Search results for: rescue analgesia

Authors: Siliang Luan, Zhongtai Jiang

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The risk of highway incidents is commonly recognized as a major concern for transportation authorities due to the hazardous consequences and negative influence. It is crucial to respond to these unpredictable events as soon as possible faced by emergency management decision makers. In this paper, we focus on path planning for emergency vehicles, one of the most significant processes to avoid congestion and reduce rescue time. A Mixed-Integer Linear Programming with Semi-Soft Time Windows Model (MIPSSTWM) is conducted to plan an optimal routing respectively considering the time consumption of arcs and nodes of the urban road network and the highway network, especially in developing countries with an enormous population. Here, the arcs indicate the road segments and the nodes include the intersections of the urban road network and the on-ramp and off-ramp of the highway networks. An attempt in this research has been made to develop a comprehensive and executive strategy for emergency vehicle routing in heavy traffic conditions. The proposed Cuckoo Search (CS) algorithm is designed by imitating obligate brood parasitic behaviors of cuckoos and Lévy Flights (LF) to solve this hard and combinatorial problem. Using a Chinese city as our case study, the numerical results demonstrate the approach we applied in this paper outperforms the previous method without considering the nodes of the road network for a real-world situation. Meanwhile, the accuracy and validity of the CS algorithm also show better performances than the traditional algorithm.

Keywords: emergency vehicle, path planning, cs algorithm, urban traffic management and urban planning

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Authors: Shibinu S, Mohamed Haseeb N

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In times of crisis, the diaspora's role and the help it offers are seen to be vital in determining how many countries, particularly low- and middle-income nations that significantly rely on remittances, recover. Twenty-one lakh twenty thousand Keralites have emigrated abroad, with 81.2 percent of these outflows occurring in the Gulf Cooperative Council (GCC). Most of them are semi-skilled or low-skilled laborers employed in GCC nations. Additionally, a sizeable portion of migrants are employed in industrialized nations like the UK and the US. These nations have seen the development of a highly robust Indian Diaspora. India's development is largely dependent on the generosity of its diaspora, and the nation has benefited greatly from the substantial contributions made by several emigrant generations. Its strength was noticeable during the COVID-19 and Kerala floods. Millions of people were displaced, millions of properties were damaged, and many people died as a result of the 2018 Kerala floods. The Malayalee diaspora played a crucial role in the reconstruction of Kerala by providing support for the rescue efforts underway on the ground through their extensive worldwide network. During COVID-19, an analogous outreach was also noted, in which the diaspora assisted stranded migrants across the globe. Together with the work the diaspora has done for the state's development and recovery, there has also been a recent outpouring of assistance during the COVID-19 pandemic. The study focuses on the subtleties of diaspora philanthropic scholarship and how Kerala was able to recover from the COVID-19 pandemic and floods thanks to it. Semi-structured in-depth interviews with migrants, migrant organizations, and beneficiaries from the diaspora through snowball sampling to better understand the role that diaspora philanthropy plays in times of crisis.

Keywords: crises, diaspora, remittances, COVID-19, flood, economic development of Kerala

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Authors: Rabih Ghostine, Craig Kapfer, Viswanathan Kannan, Ibrahim Hoteit

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Urban flooding resulting from a sudden release of water due to dam-break or excessive rainfall is a serious threatening environment hazard, which causes loss of human life and large economic losses. Anticipating floods before they occur could minimize human and economic losses through the implementation of appropriate protection, provision, and rescue plans. This work reports on the numerical modelling of flash flood propagation in urban areas after an excessive rainfall event or dam-break. A two-dimensional (2D) depth-averaged shallow water model is used with a refined unstructured grid of triangles for representing the urban area topography. The 2D shallow water equations are solved using a second-order well-balanced discontinuous Galerkin scheme. Theoretical test case and three flood events are described to demonstrate the potential benefits of the scheme: (i) wetting and drying in a parabolic basin (ii) flash flood over a physical model of the urbanized Toce River valley in Italy; (iii) wave propagation on the Reyran river valley in consequence of the Malpasset dam-break in 1959 (France); and (iv) dam-break flood in October 1982 at the town of Sumacarcel (Spain). The capability of the scheme is also verified against alternative models. Computational results compare well with recorded data and show that the scheme is at least as efficient as comparable second-order finite volume schemes, with notable efficiency speedup due to parallelization.

