Search results for: Significant Factors
Commenced in January 2007
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Edition: International
Paper Count: 5537

Search results for: Significant Factors

437 The Results of the Fetal Weight Estimation of the Infants Delivered in the Delivery Room At Dan Khunthot Hospital by Johnson-s Method

Authors: Nareelux Suwannobol, JintanaTapin, Khuanchanok Narachan

Abstract:

The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight (<2500 g) and the appropriate birth weight (2500-3999g) actual birth weight less than estimate fetal weight . But the high birth weight (> 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (<2500 g) respectively. The rate of estimates fetal weight within 10% of actual birth weight was 35.7%. Actual birth weight were compared with the found that the difference is statistically significant (p <.000). Employing Johnson-s method to estimate fetal weight can estimate initial fetal weight before passing to special examinations, which may require excessive high cost. A variety of methods should be employed to estimate fetal weight more precisely, which will help plan care for mother-s and infant-s safety.

Keywords: Johnson's method, Fetal weight estimate, Delivery Room, Student nurse.

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436 Using Dynamic Glazing to Eliminate Mechanical Cooling in Multi-family Highrise Buildings

Authors: Ranojoy Dutta, Adam Barker

Abstract:

Multifamily residential buildings are increasingly being built with large glazed areas to provide tenants with greater daylight and outdoor views. However, traditional double-glazed window assemblies can lead to significant thermal discomfort from high radiant temperatures as well as increased cooling energy use to address solar gains. Dynamic glazing provides an effective solution by actively controlling solar transmission to maintain indoor thermal comfort, without compromising the visual connection to outdoors. This study uses thermal simulations across three Canadian cities (Toronto, Vancouver and Montreal) to verify if dynamic glazing along with operable windows and ceiling fans can maintain the indoor operative temperature of a prototype southwest facing high-rise apartment unit within the ASHRAE 55 adaptive comfort range for a majority of the year, without any mechanical cooling. Since this study proposes the use of natural ventilation for cooling and the typical building life cycle is 30-40 years, the typical weather files have been modified based on accepted global warming projections for increased air temperatures by 2050. Results for the prototype apartment confirm that thermal discomfort with dynamic glazing occurs only for less than 0.7% of the year. However, in the baseline scenario with low-E glass there are up to 7% annual hours of discomfort despite natural ventilation with operable windows and improved air movement with ceiling fans.

Keywords: Electrochromic, operable windows, thermal comfort, natural ventilation, adaptive comfort.

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435 Difference in Psychological Well-Being Based On Comparison of Religions: A Case Study in Pekan District, Pahang, Malaysia

Authors: Amran Hassan, Fatimah Yusooff, Khadijah Alavi

Abstract:

The psychological well-being of a family is a subjective matter for evaluation, all the more when it involves the element of religions, whether Islam, Christianity, Buddhism or Hinduism. Each of these religions emphasises similar values and morals on family psychological well-being. This comparative study is specifically to determine the role of religion on family psychological well-being in Pekan district, Pahang, Malaysia. The study adopts a quantitative and qualitative mixed method design and considers a total of 412 samples of parents and children for the quantitative study, and 21 samples for the qualitative study. The quantitative study uses simple random sampling, whereas the qualitative sampling is purposive. The instrument for quantitative study is Ryff’s Psychological Well-being Scale and the qualitative study involves the construction of a guidelines protocol for in-depth interviews of respondents. The quantitative study uses the SPSS version .19 with One Way Anova, and the qualitative analysis is manual based on transcripts with specific codes and themes. The results show nonsignificance, that is, no significant difference among religions in all family psychological well-being constructs in the comparison of Islam, Christianity, Buddhism and Hinduism, thereby accepting a null hypothesis and rejecting an alternative hypothesis. The qualitative study supports the quantitative study, that is, all 21 respondents explain that no difference exists in psychological wellbeing in the comparison of teachings in all the religious mentioned. These implications may be used as guidelines for government and non-government bodies in considering religion as an important element in family psychological well-being in the long run. 

Keywords: Psychological well-being, comparison of religions, family, Malaysia.

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434 Influence of Dilution and Lean-premixed on Mild Combustion in an Industrial Burner

Authors: Sh.Khalilarya, H.Oryani, S.Jafarmadar, H.Khatamnezhad, A.Nemati

Abstract:

Understanding of how and where NOx formation occurs in industrial burner is very important for efficient and clean operation of utility burners. Also the importance of this problem is mainly due to its relation to the pollutants produced by more burners used widely of gas turbine in thermal power plants and glass and steel industry. In this article, a numerical model of an industrial burner operating in MILD combustion is validated with experimental data.. Then influence of air flow rate and air temperature on combustor temperature profiles and NOX product are investigated. In order to modification this study reports on the effects of fuel and air dilution (with inert gases H2O, CO2, N2), and also influence of lean-premixed of fuel, on the temperature profiles and NOX emission. Conservation equations of mass, momentum and energy, and transport equations of species concentrations, turbulence, combustion and radiation modeling in addition to NO modeling equations were solved together to present temperature and NO distribution inside the burner. The results shows that dilution, cause to a reduction in value of temperature and NOX emission, and suppresses any flame propagation inside the furnace and made the flame inside the furnace invisible. Dilution with H2O rather than N2 and CO2 decreases further the value of the NOX. Also with raise of lean-premix level, local temperature of burner and the value of NOX product are decreases because of premixing prevents local “hot spots" within the combustor volume that can lead to significant NOx formation. Also leanpremixing of fuel with air cause to amount of air in reaction zone is reach more than amount that supplied as is actually needed to burn the fuel and this act lead to limiting NOx formation

Keywords: Mild combustion, Flameless, Numerical simulation, Burner, CFD.

