Search results for: secondary school

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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Authors: Vanessa A. Segovia, Sonia E. Ruiz

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The use of energy dissipation systems for seismic applications has increased worldwide, thus it is necessary to develop practical and modern criteria for their optimal design. Here, a direct displacement-based seismic design approach for frame buildings with hysteretic energy dissipation systems (HEDS) is applied. The building is constituted by two individual structural systems consisting of: 1) A main elastic structural frame designed for service loads and 2) A secondary system, corresponding to the HEDS, that controls the effects of lateral loads. The procedure implies to control two design parameters: A) The stiffness ratio (α=K_frame/K_(total system)), and B) The strength ratio (γ= V_damper / V_(total system)). The proposed damage-controlled approach contributes to the design of a more sustainable and resilient building because the structural damage is concentrated on the HEDS. The reduction of the design displacement spectrum is done by means of a damping factor (recently published) for elastic structural systems with HEDS, located in Mexico City. Two limit states are verified: Serviceability and near collapse. Instead of the traditional trial-error approach, a procedure that allows the designer to establish the preliminary sizes of the structural elements of both systems is proposed. The design methodology is applied to an 8-story steel building with buckling restrained braces, located in soft soil of Mexico City. With the aim of choosing the optimal design parameters, a parametric study is developed considering different values of α and γ. The simplified methodology is for preliminary sizing, design, and evaluation of the effectiveness of HEDS, and it constitutes a modern and practical tool that enables the structural designer to select the best design parameters.

Keywords: damage-controlled buildings, direct displacement-based seismic design, optimal hysteretic energy dissipation systems, hysteretic dampers

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Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

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Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

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Authors: Wanlapa Boonsod, Nisachon Yangprasong, Udomsak Kitthawee

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Thermal physics education is a complicated and challenging topic to discuss in any classroom. As a result, most students tend to be uninterested in learning this topic. In the current study, a convection experiment set was devised to show how heat can be transferred by a convection system to a thermoelectric plate until a LED flashes. This research aimed to 1) create a natural convection experimental set, 2) study learning achievement on the convection experimental set with the predict-observe-explain (POE) technique, and 3) study satisfaction for the convection experimental set with the predict-observe-explain (POE) technique. The samples were chosen by purposive sampling and comprised 28 students in grade 11 at Patumkongka School in Bangkok, Thailand. The primary research instrument was the plan for predict-observe-explain (POE) technique on heat transfer using a convection experimental set. Heat transfer experimental set by convection. The instruments used to collect data included a heat transfer achievement model by convection, a Satisfaction Questionnaire after the learning activity, and the predict-observe-explain (POE) technique for heat transfer using a convection experimental set. The research format comprised a one-group pretest-posttest design. The data was analyzed by GeoGebra program. The statistics used in the research were mean, standard deviation and t-test for dependent samples. The results of the research showed that achievement on heat transfer using convection experimental set was composed of thermo-electrics on the top side attached to the heat sink and another side attached to a stainless plate. Electrical current was displayed by the flashing of a 5v LED. The entire set of thermo-electrics was set up on the top of the box and heated by an alcohol burner. The achievement of learning was measured with the predict-observe-explain (POE) technique, with the natural convection experimental set statistically higher than before learning at a 0.01 level. Satisfaction with POE for physics learning of heat transfer by using convection experimental set was at a high level (4.83 from 5.00).

Keywords: convection, heat transfer, physics education, POE

Procedia PDF Downloads 184

Authors: Karish Thavabalan, Aman Sutaria, Alistair Ovenell, Annabelle Parkhouse, Numan Baydemir, Theodore Lally

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Background: Open discussions surrounding menopause are often associated with stigma, with many women feeling uncomfortable engaging in them with friends, colleagues, and healthcare professionals. Though the barriers regarding safe discussions of symptom management experienced by menopausal women are well documented, existing research offers little insight into whether these were shared by pre-menopausal women. This study aimed to explore the barriers regarding safe discussions about menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. Methods: This qualitative study was conducted over a 2-month period (March 2022 - April 2022) under the auspices of Imperial College Business School, London, UK. Snowball sampling was used to recruit both menopausal (age 45-70) and pre-menopausal participants (age <45) and sampling continued until data saturation was achieved. Sixteen semi-structured online interviews were conducted, and transcripts were thematically analyzed following Braun and Clarke’s six-step methodology. Results: A total of 7 higher themes regarding safe discussion of menopausal symptom management were identified by both pre-menopausal and menopausal women, including: “ineffective coping mechanisms,” “perceived onus to self-endure,” “lack of workplace support,” “poor knowledge of management approaches,” “poor healthcare infrastructure,” “poor support from friends and family,” “lack of knowledge and interest from a young age.” Conclusion: Identifying the barriers regarding safe discussion helped to highlight which areas require the most significant intervention. Alongside tackling the barriers, menopausal women face, ultimately, there is a pertinent need to address the lack of insight into menopause from a younger age and to encourage earlier discussions so as to not propagate the cycle of stigma.