Keywords: dam-break, discontinuous Galerkin scheme, flood modeling, shallow water equations

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Authors: Jerzy Ejsmont, Beata Świeczko-Żurek, Grzegorz Ronowski

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Gas cylinders in general and particularly cylinders containing acetylene constitute a great potential danger for fire and rescue services involved in salvage operations. Experiments show that gas cylinders with acetylene, oxygen, hydrogen, CNG, LPG or CO2 may blow after short exposition to heat with very destructive effect as fragments of blown cylinder may fly even several hundred meters. In the case of acetylene, the explosion may occur also several hours after the cylinder is cooled down. One of the possible neutralization procedures that in many cases may be used to prevent explosions is shooting dangerous cylinders by rifle bullets. This technique is used to neutralize acetylene cylinders in a few European countries with great success. In Poland research project 'BLOW' was launched in 2014 with the aim to investigate phenomena related to fire influence on industrial and home used cylinders and to evaluate usefulness of the shooting technique. All together over 100 gas cylinders with different gases were experimentally tested at the military blasting grounds and in shelters. During the experiments cylinder temperature and pressure were recorded. In the case of acetylene that is subjected to thermal decomposition also concentration of hydrogen was monitored. Some of the cylinders were allowed to blow and others were shot by snipers. It was observed that shooting hot cylinders has never created more dangerous situations than letting the cylinders to explode spontaneously. In a great majority of cases cylinders that were punctured by bullets released gas in a more or less violent but relatively safe way. The paper presents detailed information about experiments and presents particularities of behavior of cylinders containing different gases. Extensive research was also done in order to select bullets that may be safely and efficiently used to puncture different cylinders. The paper shows also results of those experiments as well as gives practical information related to techniques that should be used during shooting.

Keywords: fire, gas cylinders, neutralization, shooting

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Authors: Repaul Kanji, Rajat Agrawal

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In this era where issues like climate change and disasters are the topics of discussion at national and international forums, it is very often that humanity questions the causative role of corporates in such events. It is beyond any doubt that rapid industrialisation and development has taken a toll in the form of climate change and even disasters, in some case. Thus, demanding to fulfill a corporate's responsibilities in the form of rescue and relief in times of disaster, rehabilitation and even mitigation and preparedness to adapt to the oncoming changes is obvious. But how can the responsibilities of the corporates be channelised to ensure all this, i.e., develop a resilient society? More than that, which factors, when emphasised upon, can lead to the holistic development of the society. To answer this query, an extensive literature review was done to identify several enablers like legislations of a nation, the role of brand and reputation, ease of doing Corporate Social Responsibility, mission and vision of an organisation, religion and culture, etc. as a tool for building disaster resilience. A questionnaire survey, interviews with experts and academicians followed by interpretive structural modelling (ISM) were used to construct a multi-hierarchy model depicting the contextual relationship among the identified enablers. The study revealed that culture and religion are the most powerful driver, which affects other enablers either directly or indirectly. Taking cognisance of the fact that an idea of separation between religion and workplace (business) resides subconsciously within the society, the study tries to interpret the outcome of the ISM through the lenses of past researches (The Integrating Box) and explores how it can be leveraged to build a resilient society.

Keywords: corporate social responsibility, interpretive structural modelling, disaster resilience and risk reduction, the integration box (TIB)

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Authors: Jireh Reinor L. Vitto, Mylene S. Gumarao, Levy M. Fajanilan, Sheryll Ann M. Castillo, Leonardo B. Dorado, Miriam P. Narbarte

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Human trafficking may happen to anyone. The study aimed to explore the experiences of victim witnesses of human trafficking. It utilized a qualitative phenomenological study design. Eighteen women, 15 to 46 years old, had experienced human trafficking (sex or labor trafficking), and with a filed case or not. An in-depth semi-structured, open-ended interview was employed to gather information. Guardians were also interviewed for triangulation purposes. Findings showed that the participants experienced fatigue and abuse for their physical aspect and gained negative feelings such as burdened, sad, scared (fear), stress, anger, trauma, depress and suicidal thoughts for their psychological aspect. For the spiritual aspect, the participants concluded to have enhanced spiritual life where they knew about God, became closer to God, and learned how to pray. They also faced challenges such as dysfunctional family, delinquent friends, exploitation, problems kept from the family, and poverty, which resulted in their becoming victims of human trafficking. To cope with the situation, they utilized family support, prayers, guts or courage (lakas ng loob), negotiation with their employer, and support from kababayans. Their practices and mechanisms to recover were the Blas Ople Center, rescue/entrapment operation, shelter, and embassy. After the incident, the participants shared that they earned to have thoughts of having a good life without going abroad/makabayan, knowledge of overseas Filipino workers, wise choice of friends, contentment, and value for the family.