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433 Cirrhosis Mortality Prediction as Classification Using Frequent Subgraph Mining

Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

Abstract:

In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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432 Genetic Polymorphism of the Acute Lymphoblastic Leukaemia and Hyperhomocysteinemia its Relation with the for a Group of Children in the East of Algeria

Authors: Yahia Massinissa, Kalla A, Yahia M, Benbia S

Abstract:

A lot of recent research have spoken on the relation between the increase of the homocysteinemia and some kinds of cancer . For that, our study was based on the research of a possible relation between the increase of the concentration of this amino-acid in the plasma and the appearance of the disease of the Acute Lymphoblastic Leukaemia in a part of Algerian children with Berber origin in the East of Algeria . The study has done on 47 ill persons with an average age of (09±06 ) years , with whom the disease has diagnosed by blood and marrow examination in the hospital of blood diseases in the CHU of Batna, and on 194 healthy witnesses of the same age. The two groups were benefited by a dosage of the concentration of the homocysteine vitamin B9 ,vitamin B12 , and also of the study of special polymorphisms of indispensable enzymes in the metabolism of this acid , and that by the use of the method ( Light cycler ) Real time PCR , on the following enzymes : MS ( C2756G ), MSR ( A66G ) ,MTHFR1 ( C677T ) and MTHFR2 (A1298C). The obtained results have revealed that the rate of the homozygote muted genotype is the less frequent in the two groups , and that exist at list one genotype of each enzyme in the ill group and in which the percentage exceed with remarkable way the same genotype in the healthy group and we notice specially the muted genotype GG of -the methionine synthetase-and the form TT of the enzyme – methyline tetra hydrofolate reductase – We notice the existence of considerable number of genotypes in the ill group lied with characteristic increase of this Amino-acid ,and that for the reduction of the biologic activity of these enzymes which become inefficient in the transfer of the homocysteine into the methionine and cause the diminution of the biologic activity of these enzymes and with consequence the reduction of the percentage of methylic radicals in the DNA of studied genes and that lead to the increase of the activity and the capacity of transcription , and it-s so probably that this last one is one of the factors of this disease especially if we know that the specific check-up of vitamins is normal and similar in the two groups , which ovoid the hypothesis of the reduction of vitamins . We notice also that the heterozygote genotype is the less in the sick category except the MTHFR2. Wild genotype is more frequent in the witness group except MSR. Even these results are partials; they open a new way in the genetic diagnosis of this malicious disease which allow a precocious diagnosis and the use of an effective and appropriated treatment in the same time.

Keywords: Genetic polymorphism, Acute Lymphoblastic Leukaemia, Biomarkers, Metabolism of homocystein

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431 Life Cycle Assessment of Seawater Desalinization in Western Australia

Authors: Wahidul K. Biswas

Abstract:

Perth will run out of available sustainable natural water resources by 2015 if nothing is done to slow usage rates, according to a Western Australian study [1]. Alternative water technology options need to be considered for the long-term guaranteed supply of water for agricultural, commercial, domestic and industrial purposes. Seawater is an alternative source of water for human consumption, because seawater can be desalinated and supplied in large quantities to a very high quality. While seawater desalination is a promising option, the technology requires a large amount of energy which is typically generated from fossil fuels. The combustion of fossil fuels emits greenhouse gases (GHG) and, is implicated in climate change. In addition to environmental emissions from electricity generation for desalination, greenhouse gases are emitted in the production of chemicals and membranes for water treatment. Since Australia is a signatory to the Kyoto Protocol, it is important to quantify greenhouse gas emissions from desalinated water production. A life cycle assessment (LCA) has been carried out to determine the greenhouse gas emissions from the production of 1 gigalitre (GL) of water from the new plant. In this LCA analysis, a new desalination plant that will be installed in Bunbury, Western Australia, and known as Southern Seawater Desalinization Plant (SSDP), was taken as a case study. The system boundary of the LCA mainly consists of three stages: seawater extraction, treatment and delivery. The analysis found that the equivalent of 3,890 tonnes of CO2 could be emitted from the production of 1 GL of desalinated water. This LCA analysis has also identified that the reverse osmosis process would cause the most significant greenhouse emissions as a result of the electricity used if this is generated from fossil fuels

Keywords: Desalinization, Greenhouse gas emissions, life cycle assessment.

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430 An Obesity Index Derived from Waist and Hip Circumferences Well-Matched with Other Indices in Children with Obesity