Keywords: menopause, safe discussion, symptom management, stigma

Procedia PDF Downloads 38

Authors: Liang Wang, Wei Zhang

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Nowadays, sustainable development has increasingly become an important research topic of engineering education. Existing research on Engineering Education for Sustainable Development (EESD) has highlighted the importance of perceptions for ethical responsibility to address sustainable development in practice. However, whether and how the professional engineering experience affects those perceptions has not been proved, especially in a Chinese context. Our study fills this gap by investigating the perceptions bias of EESD between experienced engineers and engineering students. We specifically examined what EESD means for experienced engineers and engineering students using a triple-dimensional model to understand if there are obvious differences between the two groups. Our goal is to make the benefits of these experiences more accessible in school context. The data (n=438) came from a questionnaire created and adapted from previously published studies containing 288 students from mechanical or civil engineering and 150 civil engineers with rich working experience, and the questionnaire was distributed during Fall 2020. T-test was used to find the difference in different dimensions between the two groups. The statistical results show that there is a significant difference in the perceptions of EESD between experienced engineers and inexperienced engineering students in China. Experienced engineers tend to consider sustainable development from ecological, economic, and social perspectives, while engineering students' answers focus more on ecology and ignore economic and social dimensions to some extend. The findings provide empirical evidence that professional experience is helpful to cultivate the cognition and ability of sustainable development in engineering education. The results of this work indicate that more practical content should be added to engineering education to promote sustainable development. In addition, for the design of engineering courses and professional practice systems for sustainable development, we should not only pay attention to the ecological aspects but also emphasize the coordination of ecological, economic, and socially sustainable development (e.g., engineer's ethical responsibility).

Keywords: engineering education, sustainable development, experienced engineers, engineering students

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Authors: Masita Mokeira, Kimani Rita, Obonyo Brian, Kwenda Kennedy, Mugambi Purity, Kirui Joan, Chomba Eric, Orwa Daniel, Waiganjo Peter

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Rugby is a highly intense and physical game requiring speed and strength. The need for physical fitness therefore cannot be over-emphasized. Sports are no longer about lifting weights so as to build muscle. Most professional teams are investing much more in the sport in terms of time, equipment and other resources. To play competitively, Kenyan players may therefore need to complement their ‘home-grown’ and sometimes ad-hoc training and nutrition regimes with carefully measured strength and conditioning, diet, nutrition, and supplementation. Nokia Research Center and University of Nairobi conducted an exploratory study on needs and behaviours surrounding sports in Africa. Rugby being one sport that is gaining ground in Kenya was selected as the main focus. The end goal of the research was to identify areas where mobile technology could be used to address gaps, challenges and/or unmet needs. Themes such as information gap, social culture, growth, and development, revenue flow, and technology adoption among others emerged about the sport. From the growth and development theme, it was clear that as rugby continues to grow in the country, teams, coaches, and players are employing interesting techniques both in training and playing. Though some of these techniques are indeed scientific, those employing them are sometimes not fully aware of their scientific basis. A further case study on sports science in rugby in Kenya focusing on physical fitness and nutrition revealed interesting findings. This paper discusses findings on emerging adoption of techniques in managing physiological and nutritional needs of rugby players across different levels of rugby in Kenya namely high school, club and national levels.

Keywords: rugby, nutrition, physiological needs, sports science

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Authors: Arwin Malabanan, Carl Chester Ragudo, Jerome Tadiosa, John Dee Mangoba, Eric Augustus Tingatinga, Romeo Eliezer Longalong

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Concrete hollow blocks (CHB) are the most commonly used masonry block for walls in residential houses, school buildings and public buildings in the Philippines. During the recent 2013 Bohol earthquake (Mw 7.2), it has been proven that CHB walls are very vulnerable to severe external action like strong ground motion. In this paper, a numerical model of CHB structures is proposed, and seismic behavior of CHB houses is presented. In modeling, the Rigid Body Spring-Discrete Element method (RBS-DEM)) is used wherein masonry blocks are discretized into rigid elements and connected by nonlinear springs at preselected contact points. The shear and normal stiffness of springs are derived from the material properties of CHB unit incorporating the grout and mortar fillings through the volumetric transformation of the dimension using material ratio. Numerical models of reinforced and unreinforced walls are first subjected to linearly-increasing in plane loading to observe the different failure mechanisms. These wall models are then assembled to form typical model masonry houses and then subjected to the El Centro and Pacoima earthquake records. Numerical simulations show that the elastic, failure and collapse behavior of the model houses agree well with shaking table tests results. The effectiveness of the method in replicating failure patterns will serve as a basis for the improvement of the design and provides a good basis of strengthening the structure.

Keywords: concrete hollow blocks, discrete element method, earthquake, rigid body spring model

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Authors: Vishakha Kaim, Mookan Natarajan, Sandeep Kaur-Ghumaan

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Hydrogen is one of the most abundant elements present on earth’s crust and considered to be the simplest element in existence. It is not found naturally as a gas on earth and thus has to be manufactured. Hydrogen can be produced from a variety of sources, i.e., water, fossil fuels, or biomass and it is a byproduct of many chemical processes. It is also considered as a secondary source of energy commonly referred to as an energy carrier. Though hydrogen is not widely used as a fuel, it still has the potential for greater use in the future as a clean and renewable source of energy. Electrocatalysis is one of the important source for the production of hydrogen which could contribute to this prominent challenge. Metals such as platinum and palladium are considered efficient for hydrogen production but with limited applications. As a result, a wide variety of metal complexes with earth abundant elements and varied ligand environments have been explored for the electrochemical production of hydrogen. In nature, [FeFe] hydrogenase enzyme present in DesulfoVibrio desulfuricans and Clostridium pasteurianum catalyses the reversible interconversion of protons and electrons into dihydrogen. Since the first structure for the enzyme was reported in 1990s, a range of iron complexes has been synthesized as structural and functional mimics of the enzyme active site. Mn is one of the most desirable element for sustainable catalytic transformations, immediately behind Fe and Ti. Only limited number manganese complexes have been reported in the last two decades as catalysts for proton reduction. Furthermore, redox reactions could be carried out in a facile manner, due to the capability of manganese complexes to be stable at different oxidation states. Herein are reported, four µ2-thiolate bridged manganese complexes [Mn₂(CO)₆(μ-S₂N₄C₁₄H₁₀)] 1, [Mn₂(CO)7(μ- S₂N₄C₁₄H₁₀)] 2, Mn₂(CO)₆(μ-S₄N₂C₁₄H₁₀)] 3 and [Mn₂(CO)(μ- S₄N₂C₁₄H₁₀)] 4 have been synthesized and characterized. The cyclic voltammograms of the complexes displayed irreversible reduction peaks in the range - 0.9 to -1.3 V (vs. Fc⁺/Fc in acetonitrile at 0.1 Vs⁻¹). The complexes were catalytically active towards proton reduction in the presence of trifluoroacetic acid as seen from electrochemical investigations.