Keywords: victim-witnesses, human trafficking, lived experiences, challenges, coping strategies

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Authors: Bilge Kaan Tekelioglu, Mehmet Celik, Mahmut Ali Gokce, Ladine Celik, Yusuf Uzun

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A male mature barn owl (Tyto alba) was brought to Cukurova University Ceyhan Veterinary Medicine Faculty at the beginning of January 2017. The bird was found at a local state elementary school’s garden where had been terribly damaged by metal wires. On the clinical examination, the animal was in shock and atonic position at arrival and seems to have feather problems and severe injuries. The ears, eyes, claws and wounded areas were checked and no signs of viral, microbial or ecto-parasitic infection were observed. The bird has been declared by U.S. wild life Office as endangered species. At first, the owl was kept in silent, warm and darkened cabinet against shock and warmed fluid replacement was started by % 5 dextrose solution per orally. On the second day, we started per oral forced feeding with chicken flesh meat dipped into the dextrose solution. On the third day, the bird was continued to be fed with fresh meat. At the fourth day, the owl was started to be fed with chicks during the next 3 days died by natural means which has been supplied by a local breeder. At the first 3 days 1 chick per day and the following days 2 chicks per day has been given per orally. The tenth day we started flying exercises in a small and non-windowed room safely. The saved owl was kept in this room for 10 more days. Finally, the owl was released at the habitation where it had been found injured. This study has one more time proved that, if you save one, you can save more. Wild life is in danger all over the world. Every living creature has right and deserves a chance to live.

Keywords: wild life, barn owl, Tyto alba, rescue, life support, feeding

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Authors: Akram Mahdaviparsa, Tamera McCuen, Vahideh Karimimansoob

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Fire service is responsible for protecting life, assets, and natural resources from fire and other hazardous incidents. Search and rescue in unfamiliar buildings is a vital part of firefighters’ responsibilities. Providing firefighters with precise building information in an easy-to-understand format is a potential solution for mitigating the negative consequences of fire hazards. The negative effect of insufficient knowledge about a building’s indoor environment impedes firefighters’ capabilities and leads to lost property. A data rich building information modeling (BIM) is a potentially useful source in three-dimensional (3D) visualization and data/information storage for fire emergency response. Therefore, this research’s purpose is prioritizing the required information for firefighters from the most important information to the least important. A survey was carried out with firefighters working in the Norman Fire Department to obtain the importance of each building information item. The results show that “the location of exit doors, windows, corridors, elevators, and stairs”, “material of building elements”, and “building data” are the three most important information specified by firefighters. The results also implied that the 2D model of architectural, structural and way finding is more understandable in comparison with the 3D model, while the 3D model of MEP system could convey more information than the 2D model. Furthermore, color in visualization can help firefighters to understand the building information easier and quicker. Sufficient internal consistency of all responses was proven through developing the Pearson Correlation Matrix and obtaining Cronbach’s alpha of 0.916. Therefore, the results of this study are reliable and could be applied to the population.

Keywords: BIM, building fire response, ranking, visualization

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Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

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This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

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The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

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Authors: Siamak Yaghoubi, Mohammad Reza Abootorabi, Hamid Kayalha

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Objective: The study was aimed to evaluate the applicability of the Cobra Perilaryngeal Airway (Cobra PLATM) for patients under general anesthesia and also compare result with the Laryngeal Mask Airway (LMA). Methods: Seventy three obese and overweight patients were included in the study. The patients were randomly assigned to either LMA or Cobra PLATM. Time required for intubation, successful intubation attempt, airway sealing pressure, the incidences of complications including blood staining, sore throat and dysphagia were assessed and noted. Results: Thirty six and thirty seven patients were allocated randomly to either LMA or Cobra PLATM, respectively. Most of the patients were male and were in Mallampati Class II airway in both groups. The first attempt and overall insertion success for the Cobra PLATM was significantly more frequent compared to the LMA (p<0.05). Tube insertion was more successful (Cobra PLATM, 94%; LMA™, 77%; P = 0.027) with the Cobra PLATM. The insertion times were similar with the Cobra PLATM and LMA™ (Cobra PLATM, 29.94±16.35s; LMA™, 27.00±7.88s). The airway sealing pressure in the Cobra PLATM (24.80±0.90 H2O) was significantly more than LMA™ (19.13 ±0.58 H2O, p<0.001). Sore throat was more frequent in the LMA™ groups that did not reach statistical significance (Fisher’s exact test, P = 0.33). Incidences of blood staining on airway tube were seen for both groups that was higher in the Cobra PLATM group (Fisher’s exact test, P = 0.02). Incidence of dysphagia was not different between the two groups. Conclusion: The CobraPLA™ was found to be safe and low complications, better airway sealing and high rate of the first insertion success for suing in obese and overweight patients. The study recommended using the CobraPLA™ as a rescue device in an emergency situation among obese and overweight patients.