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Indices derived from anthropometric measurements [waist-to-hip ratio (WHR)] or body fat mass compositions [trunk-to-leg fat ratio (TLFR)] are used for the evaluation of obesity. The best for clinical practices is still being investigated. The aim of this study is to derive an index, which best suits the purpose for the discrimination of children with normal body mass index (N-BMI) from obese (OB) children. 83 children participated in the study. Groups 1 and 2 comprised 42 children with N-BMI and 41 OB children, whose age- and sex-adjusted BMI percentile values vary between 15-85 and 95-99, respectively. The institutional ethics committee approved the study protocol. Informed consent forms were filled by the parents of the participants. Anthropometric measurements (weight, height (Ht), waist circumference (WC), hip circumference (HC), neck circumference (NC) values) were taken. BMI, WHR, (WC+HC)/2, WC/Ht, (WC/HC)/Ht, WC*NC were calculated. Bioelectrical impedance analysis was performed to obtain body’s fat compartments in terms of total fat, trunk fat, leg fat, arm fat masses. TLFR, trunk-to-appendicular fat ratio (TAFR), (trunk fat+leg fat)/2 ((TF+LF)/2), fat mass index (FMI) and diagnostic obesity notation model assessment-II (D2I) index values were calculated. Statistical analysis was performed. Significantly higher values of (WC+HC)/2, (TF+LF)/2, D2I and FMI were observed in OB group than N-BMI group. Significant correlations were found between BMI and WC, (WC+HC)/2, (TF+LF)/2, TLFR, TAFR, D2I, FMI in both groups. Similar correlations were obtained for WC. (WC+HC)/2 was correlated with TLFR, TAFR, (TF+LF)/2, D2I and FMI in N-BMI group. In OB group, the correlations were the same except those with TLFR and TAFR. These correlations were not present with WHR. Correlations were observed between TLFR as well as TAFR and BMI, WC, (WC+HC)/2, (TF+LF)/2, D2I, FMI in N-BMI group. In OB group, correlations between TLFR or TAFR and BMI, WC as well as (WC+HC)/2 were missing. None was noted with WHR. In conclusion, the only correlation valid in both groups was that exists between (TF+LF)/2 and (WC+HC)/2, which was suggested as a link between fat-based and anthropometric indices. (WC+HC)/2, but not WHR, was much more suitable as an anthropometric obesity index.

Keywords: Children, hip circumference, obesity, waist circumference.

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429 Reconsidering the Palaeo-Environmental Reconstruction of the Wet Zone of Sri Lanka: A Zooarchaeological Perspective

Authors: Kalangi Rodrigo, Kelum Manamendra-Arachchi

Abstract:

Bones, teeth, and shells have been acknowledged over the last two centuries as evidence of chronology, Palaeo-environment, and human activity. Faunal traces are valid evidence of past situations because they have properties that have not changed over long periods. Sri Lanka has been known as an Island, which has a diverse variety of prehistoric occupation among ecological zones. Defining the Paleoecology of the past societies has been an archaeological thought developed in the 1960s. It is mainly concerned with the reconstruction from available geological and biological evidence of past biota, populations, communities, landscapes, environments, and ecosystems. This early and persistent human fossil, technical, and cultural florescence, as well as a collection of well-preserved tropical-forest rock shelters with associated 'on-site ' Palaeoenvironmental records, makes Sri Lanka a central and unusual case study to determine the extent and strength of early human tropical forest encounters. Excavations carried out in prehistoric caves in the low country wet zone has shown that in the last 50,000 years, the temperature in the lowland rainforests has not exceeded 5 degrees. Based on Semnopithecus Priam (Gray Langur) remains unearthed from wet zone prehistoric caves, it has been argued periods of momentous climate changes during the Last Glacial Maximum (LGM) and Terminal Pleistocene/Early Holocene boundary, with a recognizable preference for semi-open ‘Intermediate’ rainforest or edges. Continuous genus Acavus and Oligospira occupation along with uninterrupted horizontal pervasive of Canarium sp. (‘kekuna’ nut) have proven that temperatures in the lowland rain forests have not changed by at least 5 °C over the last 50,000 years. Site catchment or territorial analysis cannot be any longer defensible, due to time-distance based factors as well as optimal foraging theory failed as a consequence of prehistoric people were aware of the decrease in cost-benefit ratio and located sites, and generally played out a settlement strategy that minimized the ratio of energy expended to energy produced.

Keywords: Palaeo-environment, palaeo-ecology, palaeo-climate, prehistory, zooarchaeology.

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428 Protective Effect of Saponin Extract from the Root of Garcinia kola (Bitter kola) against Paracetamol- Induced Hepatotoxicity in Albino Rats

Authors: Yemisi Rufina Alli Smith, Isaac Gbadura Adanlawo

Abstract:

Liver disorders are one of the major problems of the world. Despite its frequent occurrence, high morbidity and high mortality, its medical management is currently inadequate. This study was designed to evaluate the hepatoprotective effect of saponin extract of the root of Garcinia kola on the integrity of the liver of paracetamol induced wistar albino rats. Twenty five (25) male adult wistar albino rats were divided into five (5) groups. Group I was the Control group that received distilled water only, group II was the negative control that received 2 g/kg of paracetamol on the 13th day, and group III, IV and V were pre-treated with 100, 200 and 400mg/kg of the saponin extract before inducing the liver damage on the 13th day with 2 g/kg of paracetamol. Twenty four (24) h after administration, the rats were sacrificed and blood samples were collected. The serum Alanine Transaminase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP) activities, Bilirubin and conjugated bilirubin, glucose and protein concentrations were evaluated. The liver was fixed immediately in Formalin and was processed and stained in Haematoxylin and Eosin (H&E). Administration of saponin extract from the root of Garcinia kola significantly decreased paracetamol induced elevated enzymes in the test group. Also histological observations showed that saponin extract of the root of Garcinia kola exhibited a significant liver protection against the toxicant as evident by the cells trying to return to normal. Saponin extract from the root of Garcinia kola indicated a protection of structural integrity of the hepatocytic cell membrane and regeneration of the damaged liver.

Keywords: Garcinia kola, Hepatoprotective, paracetamol, Saponin.