Keywords: earth abundant, electrocatalytic, hydrogen, manganese

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Authors: Yosef Ferede Bogale

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The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality services risk, bank

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Authors: Sara Piccirillo

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The integrated urban regeneration represents a great opportunity to deliver correct management of the territory if implemented through the reuse, enhancement, and transformation of abandoned industrial areas, according to sustainability strategies. In environmental terms, recycling abandoned sites by demolishing buildings and regenerating the urban areas means promoting adaptation to climate change and a new sensitivity towards city living. The strategic vision of 'metabolism' can be implemented through diverse actions made on urban settlements, and planning certainly plays a primary role. Planning an urban transformation in a sustainable way is more than auspicable. It is necessary to introduce innovative urban soil management actions to mitigate the environmental costs associated with current land use and to promote projects for the recovery/renaturalization of urban or non-agricultural soils. However, by freeing up these through systematic demolition of the disused heritage, new questions open up in terms of environmental costs deriving from the inevitable impacts caused by the disposal of waste. The mitigation of these impacts involves serious reflection on the recycling supply chains aimed at the production and reuse of secondary raw materials in the construction industry. The recent developments in R&D of recycling materials are gradually becoming more and more pivotal in consideration of environmental issues such as increasing difficulties in exploiting natural quarries or strict regulations for the management and disposal of waste sites. Therefore, this contribution, set as a critical essay, presents the reconstruction outputs of the regulatory background on the material recycling chain up to the 'end of waste' stage, both at a national and regional scale. This extended approach to this urban design practice goes beyond the cultural dimension that has relegated urban regeneration to pure design only. It redefines its processes through an interdisciplinary system that affects human, environmental and financial resources.

Keywords: waste management, C&D waste, recycling, urban trasformation

Procedia PDF Downloads 174

Authors: A. Pensiri, K. Nantaporn, P. Parichut

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Tourism is very important to the economy of many countries due to the large contribution in the areas of employment and income generation. However, the rapid growth of tourism can also be considered as one of the major uses of water user, and therefore also have a significant and detrimental impact on the environment. Guest behavior in water usage can be used to manage water in hotels for sustainable water resources management. This research presents a study of hotel guest water usage behavior at two hotels, namely Hotel A (located in Kathu district) and Hotel B (located in Muang district) in Phuket Province, Thailand, as case studies. Primary and secondary data were collected from the hotel manager through interview and questionnaires. The water flow rate was measured in-situ from each water supply device in the standard room type at each hotel, including hand washing faucets, bathroom faucets, shower and toilet flush. For the interview, the majority of respondents (n = 204 for Hotel A and n = 244 for Hotel B) were aged between 21 years and 30 years (53% for Hotel A and 65% for Hotel B) and the majority were foreign (78% in Hotel A, and 92% in Hotel B) from American, France and Austria for purposes of tourism (63% in Hotel A, and 55% in Hotel B). The data showed that water consumption ranged from 188 litres to 507 liters, and 383 litres to 415 litres per overnight guest in Hotel A and Hotel B (n = 244), respectively. These figures exceed the water efficiency benchmark set for Tropical regions by the International Tourism Partnership (ITP). It is recommended that guest water saving initiatives should be implemented at hotels. Moreover, the results showed that guests have high satisfaction for the hotels, the front office service reveal the top rates of average score of 4.35 in Hotel A and 4.20 in Hotel B, respectively, while the luxury decoration and room cleanliness exhibited the second satisfaction scored by the guests in Hotel A and B, respectively. On the basis of this information, the findings can be very useful to improve customer service satisfaction and pay attention to this particular aspect for better hotel management.

Keywords: hotel, tourism, Phuket, water usage

Procedia PDF Downloads 222

Authors: Shanika Y. Koreshi

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Sri Lanka housed the lingerie product development and manufacturing subsidiary to renowned brands such as La Senza, Marks & Spencer, H&M, Etam, Lane Bryant, and George. Over the last few years, they have produced local brands such as Amante to cater to the local and regional customers. Past research has identified factors such as quality, price, and design to be vital when marketing lingerie to consumers. However, there has been minimum research that looks into the ethnically targeted market and skin colour within the Asian population. Therefore, the main aim of the research was to identify whether consumer preference for lingerie is influenced by the skin tone of the model wearing it. Moreover, the secondary aim was to investigate if the consumer preference for lingerie is influenced by the consumer’s ethnic identification with the skin tone of the model. An experimental design was used to explore the above aims. The participants constituted of 66 females residing in the western province of Sri Lanka and were gathered via convenience sampling. Six computerized images of a real model were used in the study, and her skin tone was digitally manipulated to express three different skin tones (light, tan and dark). Consumer preferences were measured through a ranking order scale that was constructed via a focus group discussion and ethnic identity was measured by the Multigroup Ethnic Identity Measure-Revised. Wilcoxon signed-rank test, Friedman test, and chi square test of independence were carried out using SPSS version 20. The results indicated that majority of the consumers ethnically identified and preferred the tan skin over the light and dark skin tones. The findings support the existing literature that states there is a preference among consumers when models have a medium skin tone over a lighter skin tone. The preference for a tan skin tone in a model is consistent with the ethnic identification of the Sri Lankan sample. The study implies that lingerie brands should consider the model's skin tones when marketing the brand to different ethnic backgrounds.