Keywords: CobraPLA™, flexible laryngeal mask airway, obese patients, perilaryngeal airway

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Authors: Okike Benjamin

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Terrorism is the use of violence and threat to intimidate or coerce a person, group, society or even government especially for political purposes. Terrorism may be a way of resisting government by some group who may feel marginalized. It could also be a way of expressing displeasure over the activities of government. On 26th December, 2009, US placed Nigeria as a terrorist nation. Recently, the occurrences of terrorism in Nigeria have increased considerably. In Jos, Plateau state, Nigeria, there was a bomb blast which claimed many lives on the eve of 2010 Christmas. Similarly, there was another bomb blast in Mugadishi (Sani Abacha) Barracks Mammy market on the eve of 2011 New Year. For some time now, it is no longer news that bomb exploded in some Northern part of Nigeria. About 25 years ago, stopping terrorism in America by the Americans relied on old-fashioned tools such as strict physical security at vulnerable places, intelligence gathering by government agents, or individuals, vigilance on the part of all citizens, and a sense of community in which citizens do what could be done to protect each other. Just as technology has virtually been used to better the way many other things are done, so also this powerful new weapon called computer technology can be used to detect and prevent terrorism not only in Nigeria, but all over the world. This paper will x-ray the possible causes and effects of bomb blast, which is an act of terrorism and suggest ways in which Explosive Detection Devices (EDDs) and computer software technology could be deployed to reduce the occurrences of terrorism in Nigeria. This become necessary with the abduction of over 200 schoolgirls in Chibok, Borno State from their hostel by members of Boko Haram sect members on 14th April, 2014. Presently, Barrack Obama and other world leaders have sent some of their military personnel to help rescue those innocent schoolgirls whose offence is simply seeking to acquire western education which the sect strongly believe is forbidden.

Keywords: terrorism, bomb blast, computer technology, explosive detection devices, Nigeria

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Authors: Noah G. Akhimien, Eshrar Latif

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The natural environment is in need for an urgent rescue due to dilapidation and recession of resources. Passive design strategies have proven to be one of the effective ways to reduce CO₂ emissions and to improve building performance. On the other hand, there is a huge drop in material availability due to poor recycling culture. Consequently, building waste pose environmental hazard due to unrecycled building materials from construction and deconstruction. Buildings are seen to be material banks for a circular economy, therefore incorporating circular economy into passive housing will not only safe guide the climate but also improve resource efficiency. The study focuses on incorporating a circular economy in passive design strategies for an affordable energy and resource efficient residential building in Nigeria. Carbon dioxide (CO₂) concentration is still on the increase as buildings are responsible for a significant amount of this emission globally. Therefore, prompt measures need to be taken to combat the effect of global warming and associated threats. Nigeria is rapidly growing in human population, resources on the other hand have receded greatly, and there is an abrupt need for recycling even in the built environment. It is necessary that Nigeria responds to these challenges effectively and efficiently considering building resource and energy. Passive design strategies were assessed using simulations to obtain qualitative and quantitative data which were inferred to case studies as it relates to the Nigeria climate. Building materials were analysed using the ReSOLVE model in order to explore possible recycling phase. This provided relevant information and strategies to illustrate the possibility of circular economy in passive buildings. The study offers an alternative approach, as it is the general principle for the reworking of an economy on ecological lines in passive housing and by closing material loops in circular economy.

Keywords: building, circular, efficiency, environment, sustainability

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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Authors: Maram Shahad Dana Anfal

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This research paper presents the design of a surveillance drone with computer-aided durability and model analyses that provides a cost-effective and efficient solution for various applications. The quadcopter's design is based on a lightweight and strong structure made of materials such as aluminum and titanium, which provide a durable structure for the quadcopter. The structure of this product and the computer-aided durability system are both designed to ensure frequent repairs or replacements, which will save time and money in the long run. Moreover, the study discusses the drone's ability to track, investigate, and deliver objects more quickly than traditional methods, makes it a highly efficient and cost-effective technology. In this paper, a comprehensive analysis of the quadcopter's operation dynamics and limitations is presented. In both simulation and experimental data, the computer-aided durability system and the drone's design demonstrate their effectiveness, highlighting the potential for a variety of applications, such as search and rescue missions, infrastructure monitoring, and agricultural operations. Also, the findings provide insights into possible areas for improvement in the design and operation of the drone. Ultimately, this paper presents a reliable and cost-effective solution for surveillance applications by designing a drone with computer-aided durability and modeling. With its potential to save time and money, increase reliability, and enhance safety, it is a promising technology for the future of surveillance drones. operation dynamic equations have been evaluated successfully for different flight conditions of a quadcopter. Also, CAE modeling techniques have been applied for the modal risk assessment at operating conditions.Stress analysis have been performed under the loadings of the worst-case combined motion flight conditions.

Keywords: drone, material, solidwork, hypermesh

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Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles

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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.