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427 Biodiversity and Climate Change: Consequences for Norway Spruce Mountain Forests in Slovakia

Authors: Jozef Mindas, Jaroslav Skvarenina, Jana Skvareninova

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Study of the effects of climate change on Norway Spruce (Picea abies) forests has mainly focused on the diversity of tree species diversity of tree species as a result of the ability of species to tolerate temperature and moisture changes as well as some effects of disturbance regime changes. The tree species’ diversity changes in spruce forests due to climate change have been analyzed via gap model. Forest gap model is a dynamic model for calculation basic characteristics of individual forest trees. Input ecological data for model calculations have been taken from the permanent research plots located in primeval forests in mountainous regions in Slovakia. The results of regional scenarios of the climatic change for the territory of Slovakia have been used, from which the values are according to the CGCM3.1 (global) model, KNMI and MPI (regional) models. Model results for conditions of the climate change scenarios suggest a shift of the upper forest limit to the region of the present subalpine zone, in supramontane zone. N. spruce representation will decrease at the expense of beech and precious broadleaved species (Acer sp., Sorbus sp., Fraxinus sp.). The most significant tree species diversity changes have been identified for the upper tree line and current belt of dwarf pine (Pinus mugo) occurrence. The results have been also discussed in relation to most important disturbances (wind storms, snow and ice storms) and phenological changes which consequences are little known. Special discussion is focused on biomass production changes in relation to carbon storage diversity in different carbon pools.

Keywords: Biodiversity, climate change, Norway spruce forests, gap model.

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426 Lifelong Education for Teachers: A Tool for Achieving Effective Teaching and Learning in Secondary Schools in Benue State, Nigeria

Authors: P. I. Adzongo, O. A. Aloga

Abstract:

The purpose of the study was to examine lifelong education for teachers as a tool for achieving effective teaching and learning. Lifelong education enhances social inclusion, personal development, citizenship, employability, teaching and learning, community and the nation. It is imperative that the teacher needs to update his knowledge regularly to be able to perform optimally, since he has a major position in the inculcation of desirable elements in students, and the challenges of lifelong education were also discussed. Descriptive survey design was adopted for the study. A simple random sampling technique was used to select 80 teachers as sample from a population of 105 senior secondary school teachers in Makurdi Local Government Area of Benue State. A 20-item self designed questionnaire subjected to expert validation and reliability was used to collect data. The reliability Alpha coefficient of 0.87 was established using Cronbach’s Alpha technique, mean scores and standard deviation were used to answer the 2 research questions while chi-square was used to analyse data for the 2 null hypotheses, which states that lifelong education for teachers is not a significant tool for achieving effective teaching and lifelong education for teachers does not significantly impact on effective learning. The findings of the study revealed that, lifelong education for teachers can be used as a tool for achieving effective teaching and learning, and the study recommended among others that government, organizations and individuals should in collaboration put lifelong education programmes for teachers on the priority list. The paper concluded that the strategic position of lifelong education for teachers towards enhanced teaching, learning and the production of quality manpower in the society makes it imperative for all hands to be on “deck” to support the programme financially and otherwise.

Keywords: Lifelong Education, Tool, Effective Teaching and Learning.

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425 Growth Performance and Blood Characteristics of Broilers Chicken Fed on Diet Containing Brewer Spent Grain at Finisher Phase

Authors: O. A. Anjola, M. A. Adejobi, L. A Tijani

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This study was conducted to investigate the effects of brewer spent grain (BSG) on growth performance and serum biochemistry characteristics of blood of broilers chickens. Three hundred and fifteen (4 weeks old) Oba – Marshall Broilers were used for the experiment. Five experimental diets were formulated with diet 1 (T1) containing 100% soya bean meal as the control, Diet 2, 3, 4 and 5 had BSG as replacement for soya bean meal at 0%, 36%, 57%, 76% and 100% respectively. The birds were allocated into each dietary group in a completely randomized design with 63 chicks in 3 replicates of 21 chicks each. The birds were offered these diets ad libitum from four weeks old to nine weeks old (35 days). Feed intake, body weight, weight gain, and feed conversion ratio (FCR) were assessed. Blood samples were also collected to examine the effect of BSG waste on hematology and serum biochemistry of broilers. Result indicated that BSG did not significantly (P>0.05) affect feed intake and weight gain. However, FCR and final weight of finishing broilers differs significantly (P<0.05) among treatments. The blood hematology and serum biochemistry indices did not follow a particular trend. Cholesterol concentration reduced with increasing level of BSG in the diet. Hb, RBC, WBC, neutrophils, lymphocytes, heterophiles and MCHC were significant (P<0.05) while MHC and MVC were not significantly (P>0.05) affected by BSG in diets. serum total protein, albumin, and cholesterol concentration also showed significance (P<0.05) difference. Thus, BSG can replace soya bean meal up to 14% in the broiler finisher diet without deleterious effect on the growth, hematology and the serum biochemistry of broiler chicken.

Keywords: Broilers, growth performance, hematology, serum biochemistry.