Keywords: consumer preference, ethnic identification, lingerie, skin tone

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Authors: Nur Aziza Luxfiati

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Clustering is partitioning data sets into sub-sets or groups in such a way that elements certain properties have shared property settings with a high level of similarity within one group and a low level of similarity between groups. . The K-Means algorithm is one of thealgorithmsclustering as a grouping tool that is most widely used in scientific and industrial applications because the basic idea of the kalgorithm is-means very simple. In this research, applying the technique of clustering using the k-means algorithm as a method of solving the problem of national development imbalances between regions in Central Java Province based on macroeconomic indicators. The data sample used is secondary data obtained from the Central Java Provincial Statistics Agency regarding macroeconomic indicator data which is part of the publication of the 2019 National Socio-Economic Survey (Susenas) data. score and determine the number of clusters (k) using the elbow method. After the clustering process is carried out, the validation is tested using themethodsBetween-Class Variation (BCV) and Within-Class Variation (WCV). The results showed that detection outlier using z-score normalization showed no outliers. In addition, the results of the clustering test obtained a ratio value that was not high, namely 0.011%. There are two district/city clusters in Central Java Province which have economic similarities based on the variables used, namely the first cluster with a high economic level consisting of 13 districts/cities and theclustersecondwith a low economic level consisting of 22 districts/cities. And in the cluster second, namely, between low economies, the authors grouped districts/cities based on similarities to macroeconomic indicators such as 20 districts of Gross Regional Domestic Product, with a Poverty Depth Index of 19 districts, with 5 districts in Human Development, and as many as Open Unemployment Rate. 10 districts.

Keywords: clustering, K-Means algorithm, macroeconomic indicators, inequality, national development

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Authors: Omotoyosi Bilikies Ilori, Adekunle Saheed Ajisebiyawo

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After the Second World War, there was an emergence of a new stage of capitalist globalization with its Neo-liberal ideology. There were global economic and political restructurings that affected third-world countries like Nigeria. Neo-liberalism is the driving force of globalization, which is the latest manifestation of imperialism that engenders endemic poverty in Nigeria. Poverty is severe and widespread in Nigeria. Poverty entails a situation where a person lives on less than one dollar per day and has no access to basic necessities of life. Poverty is inhuman and a breach of human rights. The Nigerian government initiated some strategies in the past to help in poverty reduction. Neo-liberalism manifested in the Third World, such as Nigeria, through the privatization of public enterprises, trade liberalization, and the rollback of the state investments in providing important social services. These main ideas of Neo-liberalism produced poverty in Nigeria and also encouraged the abandonment of the social contract between the government and the people. There is thus a gap in the provision of social services and subsidies for the masses, all of which Neo-liberal ideological positions contradict. This paper is a qualitative study which draws data from secondary sources. The theoretical framework is anchored on the market theory of capitalist globalization and public choice theory. The objectives of this study are to (i) examine the impacts of Neo-liberalism on poverty in Nigeria as a typical example of a Third World country and (ii) find out the effects of Neo-liberalism on the provision of social services and subsidies and employment. The findings from this study revealed that (i) the adoption of the Neo-liberal ideology by the Nigerian government has led to increased poverty and poor provision of social services and employment in Nigeria; and (ii) there is an increase in foreign debts which compounds poverty situation in Nigeria. This study makes the following recommendations: (i) Government should adopt strategies that are pro-poor to eradicate poverty; (ii) The Trade Unions and the masses should develop strategies to challenge Neo-liberalism and reject Neo-liberal ideology.

Keywords: neo-liberalism, poverty, employment, poverty reduction, structural adjustment programme

Procedia PDF Downloads 46

Authors: Guilherme Giacomini, Ana Luiza Menegatti Pavan, Allan Felipe Fattori Alves, Marcela de Oliveira, Fernando Antonio Bacchim Neto, José Ricardo de Arruda Miranda, Seizo Yamashita, Diana Rodrigues de Pina