Keywords: general surgery, telemedicine, patient satisfaction, patient safety

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service (GLIS), location-based service (LBS), emergency medical services information system (EMSIS)

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: Guillaume Richard, Sarra Zaied

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Marine waste quantities increase more and more, 5 million tons of plastic waste enter the ocean every year. Their spatiotemporal distribution is never homogeneous and depends mainly on the hydrodynamic characteristics of the environment, as well as the size and location of the waste. As part of optimizing collect of marine plastic wastes, it is important to measure and monitor their evolution over time. In this context, diverse studies have been dedicated to describing waste behavior in order to identify its accumulation in ocean areas. None of the existing tools which track objects at sea had the objective of tracking down a slick of waste. Moreover, the applications related to marine waste are in the minority compared to rescue applications or oil slicks tracking applications. These approaches are able to accurately simulate an object's behavior over time but not during the collection mission of a waste sheet. This paper presents numerical modeling of a boat’s wake impact on the floating marine waste behavior during a collection mission. The aim is to predict the trajectory of a marine waste slick to optimize its collection using meteorological data of ocean currents, wind, and possibly waves. We have made the choice to use Ocean Parcels which is a Python library suitable for trajectoring particles in the ocean. The modeling results showed the important role of advection and diffusion processes in the spatiotemporal distribution of floating plastic litter. The performance of the proposed method was evaluated on real data collected from the Copernicus Marine Environment Monitoring Service (CMEMS). The results of the evaluation in Cape of Good Hope (South Africa) prove that the proposed approach can effectively predict the position and velocity of marine litter during collection, which allowed for optimizing time and more than $90\%$ of the amount of collected waste.

Keywords: marine litter, advection-diffusion equation, sea current, numerical model

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Authors: Nisha James, Shubha Ranganathan

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Sex trafficking is a type of human trafficking involving prostitution of individuals for sexual exploitation. The stigma and social isolation they face in the society often makes it difficult for them to become rehabilitated from trafficking, due to which many of them continue in prostitution for years after being sex trafficked. Victims are subjected to violations of their fundamental human rights, deprived of basic medical facilities and undergo long-term abuse. This paper focuses on the role of Non-Governmental Organizations (NGOs) in the rescue and rehabilitation of victims of sex trafficking. Semi-structured interviews were conducted with 26 survivors of sex trafficking, five sex workers and 14 non-community staff members of a project running NGO in the city of Chennai in South India. Chennai has a number of NGOs that are involved in HIV/AIDS awareness and prevention programs. In many cases, rehabilitation of sex trafficking victims is also a mandate of these NGOs. This particular NGO was also involved in development activities towards the eradication of HIV/AIDS. For instance, they were engaged in inculcating safe sex practices among high-risk groups such as sex workers or in fighting for sex worker rights. The study found that the NGO’s role in combatting sex trafficking is overrun by the way it approaches these issue related to HIV/AIDS. Further, their activities are dependent solely on funding. Given that gradually, international funding for HIV/AIDS has slowly been withdrawn, there have been problems such as reduction in the salary of the project staff, the outreach workers and peer educators, many of whom were survivors of sex trafficking who have been able to survive on their wages instead of continuing in prostitution. Therefore, till date, the project funding has helped in making them aware of the health and social consequences of continuing in prostitution, and in supporting them socioeconomically, but the lack of funding may also lead the NGO workers into a state of unemployment, poverty and eventually into being re-trafficked. The study concludes by pointing to the need for disengaging anti-trafficking efforts from the HIV/AIDS related programs.

Keywords: non-governmental organization role, non-governmental organization staff, sex trafficking survivors, sex workers

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Authors: T. N. Goh, M. Hashmi, O. Hussain

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Temporomandibular joint (TMJ) dysfunction (TMD) is a condition that may affect patients via restricted mouth opening, significant pain during normal functioning, and/or reproducible joint noise. TMD includes myofascial pain, TMJ functional derangements (internal derangement, dislocation), and TMJ degenerative/inflammatory joint disease. Internal derangement (ID) is the most common cause of TMD-related clicking and locking. These patients are managed in a stepwise approach, from patient education (homecare advice and analgesia), splint therapy, physiotherapy, botulinum toxin treatment, to arthrocentesis. Arthrotomy is offered when the aforementioned treatment options fail to alleviate symptoms and improve quality of life. The aim of this prospective study was to review the outcomes of jaw joint open surgery in TMD patients. Patients who presented from 2015-2022 at the Oral and Maxillofacial Surgery Department in the Doncaster NHS Foundation Trust, UK, with a Wilkes classification of III -V were included. These patients underwent either i) discopexy with bone-anchoring suture (9); ii) intrapositional temporalis flap (ITF) with bone-anchoring suture (3); iii) eminoplasty and discopexy with suturing to the capsule (3); iii) discectomy + ITF with bone-anchoring suture (1); iv) discoplasty + bone-anchoring suture (1); v) ITF (1). Maximum incisal opening (MIO) was assessed pre-operatively and at each follow-up. Pain score, determined via the visual analogue scale (VAS, with 0 being no pain and 10 being the worst pain), was also recorded. A total of 18 eligible patients were identified with a mean age of 45 (range 22 - 79), of which 16 were female. The patients were scored by Wilkes Classification as III (14), IV (1), or V (4). Twelve patients had anterior disc displacement without reduction (66%) and six had degenerative/arthritic changes (33%) to the TMJ. The open joint procedure resulted in an increase in MIO and reduction in pain VAS and for the majority of patients, across all Wilkes Classifications. Pre-procedural MIO was 22.9 ± 7.4 mm and VAS was 7.8 ± 1.5. At three months post-procedure there was an increase in MIO to 34.4 ± 10.4 mm (p < 0.01) and a decrease in the VAS to 1.5 ± 2.9 (p < 0.01). Three patients were lost to follow-up prior to six months. Six were discharged at six month review and five patients were discharged at 12 months review as they were asymptomatic with good mouth opening. Four patients are still attending for annual botulinum toxin treatment. Two patients (Wilkes III and V) subsequently underwent TMJ replacement (11%). One of these patients (Wilkes III) had improvement initially to MIO of 40 mm, but subsequently relapsed to less than 20 mm due to lack of compliance with jaw rehabilitation device post-operatively. Clinical improvements in 89% of patients within the study group were found, with a return to near normal MIO range and reduced pain score. Intraoperatively, the operator found bone-anchoring suture used for discopexy/discoplasty more secure than the soft tissue anchoring suturing technique.