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424 An Evaluation of the Feasibility of Several Industrial Wastes and Natural Materials as Precursors for the Production of Alkali Activated Materials

Authors: O. Alelweet, S. Pavia

Abstract:

In order to face current compelling environmental problems affecting the planet, the construction industry needs to adapt. It is widely acknowledged that there is a need for durable, high-performance, low-greenhouse gas emission binders that can be used as an alternative to Portland cement (PC) to lower the environmental impact of construction. Alkali activated materials (AAMs) are considered a more sustainable alternative to PC materials. The binders of AAMs result from the reaction of an alkali metal source and a silicate powder or precursor which can be a calcium silicate or an aluminosilicate-rich material. This paper evaluates the particle size, specific surface area, chemical and mineral composition and amorphousness of silicate materials (most industrial waste locally produced in Ireland and Saudi Arabia) to develop alkali-activated binders that can replace PC resources in specific applications. These include recycled ceramic brick, bauxite, illitic clay, fly ash and metallurgical slag. According to the results, the wastes are reactive and comply with building standards requirements. The study also evidenced that the reactivity of the Saudi bauxite (with significant kaolinite) can be enhanced on thermal activation; and high calcium in the slag will promote reaction; which should be possible with low alkalinity activators. The wastes evidenced variable water demands that will be taken into account for mixing with the activators. Finally, further research is proposed to further determine the reactive fraction of the clay-based precursors.

Keywords: Reactivity, water demand, alkali-activated materials, brick, bauxite, illitic clay, fly ash, slag.

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423 Statistical Analysis and Impact Forecasting of Connected and Autonomous Vehicles on the Environment: Case Study in the State of Maryland

Authors: Alireza Ansariyar, Safieh Laaly

Abstract:

Over the last decades, the vehicle industry has shown increased interest in integrating autonomous, connected, and electrical technologies in vehicle design with the primary hope of improving mobility and road safety while reducing transportation’s environmental impact. Using the State of Maryland (M.D.) in the United States as a pilot study, this research investigates Connected and Autonomous Vehicles (CAVs) fuel consumption and air pollutants including Carbon Monoxide (CO), Particulate Matter (PM), and Nitrogen Oxides (NOx) and utilizes meaningful linear regression models to predict CAV’s environmental effects. Maryland transportation network was simulated in VISUM software, and data on a set of variables were collected through a comprehensive survey. The number of pollutants and fuel consumption were obtained for the time interval 2010 to 2021 from the macro simulation. Eventually, four linear regression models were proposed to predict the amount of C.O., NOx, PM pollutants, and fuel consumption in the future. The results highlighted that CAVs’ pollutants and fuel consumption have a significant correlation with the income, age, and race of the CAV customers. Furthermore, the reliability of four statistical models was compared with the reliability of macro simulation model outputs in the year 2030. The error of three pollutants and fuel consumption was obtained at less than 9% by statistical models in SPSS. This study is expected to assist researchers and policymakers with planning decisions to reduce CAV environmental impacts in M.D.

Keywords: Connected and autonomous vehicles, statistical model, environmental effects, pollutants and fuel consumption, VISUM, linear regression models.

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422 A Study on the Effectiveness of Alternative Commercial Ventilation Inlets That Improve Energy Efficiency of Building Ventilation Systems

Authors: Brian Considine, Aonghus McNabola, John Gallagher, Prashant Kumar

Abstract:

Passive air pollution control devices known as aspiration efficiency reducers (AER) have been developed using aspiration efficiency (AE) concepts. Their purpose is to reduce the concentration of particulate matter (PM) drawn into a building air handling unit (AHU) through alterations in the inlet design improving energy consumption. In this paper an examination is conducted into the effect of installing a deflector system around an AER-AHU inlet for both a forward and rear-facing orientations relative to the wind. The results of the study found that these deflectors are an effective passive control method for reducing AE at various ambient wind speeds over a range of microparticles of varying diameter. The deflector system was found to induce a large wake zone at low ambient wind speeds for a rear-facing AER-AHU, resulting in significantly lower AE in comparison to without. As the wind speed increased, both contained a wake zone but have much lower concentration gradients with the deflectors. For the forward-facing models, the deflector system at low ambient wind speed was preferred at higher Stokes numbers but there was negligible difference as the Stokes number decreased. Similarly, there was no significant difference at higher wind speeds across the Stokes number range tested. The results demonstrate that a deflector system is a viable passive control method for the reduction of ventilation energy consumption.

Keywords: Aspiration efficiency, energy, particulate matter, ventilation.

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421 The Effects of Pilates and McKenzie Exercises on Quality of Life and Lumbar Spine Position Sense in Patients with Low Back Pain: A Comparative Study with a 4-Week Follow-Up

Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

Abstract:

Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: Pilates, Mackenzie, proprioception, low back pain, physical health.

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420 Impact of Standardized Therapeutic Hypothermia Protocol on Neurological Performance after Resuscitation from Cardiac Arrest

Authors: Tahsien Mohamed Okasha, Warda Youssef Mohamed Morsy, Hanan Elsayed Zaghla

Abstract:

We hypothesized that post cardiac arrest patients with Glasgow Coma Scale (GCS) score of less than 8 and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. 17 subjects were enrolled in this study all over one year. The study was carried out using Quasi-experimental research design. Four tools were used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). The mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% subjects were initially arrested in form of ventricular tachycardia (VT), 23.5% initially arrested in form of ventricular fibrillation (VF), and 29.4% in form of A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also, initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. Therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than 8. Replication of the study on larger probability sample, with randomized control trial design is recommended with further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia is recommended.

Keywords: Therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest, initial arrest rhythm.