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The maxillary sinus (MS), part of the paranasal sinus complex, is one of the most enigmatic structures in modern humans. The literature has suggested that MSs function as olfaction accessories, to heat or humidify inspired air, for thermoregulation, to impart resonance to the voice and others. Thus, the real function of the MS is still uncertain. Furthermore, the MS anatomy is complex and varies from person to person. Many diseases may affect the development process of sinuses. The incidence of rhinosinusitis and other pathoses in the MS is comparatively high, so, volume analysis has clinical value. Providing volume values for MS could be helpful in evaluating the presence of any abnormality and could be used for treatment planning and evaluation of the outcome. The computed tomography (CT) has allowed a more exact assessment of this structure, which enables a quantitative analysis. However, this is not always possible in the clinical routine, and if possible, it involves much effort and/or time. Therefore, it is necessary to have a convenient, robust, and practical tool correlated with the MS volume, allowing clinical applicability. Nowadays, the available methods for MS segmentation are manual or semi-automatic. Additionally, manual methods present inter and intraindividual variability. Thus, the aim of this study was to develop an automatic tool to quantity the MS volume in CT scans of paranasal sinuses. This study was developed with ethical approval from the authors’ institutions and national review panels. The research involved 30 retrospective exams of University Hospital, Botucatu Medical School, São Paulo State University, Brazil. The tool for automatic MS quantification, developed in Matlab®, uses a hybrid method, combining different image processing techniques. For MS detection, the algorithm uses a Support Vector Machine (SVM), by features such as pixel value, spatial distribution, shape and others. The detected pixels are used as seed point for a region growing (RG) segmentation. Then, morphological operators are applied to reduce false-positive pixels, improving the segmentation accuracy. These steps are applied in all slices of CT exam, obtaining the MS volume. To evaluate the accuracy of the developed tool, the automatic method was compared with manual segmentation realized by an experienced radiologist. For comparison, we used Bland-Altman statistics, linear regression, and Jaccard similarity coefficient. From the statistical analyses for the comparison between both methods, the linear regression showed a strong association and low dispersion between variables. The Bland–Altman analyses showed no significant differences between the analyzed methods. The Jaccard similarity coefficient was > 0.90 in all exams. In conclusion, the developed tool to quantify MS volume proved to be robust, fast, and efficient, when compared with manual segmentation. Furthermore, it avoids the intra and inter-observer variations caused by manual and semi-automatic methods. As future work, the tool will be applied in clinical practice. Thus, it may be useful in the diagnosis and treatment determination of MS diseases. Providing volume values for MS could be helpful in evaluating the presence of any abnormality and could be used for treatment planning and evaluation of the outcome. The computed tomography (CT) has allowed a more exact assessment of this structure which enables a quantitative analysis. However, this is not always possible in the clinical routine, and if possible, it involves much effort and/or time. Therefore, it is necessary to have a convenient, robust and practical tool correlated with the MS volume, allowing clinical applicability. Nowadays, the available methods for MS segmentation are manual or semi-automatic. Additionally, manual methods present inter and intraindividual variability. Thus, the aim of this study was to develop an automatic tool to quantity the MS volume in CT scans of paranasal sinuses. This study was developed with ethical approval from the authors’ institutions and national review panels. The research involved 30 retrospective exams of University Hospital, Botucatu Medical School, São Paulo State University, Brazil. The tool for automatic MS quantification, developed in Matlab®, uses a hybrid method, combining different image processing techniques. For MS detection, the algorithm uses a Support Vector Machine (SVM), by features such as pixel value, spatial distribution, shape and others. The detected pixels are used as seed point for a region growing (RG) segmentation. Then, morphological operators are applied to reduce false-positive pixels, improving the segmentation accuracy. These steps are applied in all slices of CT exam, obtaining the MS volume. To evaluate the accuracy of the developed tool, the automatic method was compared with manual segmentation realized by an experienced radiologist. For comparison, we used Bland-Altman statistics, linear regression and Jaccard similarity coefficient. From the statistical analyses for the comparison between both methods, the linear regression showed a strong association and low dispersion between variables. The Bland–Altman analyses showed no significant differences between the analyzed methods. The Jaccard similarity coefficient was > 0.90 in all exams. In conclusion, the developed tool to automatically quantify MS volume proved to be robust, fast and efficient, when compared with manual segmentation. Furthermore, it avoids the intra and inter-observer variations caused by manual and semi-automatic methods. As future work, the tool will be applied in clinical practice. Thus, it may be useful in the diagnosis and treatment determination of MS diseases.

Keywords: maxillary sinus, support vector machine, region growing, volume quantification

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Authors: Iuliana-Erika Köpeczi

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‘Language is no longer regarded as peripheral to our grasp of the world we live in, but as central to it. Words are not mere vocal labels or communicational adjuncts superimposed upon an already given order of things. They are collective products of social interaction, essential instruments through which human beings constitute and articulate their world’, said Roy Harris. If we were to accept the above-mentioned premise, then we surely must accept that discourse, generally, - and political discourse, specifically -, bears a crucial importance to one’s perception of reality. The way in which political rhetoric constructs reality changes the relationship between the voter and his/her view of the world, which, in turn, influences greatly the future trends of political participation. In this context, our inquiry focuses on the role of populist discourses in the post 9/11 political rhetoric, and how this led to the formation, construction and reconstruction of identity within the ‘us’ vs. ‘them’ dichotomy. It is our hypothesis that anti-intellectualistic elements played a significant role in the manner in which identity construction had been carried out on a discursive level. By adopting a comparative approach, we intend to identify the similarities and differences between the use of such anti-intellectualist elements in the United States of America on one hand – within the discourse of Rick Santorum, – and France on the other – with Marine le Pen’s discourse. Our methodological approach uses close textual analysis of primary source material (discourse analysis); historical contextualization of both primary documents and broader socio-political and cultural framework through archival research and secondary sources; as well as interpretation of primary texts through theoretical frameworks (qualitative research). We hope that the output of our endeavor will be useful in better understanding the different correlations that exist between anti-intellectualism and populism and how the interactions between these two elements aids in political identity construction through discourse.

Keywords: anti-intellectualism, discourse theory, France, identity construction, populism, United States of America

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Authors: Amriana Hifizah, Philip Edward Vercoe, Graeme Bruce Martin, Teuku Reza Ferasy, Muhammad Hambal

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Many native forage plant species have been used in Indonesia as feed for ruminants. However, less information is available about how these plants affect productivity, let alone methane emissions. In the province of Aceh, where the traditional practice is to feed local forages to small ruminants, the farmers are not satisfied with the productivity of their livestock, and they attribute this problem to poor availability and too few options for good quality forages. Forage quality is reduced by high environmental temperatures which increase the amount of lignification. In addition to reducing productivity, these factors also increase enteric methane production. A preliminary survey about potential forage species was completed in three different districts, two of low elevation and one of high elevation: Syiah Kuala (05°30’5.08” N to 095°24’7.35” E), elevation 29 m MSL; Kajhu (05°32’34.6” N to 095°21’17.7” E), elevation 30 m MSL; Lembah Seulawah (05°28'06.4" N to 095°43' 14.2" E), elevation 254 m MSL. Information about local plants was collected in a semi-structured interview with scientists, government field officers and local farmers, in the city of Banda Aceh and in those three districts. The outcome was a list 40 species that could be useful, of which 21 were selected for further study. The selection process was based on several criteria: high availability, high protein content, low toxicity, and evidence of secondary metabolites (eg, history of medicinal plants for both human and animals). For some of the selected medicinal plants, there is experimental evidence of effects on methane production during rumen fermentation. Subsequently, the selected forages were tested for their effects on rumen fermentation in vitro, using batch culture. The data produced will be used to identify forages with the potential to reduce CH4 emissions. These candidates will then be assessed for their benefits (fermentability and productivity) and potential deleterious side-effects.