Keywords: bone anchoring suture, open temporomandibular joint surgery, temporomandibular joint, temporomandibular joint dysfunction

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Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Marijana Ivanov, Roman Šubić

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The single rulebook together with the Single Supervisory Mechanism and the Single Resolution Mechanism - as two main pillars of the banking union, represent important steps towards completing the Economic and Monetary Union. It should provide a consistent application of common rules and administrative standards for supervision, recovery and resolution of banks – with the final aim that a former practice of the bail-out is replaced with the bail-in system through which bank failures will be resolved by their own funds, i.e. with minimal costs for taxpayers and real economy. It has to reduce the financial fragmentation recorded in the years of crisis as the result of divergent behaviors in risk premium, lending activities, and interest rates between the core and the periphery. In addition, it should strengthen the effectiveness of monetary transmission channels, in particular the credit channels and overflows of liquidity on the single interbank money market. However, contrary to all the positive expectations related to the future functioning of the banking union, low and unbalanced economic growth rates remain a challenge for the maintenance of financial stability in the euro area, and this problem cannot be resolved just by a single supervision. In many countries bank assets exceed their GDP by several times, and large banks are still a matter of concern because of their systemic importance for individual countries and the euro zone as a whole. The creation of the SSM and the SRM should increase transparency of the banking system in the euro area and restore confidence that have been disturbed during the depression. It would provide a new opportunity to strengthen economic and financial systems in the peripheral countries. On the other hand, there is a potential threat that future focus of the ECB, resolution mechanism and other relevant institutions will be extremely oriented to the large and significant banks (whereby one half of them operate in the core and most important euro area countries), while it is questionable to what extent the common resolution funds will be used for rescue of less important institutions.

Keywords: banking union, financial integration, single supervision mechanism (SSM)

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

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Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

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Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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Authors: Shalini Saini, Sharmila Ahuja

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Anaesthesia for caesarean section poses challenges unique to the obstetric patient due to changes in the airway and respiratory system. The choice of anaesthesia for caesarean section depends on various factors however general anaesthesia (GA) is necessary for certain situations. Supraglottic airway devices are an emerging method to secure airway, especially in difficult situations. Of these devices, proseal –LMA (PLMA) is designed to provide better protection of the airway. The use of PLMA has been reported successfully as a rescue device in difficult intubation situations and in patients undergoing elective caesarean section without any complications. The study was prospective and randomised and was designed to compare PLMA in patients undergoing elective lower segment caesarean section (LSCS) with the endotracheal tube (ETT). Patients undergoing LSCS under GA belonging to ASA grade 1 and 2 were included. Patients with the history of fewer than 6 hrs of fasting, known/predicted difficult airway, obesity, gastroesophageal reflux disease, hypertensive disorder were excluded. A standard anaesthesia protocol was followed. All patients received aspiration prophylaxis. The airway was secured with either PLMA or ETT. Parameters noted were- ease of insertion, adequacy of ventilation, hemodynamic changes at insertion and removal of device, incidence of regurgitation and aspiration. Data was analysed by unpaired t- test, Chi-square /Fisher’s test. The findings of our study indicated that PLMA was easy to insert (20.67±6.835 sec) with comparable insertion time to TT (18.33 ± 4.971, p 0.136) and adequate ventilation was achieved with very minimal hemodynamic changes seen with PLMA as compared to ETT at insertion and removal of devices (p 0.01). There was no incidence of regurgitation with the use of PLMA. The incidence of a postoperative sore throat was minimal (6.7%) with PLMA (p<0.05). PLMA appears to be a safe alternative to ETT for selected obstetric patients undergoing elective LSCS. Further study with a larger group of patients is required to establish the safety of PLMA in obstetric patients.