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419 Methodology of the Turkey’s National Geographic Information System Integration Project

Authors: Buse A. Ataç, Doğan K. Cenan, Arda Çetinkaya, Naz D. Şahin, Köksal Sanlı, Zeynep Koç, Akın Kısa

Abstract:

With its spatial data reliability, interpretation and questioning capabilities, Geographical Information Systems make significant contributions to scientists, planners and practitioners. Geographic information systems have received great attention in today's digital world, growing rapidly, and increasing the efficiency of use. Access to and use of current and accurate geographical data, which are the most important components of the Geographical Information System, has become a necessity rather than a need for sustainable and economic development. This project aims to enable sharing of data collected by public institutions and organizations on a web-based platform. Within the scope of the project, INSPIRE (Infrastructure for Spatial Information in the European Community) data specifications are considered as a road-map. In this context, Turkey's National Geographic Information System (TUCBS) Integration Project supports sharing spatial data within 61 pilot public institutions as complied with defined national standards. In this paper, which is prepared by the project team members in the TUCBS Integration Project, the technical process with a detailed methodology is explained. In this context, the main technical processes of the Project consist of Geographic Data Analysis, Geographic Data Harmonization (Standardization), Web Service Creation (WMS, WFS) and Metadata Creation-Publication. In this paper, the integration process carried out to provide the data produced by 61 institutions to be shared from the National Geographic Data Portal (GEOPORTAL), have been trying to be conveyed with a detailed methodology.

Keywords: Data specification, geoportal, GIS, INSPIRE, TUCBS, Turkey’s National Geographic Information System.

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418 Prophylactic Effects of Dairy Kluyveromyces marxianus YAS through Overexpression of BAX, CASP 3, CASP 8 and CASP 9 on Human Colon Cancer Cell Lines

Authors: Amir Saber Gharamaleki, Beitollah Alipour, Zeinab Faghfoori, Ahmad YariKhosroushahi

Abstract:

Colorectal cancer (CRC) is one of the most prevalent cancers and intestinal microbial community plays an important role in colorectal tumorigenesis. Probiotics have recently been assessed as effective anti-proliferative agents and thus this study was performed to examine whether CRC undergo apoptosis by treating with isolated Iranian native dairy yeast, Kluyveromyces marxianus YAS, secretion metabolites. The cytotoxicity assessments on cells (HT-29, Caco-2) were accomplished through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay as well as qualitative DAPI (4',6-diamidino-2-phenylindole staining) and quantitative (flow cytometry assessments) evaluations of apoptosis. To evaluate the main mechanism of apoptosis, Real time PCR method was applied. Kluyveromyces marxianus YAS secretions (IC50) showed significant cytotoxicity against HT-29 and Caco-2 cancer cell lines (66.57 % and 66.34 % apoptosis) similar to 5-Fluorouracil (5-FU) while apoptosis only was developed in 27.57 % of KDR normal cells. The prophylactic effects of Kluyveromyces marxianus (PTCC 5195), as a reference yeast, was not similar to Kluyveromyces marxianus YAS indicating strain dependency of bioactivities on CRC disease prevention. Based on real time PCR results, the main cytotoxicity is related to apoptosis phenomenon and the core related mechanism is depended on the overexpression of BAX, CASP 9, CASP 8 and CASP 3 inducing apoptosis genes. However, several investigations should be conducted to precisely determine the effective compounds to be used as anticancer therapeutics in the future.

Keywords: Anticancer, anti-proliferative, apoptosis, cytotoxicity, yeast.

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417 Microbubbles Enhanced Synthetic Phorbol Ester Degradation by Ozonolysis

Authors: Kuvshinov, D., Siswanto, A., Zimmerman, W. B.

Abstract:

A phorbol-12-myristate-13-acetate (TPA) is a synthetic analogue of phorbol ester (PE), a natural toxic compound of Euphorbiaceae plant. The oil extracted from plants of this family is useful source for primarily biofuel. However this oil might also be used as a foodstuff due to its significant nutrition content. The limitations for utilizing the oil as a foodstuff are mainly due to a toxicity of PE. Currently, a majority of PE detoxification processes are expensive as include multi steps alcohol extraction sequence.

Ozone is considered as a strong oxidative agent. It reacts with PE by attacking the carbon-carbon double bond of PE. This modification of PE molecular structure yields a non toxic ester with high lipid content.

This report presents data on development of simple and cheap PE detoxification process with water application as a buffer and ozone as reactive component. The core of this new technique is an application for a new microscale plasma unit to ozone production and the technology permits ozone injection to the water-TPA mixture in form of microbubbles.

The efficacy of a heterogeneous process depends on the diffusion coefficient which can be controlled by contact time and interfacial area. The low velocity of rising microbubbles and high surface to volume ratio allow efficient mass transfer to be achieved during the process. Direct injection of ozone is the most efficient way to process with such highly reactive and short lived chemical.

Data on the plasma unit behavior are presented and the influence of gas oscillation technology on the microbubble production mechanism has been discussed. Data on overall process efficacy for TPA degradation is shown.

Keywords: Microbubble, ozonolysis, synthetic phorbol ester.