Keywords: batch culture, forage, methane, rumen

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Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal

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Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.

Keywords: resistant, hypertension, spironolactone, blood pressure

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Authors: Yosra Ben Salah, Wang Li Jun, Salem Bellil

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The village Hammem Zriba is a lost little paradise in the middle of a beautiful landscape that captures the eyes of every visitor. The village alone is a rich expression of different elements such as urban, architecture, technical and vernacular elements, as well as sociological, spiritual and religious behaviors. This heritage is in degrading conditions and is threatened by disappearing soon; thus, actions have to be taken as soon as possible to preserve this heritage, record, analyze and learn from its traditional ways of construction. The strategy of this study is to examine the architecture within the Berber society over a period of time and influenced by a certain location and its relationship to the social and cultural aspects; this research will focus on historical, environmental, social and cultural aspects influencing architecture. The contents of this paper should mainly be constructed by three successive layouts of historical view, a cultural view and an architectural view that will include the urban and domestic scale. This research relies on the integration of both theoretical and empirical investigations. On the theoretical level: A documentary analysis of secondary data is used. Documentary analysis means content analysis of the relevant documents that include books, journals, magazines, archival data, and field survey and observations. On the empirical level: analysis of these traditional ways of planning and house building will be carried out. Through the Analysis, three techniques will be employed to collect primary data. These techniques are; systematic analysis of the architectural drawings, quantitative analysis to the houses statistics, and a direct observation. Through this research, the technical, architectural and urban achievements of the Berber people who represent a part of the general history and architectural history will be emphasized. And on a second point the potential for the sustainability present in this traditional urban planning and housing to be used to formulate guidelines for modern urban and housing development.

Keywords: culture, history, traditional architecture, values

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Authors: Zarina Othman, Bakri Mat, Aini Fatihah Roslam

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The Burmese ethnic known as Rohingya is one of the world’s most persecuted ethnic minorities on earth. They have been massacred, discriminated, humiliated, gang-raped, trafficked, abused and neglected. More than one million Rohingyas have been displaced internally and overseas. Currently, Rohingya asylum seekers can be found in India, Bangladesh, Thailand, Malaysia, and Indonesia. This forced migration is unacceptable since the Rohingya are stateless although they have been part of Myanmar for more than one century. Why the Rohingyas crisis is important to be analyse from human security perspectives? Understanding the human security of the Rohingya is important because the crisis may have implication on the regional stability in South and South-East Asia. The objectives of the research are to provide an explanation to the current human security situation in Myanmar, to analyse the regional implication of the Rohingya’s crisis and to recommend the workable solution that may help to reduce the tension. To analyze and demonstrate the case, the research has adopted the BAGHUS or Bangi Human Security Approach, a Southeast Asian human security model, designed to protect the weakest and the vital core of human life across national borders. Based on a qualitative research, and a review of literature from secondary sources of books, reports and academic journals, the research has conducted interviews with 1) Rohingya respondents in Cox’s Baza in February 2017; 2) experts and scholars in the field in Bangladesh, Myanmar and Malaysia. Preliminary findings suggest that conflicts lead to displacement and migration across borders, human insecurity is an issue where the implementation of human rights is too slow to take place even in sovereign state like Myanmar. The political and economic interests of many extraregional powers have further contributed to the current crisis. Human security perspectives is suggested as the workable solution for stability and peace in the region.

Keywords: human security, migration, Myanmar, regional security, Rohingya

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Authors: Aurore Lechevallier, Mohend Chaouche, Jerome Soudier, Guillaume Renaudin

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The cement industry accounts for 8% of the global CO₂ emissions, and approximately 60% of these emissions are associated with the Portland cement clinker production from the decarbonization of limestone (CaCO3). Their impact on the greenhouse effect results in growing social awareness. Therefore, CO2 footprint becomes a product selection choice, and substituting Portland cement with a lower CO2-footprint alternative binder is sought. In this context, new hydraulic binders have been studied as a potential Ordinary Portland Cement substitute. Many of them are composed of iron oxides and aluminum oxides, present in the Ca₄Al₂-xFe₂+ₓO₁₀-like phase and forming Ca-LDH (i.e. AFM) as a hydration product. It has become essential to study the possible existence of Fe/Al AFM solid solutions to characterize the hydration process properly. Ca₂Al₂-xFex(OH)₆.X.nH₂O layered AFM samples intercalated with either nitrate or chloride X anions were synthesized based on the co-precipitation method under a nitrogen atmosphere to avoid the carbonation effect.AFM samples intercalated with carbonate anions were synthesized based on the anionic exchange process, using AFM-NO₃ as the source material. These three AFM samples were synthesized with varying Fe/Al molar ratios. The experimental conditions were optimized to make possible the formation of Al-AFM and Fe-AFM using the same parameters (namely pH value and salt concentration). Rietveld refinements were performed to demonstrate the existence of a solid solution between the two trivalent metallic end members. Spectroscopic analyses were used to confirm the intercalation of the targeted anion; secondary electron images were taken to analyze the AFM samples’ morphology, and energy dispersive X-ray spectroscopy (EDX) was carried out to determine the elemental composition of the AFM samples. Results of this study make it possible to quantify the Al/Fe ratio of the AFM phases precipitated in our hydraulic binder, thanks to the determined Vegard's law characteristic to the corresponding solid solutions