Keywords: caesarean section, general anaesthesia, proseal LMA, endotracheal tube

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Authors: Agoston Restas

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Introduction: This paper describes many initiatives and shows also practical examples which happened recently using Unmanned Aerial Systems (UAS) to support disaster management. Since the operation of manned aircraft at disasters is usually not only expensive but often impossible to use as well, in many cases managers fail to use the aerial activity. UAS can be an alternative moreover cost-effective solution for supporting disaster management. Methods: This article uses thematic division of UAS applications; it is based on two key elements, one of them is the time flow of managing disasters, other is its tactical requirements. Logically UAS can be used like pre-disaster activity, activity immediately after the occurrence of a disaster and the activity after the primary disaster elimination. Paper faces different disasters, like dangerous material releases, floods, earthquakes, forest fires and human-induced disasters. Research used function analysis, practical experiments, mathematical formulas, economic analysis and also expert estimation. Author gathered international examples and used own experiences in this field as well. Results and discussion: An earthquake is a rapid escalating disaster, where, many times, there is no other way for a rapid damage assessment than aerial reconnaissance. For special rescue teams, the UAS application can help much in a rapid location selection, where enough place remained to survive for victims. Floods are typical for a slow onset disaster. In contrast, managing floods is a very complex and difficult task. It requires continuous monitoring of dykes, flooded and threatened areas. UAS can help managers largely keeping an area under observation. Forest fires are disasters, where the tactical application of UAS is already well developed. It can be used for fire detection, intervention monitoring and also for post-fire monitoring. In case of nuclear accident or hazardous material leakage, UAS is also a very effective or can be the only one tool for supporting disaster management. Paper shows some efforts using UAS to avoid human-induced disasters in low-income countries as part of health cooperation.

Keywords: disaster management, floods, forest fires, Unmanned Aerial Systems

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Authors: Agnieszka Antończyk, MałGorzata Ochota, Wojciech Niżański, ZdzisłAw Kiełbowicz

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The goal of the cesarean section (CS) is the delivery of healthy, vigorous pups with the provision of surgical plane anesthesia, appropriate analgesia, and rapid recovery of the dam. In human medicine, spinal or epidural anesthesia is preferred for a cesarean section as associated with a lower risk of neonatal asphyxia and the need for resuscitation. Nevertheless, the specificity of veterinary patients makes the application of regional anesthesia as a sole technique impractical, thus to obtain patient compliance the general anesthesia is required. This study aimed to compare the influence of balanced (inhalant with epidural) and inhalant anesthesia on neonatal umbilical cord blood gas (UCBG) parameters and vitality (modified Apgar scoring). The bitches (31) undergoing elective CS were enrolled in this study. All females received a single dose of 0.2 mg/kg s.c. Meloxicam. Females were randomly assigned into two groups: Gr I (Isoflurane, n=16) and Gr IE (Isoflurane plus Epidural, n=15). Anesthesia was induced with propofol at 4-6 mg/kg to effect, and maintained with isoflurane in oxygen; in IE group epidural anesthesia was also done using lidocaine (3-4 mg/kg) into the lumbosacral space. CSs were performed using a standard mid-line approach. Directly after the puppy extraction, the umbilical cord was double clamped before the placenta detachment. The vessels were gently stretched between forceps to allow blood sampling. At least 100 mcl of mixed umbilical cord blood was collected into a heparinized syringe for further analysis. The modified Apgar scoring system (AS) was used to objectively score neonatal health and vitality immediately after birth (before first aid or neonatal care was instituted), at 5 and 20 min after birth. The neonates were scored as normal (AS 7-10), weak (AS 4-6), or critical (AS 0-3). During surgery, the IE group required a lower isoflurane concentration compared to the females in group I (MAC 1.05±0.2 and 1.4±0.13, respectively, p<0.01). All investigated UCBG parameters were not statistically different between groups. All pups had mild acidosis (pH 7.21±0.08 and 7.21±0.09 in Gr I and IE, respectively) with moderately elevated pCO2 (Gr I 57.18±11.48, Gr IE 58.74±15.07), HCO3- on the lower border (Gr I 22.58±3.24, Gr IE 22.83±3.6), lowered BE (Gr I -6.1±3.57, Gr IE -5.6±4.19) and mildly elevated level of lactates (Gr I 2.58±1.48, Gr IE2.53±1.03). The glucose levels were above the reference limits in both groups of puppies (74.50±25.32 in Gr I, 79.50±29.73 in Gr IE). The initial Apgar score results were similar in I and IE groups. However, the subsequent measurements of AS revealed significant differences between both groups. Puppies from the IE group received better AS scores at 5 and 20 min compared to the I group (6.86±2.23 and 8.06±2.06 vs 5.11±2.40 and 7.83±2.05, respectively). The obtained results demonstrated that administration of epidural anesthesia reduced the requirement for isoflurane in dams undergoing cesarean section and did not affect the neonatal umbilical blood gas results. Moreover, newborns from the epidural anesthesia group were scored significantly higher in AS at 5 and 20 min, indicating their better vitality and quicker improvement post-surgery.