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416 Fetal and Infant Mortality in Botucatu City, São Paulo State, Brazil: Evaluation of Maternal - Infant Health Care

Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

Abstract:

In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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415 Evaluation of Urban Development Proposals An ANP Approach

Authors: T. Gómez-Navarro, M. García-Melón, D. Díaz-Martín, S. Acuna-Dutra,

Abstract:

In this paper a new approach to prioritize urban planning projects in an efficient and reliable way is presented. It is based on environmental pressure indices and multicriteria decision methods. The paper introduces a rigorous method with acceptable complexity of rank ordering urban development proposals according to their environmental pressure. The technique combines the use of Environmental Pressure Indicators, the aggregation of indicators in an Environmental Pressure Index by means of the Analytic Network Process method and interpreting the information obtained from the experts during the decision-making process. The ANP method allows the aggregation of the experts- judgments on each of the indicators into one Environmental Pressure Index. In addition, ANP is based on utility ratio functions which are the most appropriate for the analysis of uncertain data, like experts- estimations. Finally, unlike the other multicriteria techniques, ANP allows the decision problem to be modelled using the relationships among dependent criteria. The method has been applied to the proposal for urban development of La Carlota airport in Caracas (Venezuela). The Venezuelan Government would like to see a recreational project develop on the abandoned area and mean a significant improvement for the capital. There are currently three options on their table which are currently under evaluation. They include a Health Club, a Residential area and a Theme Park. The participating experts coincided in the appreciation that the method proposed in this paper is useful and an improvement from traditional techniques such as environmental impact studies, lifecycle analysis, etc. They find the results obtained coherent, the process seems sufficiently rigorous and precise, and the use of resources is significantly less than in other methods.

Keywords: Environmental pressure indicators, multicriteria decision analysis, analytic network process.

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414 Thermo-mechanical Deformation Behavior of Functionally Graded Rectangular Plates Subjected to Various Boundary Conditions and Loadings

Authors: Mohammad Talha, B. N. Singh

Abstract:

This paper deals with the thermo-mechanical deformation behavior of shear deformable functionally graded ceramicmetal (FGM) plates. Theoretical formulations are based on higher order shear deformation theory with a considerable amendment in the transverse displacement using finite element method (FEM). The mechanical properties of the plate are assumed to be temperaturedependent and graded in the thickness direction according to a powerlaw distribution in terms of the volume fractions of the constituents. The temperature field is supposed to be a uniform distribution over the plate surface (XY plane) and varied in the thickness direction only. The fundamental equations for the FGM plates are obtained using variational approach by considering traction free boundary conditions on the top and bottom faces of the plate. A C0 continuous isoparametric Lagrangian finite element with thirteen degrees of freedom per node have been employed to accomplish the results. Convergence and comparison studies have been performed to demonstrate the efficiency of the present model. The numerical results are obtained for different thickness ratios, aspect ratios, volume fraction index and temperature rise with different loading and boundary conditions. Numerical results for the FGM plates are provided in dimensionless tabular and graphical forms. The results proclaim that the temperature field and the gradient in the material properties have significant role on the thermo-mechanical deformation behavior of the FGM plates.

Keywords: Functionally graded material, higher order shear deformation theory, finite element method, independent field variables.

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413 Industrial Development, Environment And Occupational Problems: The Case Of Iran

Authors: Ghaffari, H., Changi Ashtiani, A., Younessi, A.

Abstract:

There are three distinct stages in the evolution of economic thought, namely: 1. in the first stage, the major concern was to accelerate economic growth with increased availability of material goods, especially in developing economies with very low living standards, because poverty eradication meant faster economic growth. 2. in the second stage, economists made distinction between growth and development. Development was seen as going beyond economic growth, and bringing certain changes in the structure of the economy with more equitable distribution of the benefits of growth, with the growth coming automatic and sustained. 3. the third stage is now reached. Our concern is now with “sustainable development", that is, development not only for the present but also of the future. Thus the focus changed from “sustained growth" to “sustained development". Sustained development brings to the fore the long term relationship between the ecology and economic development. Since the creation of UNEP in 1972 it has worked for development without destruction for environmentally sound and sustained development. It was realised that the environment cannot be viewed in a vaccum, it is not separate from development, nor is it competing. It suggested for the integration of the environment with development whereby ecological factors enter development planning, socio-economic policies, cost-benefit analysis, trade, technology transfer, waste management, educational and other specific areas. Industrialisation has contributed to the growth of economy of several countries. It has improved the standards of living of its people and provided benefits to the society. It has also created in the process great environmental problems like climate change, forest destruction and denudation, soil erosion and desertification etc. On the other hand, industry has provided jobs and improved the prospects of wealth for the industrialists. The working class communities had to simply put up with the high levels of pollution in order to keep up their jobs and also to save their income. There are many roots of the environmental problem. They may be political, economic, cultural and technological conditions of the modern society. The experts concede that industrial growth lies somewhere close to the heart of the matter. Therefore, the objective of this paper is not to document all roots of an environmental crisis but rather to discuss the effects of industrial growth and development. We have come to the conclusion that although public intervention is often unnecessary to ensure that perfectly competitive markets will function in society-s best interests, such intervention is necessary when firms or consumers pollute.

Keywords: Development, Environment, Industrial Development, Iran, Occupational problems, Pollution.