Keywords: AFm phase, iron-rich binder, low-carbon cement, solid solution

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Authors: Peng Hao Wang, Garam Kim, Ronald Sterkenburg

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The applications of composite materials within the aviation industry has been increasing at a rapid pace.  However, the growing applications of composite materials have also led to growing demand for more tooling to support its manufacturing processes. Tooling and tooling maintenance represents a large portion of the composite manufacturing process and cost. Therefore, the industry’s adaptability to new techniques for fabricating high quality tools quickly and inexpensively will play a crucial role in composite material’s growing popularity in the aviation industry. One popular tool fabrication technique currently being developed involves additive manufacturing such as 3D printing. Although additive manufacturing and 3D printing are not entirely new concepts, the technique has been gaining popularity due to its ability to quickly fabricate components, maintain low material waste, and low cost. In this study, a team of Purdue University School of Aviation and Transportation Technology (SATT) faculty and students investigated the effectiveness of a 3D printed composite compression mold. A 3D printed composite compression mold was fabricated by 3D scanning a steel valve cover of an aircraft reciprocating engine. The 3D printed composite compression mold was used to fabricate carbon fiber versions of the aircraft reciprocating engine valve cover. The 3D printed composite compression mold was evaluated for its performance, durability, and dimensional stability while the fabricated carbon fiber valve covers were evaluated for its accuracy and quality. The results and data gathered from this study will determine the effectiveness of the 3D printed composite compression mold in a mass production environment and provide valuable information for future understanding, improvements, and design considerations of 3D printed composite molds.

Keywords: additive manufacturing, carbon fiber, composite tooling, molds

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Authors: Md Motibur Rahman

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The present paper attempts to study the electoral politics and voting behavior of 2011 assembly election of West Bengal state in India. Electoral geography is considered as the study of geographical aspects of the organization, conduct, and result of elections. It deals with the spatial voting patterns/behaviour or the study of the spatial distribution of political phenomena of voting. Voting behavior is a form of political psychology which played a great role in political decision-making process. The voting behavior of the electorates is largely influenced by their perception that existing during the time of election. The main focus of the study will be to analyze the electoral politics of the party organizations and political profile of the electorates. The principle objectives of the present work are i) to study the spatial patterns of voting behavior in 2011 assembly election in West Bengal, ii) to analysis the result and finding of 2011 assembly election. The whole study based on the secondary source of data. The electoral data have taken from Election Commission of India, New Delhi and Centre for the study of Developing Societies (CSDS) in New Delhi. In the battle of 2011 Assembly election in West Bengal, the two major parties were Left Front and Trinamool Congress. This election witnessed the remarkable successes of Trinamool Congress and decline of 34 years longest ruler party that is Left Front. Trinamool Congress won a majority of seats that 227 out of 294 but Left Front won only 62 seats out of 294 seats. The significance of the present study is that it helps in understanding the voting pattern, voting behaviour, trends of voting and also helps for further study of electoral geography in West Bengal. The study would be highly significant and helpful to the planners, politicians, and administrators who are involved in the formulation of development plans and programmes for the people of the state.

Keywords: assembly election, electoral geography, electoral politics, voting behaviour

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Authors: Shivangi Somvanshi

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Poor crop productivity in salt-affected environment in the country is due to insufficient and untimely canal supply to agricultural land and inefficient field water management practices. This could further degrade due to inadequate maintenance of canal network, ongoing secondary soil salinization and waterlogging, worsening of groundwater quality. Large patches of low productivity in irrigation commands are occurring due to waterlogging and salt-affected soil, particularly in the scarcity rainfall year. Satellite remote sensing has been used for mapping of areas of low crop productivity, waterlogging and salt in irrigation commands. The spatial results obtained for these problems so far are less reliable for further use due to rapid change in soil quality parameters over the years. The existing spatial databases of canal network and flow data, groundwater quality and salt-affected soil were obtained from the central and state line departments/agencies and were integrated with GIS. Therefore, an integrated methodology based on remote sensing and GIS has been developed in ArcGIS environment on the basis of canal supply status, groundwater quality, salt-affected soils, and satellite-derived vegetation index (NDVI), salinity index (NDSI) and waterlogging index (NSWI). This methodology was tested for identification and delineation of area of low productivity in the Gautam Buddha Nagar district (Uttar Pradesh). It was found that the area affected by this problem lies mainly in Dankaur and Jewar blocks of the district. The problem area was verified with ground data and was found to be approximately 78% accurate. The methodology has potential to be used in other irrigation commands in the country to obtain reliable spatial data on low crop productivity.

Keywords: remote sensing, GIS, salt affected soil, crop productivity, Gautam Buddha Nagar

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Authors: Ibrahim Mohammed

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Background: Diabetes mellitus is a chronic disease that can cause devastating secondary complications, reducing the quality and length of life as well as increasing medical costs for the patient and society. The guidelines recommend both clinical and preventive strategies for diabetes management and are regularly updated. The aim of the study is to assess the level of adherence of physicians to American Diabetes Association Guidelines. Method: Observational multicenter retrospective study will be conducted among different hospitals in the central region. Patient data will be collected from the records of the last three years (2017- 2020). Records will be selected randomly after a complete randomized design. The study focuses on the management of type 2 according to ADA not changed in the last three updating; those standards; all patients should be taking Metformin 1500 to 2000 mg/day as recommended dose and should be received a high dose of statin if the high risk to ASCVD or moderate statin if not at risk, patients with hypertension and diabetes should taking ACE or ARBS. Result: The study aimed to evaluate the commitment of physicians in the central region to the ADA. Out of the 153 selected patients, only 17 % were able to control their diabetes with an average A1c below 7. ADA stated that to reach the minimum benefit of using Metformin, the daily dose should be between 1500 and 2000 mg. Results showed that 110 patients were on Metformin, where 68% of them were on the recommended dose. ADA recommended the intake of high statin for diabetic patients with ASCVD risk, while diabetic patients without ASCVD risk should be on a moderate statin. Results showed that 61.5% of patients with ASCVD risk were at high statin while only 36% of patients without ASCVD risk were at moderate statin. Results showed that 89 patients have hypertension, and 80% of them are getting ACE/ARBs as recommended by the ADA. Recommendation: It is necessary to implement periodic training courses for some physicians to enhance and update their knowledge.

