robot is generally greater than that of women (with odds ratios of about 0.6 to 0.7). This applies to both assistive robots in the private household and in care environments. Men expect greater benefits of the robot than women. Women tend to be more sceptical of their technical feasibility than men. Interview results prove our hypothesis that men, in particular of the age group 60+, are more accustomed to delegate household chores to women. A delegation to machines instead of humans, therefore, seems palpable. The answer to the title question of this planned presentation is: social and assistive robots at home robots are not only accepted by men – but by fewer women than men.

Keywords: acceptance, care, gender, household

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17 Oncoplastic Augmentation Mastopexy: Aesthetic Revisional Surgery in Breast Conserving Therapy

Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

Abstract:

Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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16 The Lessons Learned from Managing Malignant Melanoma During COVID-19 in a Plastic Surgery Unit in Ireland

Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

Abstract:

Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

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15 Nuclear Powered UAV for Surveillances and Aerial Photography

Authors: Rajasekar Elangopandian, Anand Shanmugam

Abstract:

Now-a-days for surveillances unmanned aerial vehicle plays a vital role. Not only for surveillances, aerial photography disaster management and the notice of earth behavior UAV1s envisages meticulously. To reduce the maintenance and fuel nuclear powered Vehicles are greater support. The design consideration is much important for the UAV manufacturing industry and Research and development agency. Eventually design is looking like a pentagon shaped fuselage and black rubber coated paint in order to escape from the enemy radar and other targets. The pentagon shape fuselage has large space to keep the mini nuclear reactor inside and the material is carbon – carbon fiber specially designed by the software called cosmol and hyper mesh 14.2. So the weight consideration will produce the positive result for productivity. The walls of the fuselage are coated with lead and protective shield. A double layer of W/Bi sheet is proposed for radiation protection at the energy range of 70 Kev to 90 Kev. The designed W/bi sheet, only 0.14 mm thick and is 36% light. The properties of the fillers were determined from zeta potential and particle size measurements. The Exposes of the radiation can be attenuated by 3 ways such as minimizing exposure time, Maximizing distance from the radiation source and shielding the whole vehicle. The inside reactor will be switched ON when the UAV starts its cruise. The moderators and the control rods can be inserted by automation technique by newly developed software. The heat generated by the reactor will be used to run the turbine which is fixed inside the UAV called mini turbine with natural rubber composite Shaft radiation shield. Cooling system will be in two mode such as liquid and air cooled. Liquid coolant for the heat regeneration is ordinary water, liquid sodium, helium and the walls are made up of regenerative and radiation protective material. The other components like camera and arms bay will be located at the bottom of the UAV high are specially made products in order to escape from the radiation. They are coated with lead Pb and natural rubber composite material. This technique provides the long rang and endurance for eternal flight mission until we need any changeability of parts or product. This UAV has the special advantage of ` land on String` means it`ll land at electric line to charge the automated electronics. Then the fuel is enriched uranium (< 5% U - 235) contains hundreds of fuel pins. This technique provides eternal duty for surveillances and aerial photography. The landing of the vehicle is ease of operation likewise the takeoff is also easier than any other mechanism which present in nowadays. This UAV gives great immense and immaculate technology for surveillance and target detecting and smashing the target.

Keywords: mini turbine, liquid coolant for the heat regeneration, in order to escape from the radiation, eternal flight mission, it`ll land at electric line

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14 How Can Personal Protective Equipment Be Best Used and Reused: A Human Factors based Look at Donning and Doffing Procedures

Authors: Devin Doos, Ashley Hughes, Trang Pham, Paul Barach, Rami Ahmed

Abstract:

Over 115,000 Health Care Workers (HCWs) have died from COVID-19, and millions have been infected while caring for patients. HCWs have filed thousands of safety complaints surrounding safety concerns due to Personal Protective Equipment (PPE) shortages, which included concerns around inadequate and PPE reuse. Protocols for donning and doffing PPE remain ambiguous, lacking an evidence-base, and often result in wide deviations in practice. PPE donning and doffing protocol deviations commonly result in self-contamination but have not been thoroughly addressed. No evidence-driven protocols provide guidance on protecting HCW during periods of PPE reuse. Objective: The aim of this study was to examine safety-related threats and risks to Health Care Workers (HCWs) due to the reuse of PPE among Emergency Department personnel. Method: We conducted a prospective observational study to examine the risks of reusing PPE. First, ED personnel were asked to don and doff PPE in a simulation lab. Each participant was asked to don and doff PPE five times, according to the maximum reuse recommendation set by the Centers for Disease Control and Prevention (CDC). Each participant was videorecorded; video recordings were reviewed and coded independently by at least 2 of the 3trained coders for safety behaviors and riskiness of actions. A third coder was brought in when the agreement between the 2 coders could not be reached. Agreement between coders was high (81.9%), and all disagreements (100%) were resolved via consensus. A bowtie risk assessment chart was constructed analyzing the factors that contribute to increased risks HCW are faced with due to PPE use and reuse. Agreement amongst content experts in the field of Emergency Medicine, Human Factors, and Anesthesiology was used to select aspects of health care that both contribute and mitigate risks associated with PPE reuse. Findings: Twenty-eight clinician participants completed five rounds of donning/doffing PPE, yielding 140 PPE donning/doffing sequences. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE materials. 100% of participants (n= 28) deviated from the CDC recommended order, and most participants (92.85%, n=26) self-contaminated at least once during reuse. Other frequent errors included failure to tie all ties on the PPE (92.85%, n=26) and failure to wash hands after a contamination event occurred (39.28%, n=11). Conclusions: There is wide variation and regular errors in how HCW don and doffPPE while including in reusing PPE that led to self-contamination. Some errors were deemed “recoverable”, such as hand washing after touching a patient-facing surface to remove the contaminant. Other errors, such as using a contaminated mask and accidentally spreading to the neck and face, can lead to compound risks that are unique to repeated PPE use. A more comprehensive understanding of the contributing threats to HCW safety and complete approach to mitigating underlying risks, including visualizing with risk management toolsmay, aid future PPE designand workflow and space solutions.

Keywords: bowtie analysis, health care, PPE reuse, risk management

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13 Combustion Variability and Uniqueness in Cylinders of a Radial Aircraft Piston Engine

Authors: Michal Geca, Grzegorz Baranski, Ksenia Siadkowska

Abstract:

The work is a part of the project which aims at developing innovative power and control systems for the high power aircraft piston engine ASz62IR. Developed electronically controlled ignition system will reduce emissions of toxic compounds as a result of lowered fuel consumption, optimized combustion and engine capability of efficient combustion of ecological fuels. The tested unit is an air-cooled four-stroke gasoline engine of 9 cylinders in a radial setup, mechanically charged by a radial compressor powered by the engine crankshaft. The total engine cubic capac-ity is 29.87 dm3, and the compression ratio is 6.4:1. The maximum take-off power is 1000 HP at 2200 rpm. The maximum fuel consumption is 280 kg/h. Engine powers aircrafts: An-2, M-18 „Dromader”, DHC-3 „OTTER”, DC-3 „Dakota”, GAF-125 „HAWK” i Y5. The main problems of the engine includes the imbalanced work of cylinders. The non-uniformity value in each cylinder results in non-uniformity of their work. In radial engine cylinders arrangement causes that the mixture movement that takes place in accordance (lower cylinder) or the opposite (upper cylinders) to the direction of gravity. Preliminary tests confirmed the presence of uneven workflow of individual cylinders. The phenomenon is most intense at low speed. The non-uniformity is visible on the waveform of cylinder pressure. Therefore two studies were conducted to determine the impact of this phenomenon on the engine performance: simulation and real tests. Simplified simulation was conducted on the element of the intake system coated with fuel film. The study shows that there is an effect of gravity on the movement of the fuel film inside the radial engine intake channels. Both in the lower and the upper inlet channels the film flows downwards. It follows from the fact that gravity assists the movement of the film in the lower cylinder channels and prevents the movement in the upper cylinder channels. Real tests on aircraft engine ASz62IR was conducted in transients condition (rapid change of the excess air in each cylinder were performed. Calculations were conducted for mass of fuel reaching the cylinders theoretically and really and on this basis, the factors of fuel evaporation “x” were determined. Therefore a simplified model of the fuel supply to cylinder was adopted. Model includes time constant of the fuel film τ, the number of engine transport cycles of non-evaporating fuel along the intake pipe γ and time between next cycles Δt. The calculation results of identification of the model parameters are presented in the form of radar graphs. The figures shows the averages declines and increases of the injection time and the average values for both types of stroke. These studies shown, that the change of the position of the cylinder will cause changes in the formation of fuel-air mixture and thus changes in the combustion process. Based on the results of the work of simulation and experiments was possible to develop individual algorithms for ignition control. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: radial engine, ignition system, non-uniformity, combustion process

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