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412 Impact of Climate Change on Sea Level Rise along the Coastline of Mumbai City, India

Authors: Chakraborty Sudipta, A. R. Kambekar, Sarma Arnab

Abstract:

Sea-level rise being one of the most important impacts of anthropogenic induced climate change resulting from global warming and melting of icebergs at Arctic and Antarctic, the investigations done by various researchers both on Indian Coast and elsewhere during the last decade has been reviewed in this paper. The paper aims to ascertain the propensity of consistency of different suggested methods to predict the near-accurate future sea level rise along the coast of Mumbai. Case studies at East Coast, Southern Tip and West and South West coast of India have been reviewed. Coastal Vulnerability Index of several important international places has been compared, which matched with Intergovernmental Panel on Climate Change forecasts. The application of Geographic Information System mapping, use of remote sensing technology, both Multi Spectral Scanner and Thematic Mapping data from Landsat classified through Iterative Self-Organizing Data Analysis Technique for arriving at high, moderate and low Coastal Vulnerability Index at various important coastal cities have been observed. Instead of data driven, hindcast based forecast for Significant Wave Height, additional impact of sea level rise has been suggested. Efficacy and limitations of numerical methods vis-à-vis Artificial Neural Network has been assessed, importance of Root Mean Square error on numerical results is mentioned. Comparing between various computerized methods on forecast results obtained from MIKE 21 has been opined to be more reliable than Delft 3D model.

Keywords: Climate change, coastal vulnerability index, global warming, sea level rise.

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411 Evaluation of Ensemble Classifiers for Intrusion Detection

Authors: M. Govindarajan

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One of the major developments in machine learning in the past decade is the ensemble method, which finds highly accurate classifier by combining many moderately accurate component classifiers. In this research work, new ensemble classification methods are proposed with homogeneous ensemble classifier using bagging and heterogeneous ensemble classifier using arcing and their performances are analyzed in terms of accuracy. A Classifier ensemble is designed using Radial Basis Function (RBF) and Support Vector Machine (SVM) as base classifiers. The feasibility and the benefits of the proposed approaches are demonstrated by the means of standard datasets of intrusion detection. The main originality of the proposed approach is based on three main parts: preprocessing phase, classification phase, and combining phase. A wide range of comparative experiments is conducted for standard datasets of intrusion detection. The performance of the proposed homogeneous and heterogeneous ensemble classifiers are compared to the performance of other standard homogeneous and heterogeneous ensemble methods. The standard homogeneous ensemble methods include Error correcting output codes, Dagging and heterogeneous ensemble methods include majority voting, stacking. The proposed ensemble methods provide significant improvement of accuracy compared to individual classifiers and the proposed bagged RBF and SVM performs significantly better than ECOC and Dagging and the proposed hybrid RBF-SVM performs significantly better than voting and stacking. Also heterogeneous models exhibit better results than homogeneous models for standard datasets of intrusion detection. 

Keywords: Data mining, ensemble, radial basis function, support vector machine, accuracy.

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410 The Cloud Systems Used in Education: Properties and Overview

Authors: Agah Tuğrul Korucu, Handan Atun

Abstract:

Diversity and usefulness of information that used in education are have increased due to development of technology. Web technologies have made enormous contributions to the distance learning system especially. Mobile systems, one of the most widely used technology in distance education, made much easier to access web technologies. Not bounding by space and time, individuals have had the opportunity to access the information on web. In addition to this, the storage of educational information and resources and accessing these information and resources is crucial for both students and teachers. Because of this importance, development and dissemination of web technologies supply ease of access to information and resources are provided by web technologies. Dynamic web technologies introduced as new technologies that enable sharing and reuse of information, resource or applications via the Internet and bring websites into expandable platforms are commonly known as Web 2.0 technologies. Cloud systems are one of the dynamic web technologies that defined as a model provides approaching the demanded information independent from time and space in appropriate circumstances and developed by NIST. One of the most important advantages of cloud systems is meeting the requirements of users directly on the web regardless of hardware, software, and dealing with install. Hence, this study aims at using cloud services in education and investigating the services provided by the cloud computing. Survey method has been used as research method. In the findings of this research the fact that cloud systems are used such studies as resource sharing, collaborative work, assignment submission and feedback, developing project in the field of education, and also, it is revealed that cloud systems have plenty of significant advantages in terms of facilitating teaching activities and the interaction between teacher, student and environment.

Keywords: Cloud systems, cloud systems in education, distance learning, e-learning, integration of information technologies, online learning environment.

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409 A Morphological Examination of Urban Renewal Processes: The Sample of Konya City

Authors: Muzaffer Ali Yaygın, Mehmet Topçu

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This research aims to investigate morphological changes in urban patterns in urban renewal areas by using geographic information systems and to reveal pattern differences that occur before and after urban renewal processes by applying a morphological analysis. The concept of urban morphology is not involved in urban renewal and urban planning practices in Turkey. This situation destroys the structural characteristic of urban space which appears as a consequence of changes at city, street or plot level. Different approaches and renewal interventions to urban settlements, which are formed as a reflection of cultural issues, may have positive and negative results. A morphological analysis has been applied to an urban renewal area that covers 325 ha. in Konya, in which city urban renewal projects have gained speed with the increasing of economic investments in this study. The study mentions urban renewal and urban morphology relationship, varied academic approach on the urban morphology issue, urban morphology components, changes in lots pattern and numerical differences that occur on road, construction and green space ratios that are before and after the renewal project, and the results of the morphological analysis. It is seen that the built-up area has significant differences when compared to the previous situation. The amount of green areas decreased significantly in quantitative terms; the transportation systems has been changed completely; and the property ownership has been reconstructed without taking the previous situation into account. Findings show that urban renewal projects in Turkey are put into practice with a rent-oriented approach without making an in-depth analysis. The paper discusses the morphological dimension of urban renewal projects in Turkey through a case study from Konya city.

Keywords: Konya, pattern, urban morphology, urban renewal.

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408 Traumatic Ankle Pain: Adequacy of Clinical Information in X-Ray Request with Reference to the Ottawa Ankle Rule

Authors: Rania Mustafa

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This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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