Keywords: American Diabetic Association, diabetes mellitus, atherosclerotic cardiovascular disease, ACE inhibitors

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Authors: Fernanda Goulart, Rita de Cássia Barbirato

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Task-based language teaching has received attention among researchers as it has been pointed out with the potential to provide more significant opportunities for using the target language and therefore generate successful language acquisition. Nevertheless, in the Brazilian context, few studies have analyzed the potential of tasks in English language acquisition. There is also a need for textbooks to meet the needs of Brazilian students. This work is part of doctoral research in its initial phase. It aims to demonstrate and discuss thematic textbook samples on tasks designed to be applied among high school and undergraduate students in a public technological educational context in São Paulo State, Brazil. It is a qualitative study. The data collection process for course design and textbook development initially included a survey administered to 159 students. Questions related to students’ English background knowledge, main learning interests, and needs. Most students reported difficulties communicating in English and showed a strong interest in a communicative English course. The theme “Cultural diversity” was chosen among other options provided. The textbook was then designed and comprised nine task cycles divided into four sequences. Cycles were composed of pre-tasks, tasks, and post-tasks. The main findings of this first phase of the research revealed that designing a task-based textbook is not easy and requires the necessary steps and lots of effort to meet students’ language needs. Several revisions were needed before the conclusion of the final version of the textbook. The material will be further applied in a three-month English course. In this presentation, we hope to contribute to discussions in research on task-based teaching. Also, we intend to support teachers with their knowledge of tasks and thematic material development in this field.

Keywords: task-based language teaching, language acquisition, English language teaching, task cycles

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Authors: Nkrumak Micheal Atta Ofori

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The Vocational System is a decentralized Studies System implemented in Ghana as vocation studies strategy for grassroot that focuses on providing individuals with the specific skills, knowledge, and training necessary for a particular trade, craft, profession, or occupation. This article asks how devolution of vocational studies to local level authorities produces responsive and accountable representation and sustainable vocational learning under the vocational Studies System. It focuses on two case studies: Asokore Mampong and Atwima kwanwoma Municipal. Then, the paper asks how senior high school are developing new material and social practices around the vocational studies System to rebuild their livelihoods and socio-economic wellbeing. Here, the article focusses on Kumasi District, drawing lessons for the two other cases. The article shows how the creation of representative groups under the Vocational Studies System provides the democratic space necessary for effective representation of community aspirations. However, due to elite capture, the interests of privilege few people are promoted. The state vocational training fails to devolve relevant and discretionary resources to local teachers and do not follow the prescribed policy processes of the Vocational Studies System. Hence, local teachers are unable to promote responsive and accountable representation. Rural communities continue to show great interest in the Vocational Studies System, but the interest is bias towards gaining access to vocational training schools for advancing studies. There is no active engagement of the locals in vocational training, and hence, the Vocational Studies System exists only to promote individual interest of communities. This article shows how ‘failed’ interventions can gain popular support for rhetoric and individual gains.

Keywords: vocational studies system, devolution of vocational studies, local-level authorities, senior high schools and vocational learning, community aspirations and representation

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Authors: Hessah Alsulami, Majedah Aldosari

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Introduction: Platelet threshold of 10x109 /L is recommended for clinically stable thrombocytopenic pediatric patients. Transfusions at a higher level (given the absence of research evidence, as determined by clinical circumstances, generally at threshold of 40x109 /L) may be required for patients with signs of bleeding, high fever, hyper-leukocytosis, rapid fall in platelet count, concomitant coagulation abnormality, critically ill patients, and those with impaired platelet function (including drug induced). Transfusions at a higher level may be also required for patients undergoing invasive procedures. Method: This study is a retrospective observational analysis of platelet transfusion thresholds in a single secondary pediatric hospital in Riyadh. From the blood bank database, the list of the patients who received platelet transfusions in the second half of 2018 was retrieved. Patients were divided into two groups; group A, those belong to the category of high platelet level for transfusion (such as those with bleeding, high fever, rapid fall in platelet count, impaired platelet function or undergoing invasive procedures) and group B, those who were not. Then we looked at the pre and post transfusion platelet levels for each group. The data was analyzed using GraphPad software and the data expressed as Mean ± SD. Result: A total of 112 of transfusion episodes in 61 patients (38% female) were analyzed. The age ranged from 24 days to 8 years. The distribution of platelet transfusion episodes was 64% (n=72) for group A and 36% (n= 40) for group B. The mean pre-transfusion platelet count was 46x103 ± (11x 103) for group A and 28x103 ± (6x103) for group B. the post-transfusion mean platelet count was 61 x 103 ± (14 x 103) and 60 x103 ± (24 x 103) for group A and B respectively. Among the groups the rise in the mean platelet count after transfusion was significant among stable patients (group B) compared to unstable patients (group A) (P < 0.001). Conclusion: The platelet count threshold for transfusion varied with the clinical condition and is higher among unstable patients’ group which is expected. For stable patients the threshold was higher than what it should be which means that the clinicians don’t follow the guidelines in this regard. The rise of platelet count after transfusion was higher among stable patients.

Keywords: platelet, transfusion, threshold, pediatric

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Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

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Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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