Keywords: apgar scoring, balanced anesthesia, cesarean section, umbilical blood gas

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Authors: Imam Muthohar, Budi Hartono, Sigit Priyanto, Hardiansyah Hardiansyah

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The eruption of Merapi Volcano in Yogyakarta, Indonesia in 2010 caused many casualties due to minimum preparedness in facing disaster. Increasing population capacity and evacuating to safe places become very important to minimize casualties. Regional government through the Regional Disaster Management Agency has divided disaster-prone areas into three parts, namely ring 1 at a distance of 10 km, ring 2 at a distance of 15 km and ring 3 at a distance of 20 km from the center of Mount Merapi. The success of the evacuation is fully supported by road network infrastructure as a way to rescue in an emergency. This research attempts to model evacuation process based on the rise of refugees in ring 1, expanded to ring 2 and finally expanded to ring 3. The model was developed using SATURN (Simulation and Assignment of Traffic to Urban Road Networks) program version 11.3. 12W, involving 140 centroid, 449 buffer nodes, and 851 links across Yogyakarta Special Region, which was aimed at making a preliminary identification of road networks considered vulnerable to disaster. An assumption made to identify vulnerability was the improvement of road network performance in the form of flow and travel times on the coverage of ring 1, ring 2, ring 3, Sleman outside the ring, Yogyakarta City, Bantul, Kulon Progo, and Gunung Kidul. The research results indicated that the performance increase in the road networks existing in the area of ring 2, ring 3, and Sleman outside the ring. The road network in ring 1 started to increase when the evacuation was expanded to ring 2 and ring 3. Meanwhile, the performance of road networks in Yogyakarta City, Bantul, Kulon Progo, and Gunung Kidul during the evacuation period simultaneously decreased in when the evacuation areas were expanded. The results of preliminary identification of the vulnerability have determined that the road networks existing in ring 1, ring 2, ring 3 and Sleman outside the ring were considered vulnerable to the evacuation of Mount Merapi eruption. Therefore, it is necessary to pay a great deal of attention in order to face the disasters that potentially occur at anytime.

Keywords: model, evacuation, SATURN, vulnerability

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Authors: Esam Mohammed Al-shaebi

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One of the most crucial approaches for treating human diseases, particularly parasite infections, is nanomedicine. One of the most significant protozoan diseases that impact farm and domestic animals is coccidiosis. While, amprolium is one of the traditional anticoccidial medication, the advent of drug-resistant strains of Eimeria necessitates the development of novel treatments. The goal of the current investigation was to determine whether biosynthesized selenium nanoparticles (Bio-SeNPs) using Azadirachta indica leaves extract might treat mice with Eimeria papillata infection in the jejunal tissue. Five groups of seven mice each were used, as follows: Group 1: Non-infected-non-treated (negative control). Group 2: Non-infected treated group with Bio-SeNPs (0.5 mg/kg of body weight). Groups 3-5 were orally inoculated with 1×103 sporulated oocysts of E. papillata. Group 3: Infected-non-treated (positive control). Group 4: Infected and treated group with Bio-SeNPs (0.5 mg/kg). Group 5: Infected and treated group with the Amprolium. Groups 4 and 5 daily received oral administration (for 5 days) of Bio-SeNPs and anticoccidial medication, respectively, after infection. Bio-SeNPs caused a considerable reduction in oocyst output in mice feces (97.21%). This was also accompanied by a significant reduction in the number of developmental parasitic stages in the jejunal tissues. Glutathione reduced (GSH), glutathione peroxidase (GPx), and superoxide dismutase (SOD) levels were dramatically reduced by the Eimeria parasite, whereas, nitric oxide (NO) and malonaldehyde (MDA) levels were markedly elevated. The amount of goblet cells and MUC2 gene expression were used as apoptotic indicators, and both were considerably downregulated by infection. However, infection markedly increased the expression of inflammatory cytokines (IL-6 and TNF-α) and the apoptotic genes (Caspase-3 and BCL2). Bio-SeNPs were administrated to mice to drastically lower body weight, oxidative stress, and inflammatory and apoptotic indicators in the jejunal tissue. Our research thus showed the involvement of Bio-SeNPs in protecting mice with E. papillata infections against jejunal damage.

Keywords: coccidiosis, nanoparticles, azadirachta indica, oxidative stress

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