Emergency surgery on mentally impaired patients: standard in consenting

Emergency surgery is often performed on the elderly and susceptible patients with significant comorbidities; as a consequence, the risk of death or severe complications are high. Consent for surgery is a fundamental part of medical practice, in line with legal obligations and ethical principles. Obtaining consent for emergency services (for surgical patients with chronic or acute mental incapacity, due to surgical pathology) is particularly challenging, and meeting the standards requires an up-to-date understanding of legislation, professional body guidelines, and ethical or cultural aspects. The guidance related to consent requires physicians and other medical staff to work with patients according to the process of ‘supported decision-making’. Despite principles and guidelines that have been exhaustively established, the system is sometimes vulnerable in actual clinical practice. The combination of an ‘emergency’ setting and a patient without mental ‘capacity’ is a challenge between patient-centered and ‘paternalistic’ approaches, involving legislation and guidelines on ‘best interests’ of the patient

Simulation and Analysis of Wing Rock Physics for a Generic Fighter Model with Three Degrees-of-Freedom

Modern fighter designs have been associated with lateral self-excited oscillations own as Wing Rock . Simulations of wing rock by flow visualization utilities have been encouraged to develop a complete understanding of the fluid mechanism that drives the motion as well as for prediction purposes. Previous wind/water tunnel simulations have been limited to a single degree-of freedom (DoF) in roll. In this study, for the first time, wing rock is computationally simulated in three DoF: roll, sideslip, and vertical motion to study the effect of adding file sideslip and vertical motion. The results are for a generic fighter model consisting of a fore-body, a cropped delta wing, and a vertical fin. The effect of including the vertical fin is also studied. The interaction of aerodynamics and rigid-body dynamics during a single DoF wing rock for the wing-body configuration has been studied via snap shots of a cross-plane stagnation pressure distribution and tracing the instantaneous locations of vortex burst for an entire cycle of wing rock. The effect of adding the sideslip and vertical motion DoF to the simulations of the wing-body configuration was found to delay file onset and to reduce the amplitude of wing rock by about 50% with surprisingly no change in frequency. The wing rock simulation in three DoF was repeated for file full generic fighter model with the fin included. The aerodynamic effect of the fin was found to significantly delay the vortex burst on the upper surface of the wing. The net effect of the fin was found to augment the damping of the oscillations with significant increase in frequency

Concept, opportunities and challenges of urban tourism in the Arab world: Case studies of Dubai, Cairo and Amman

This paper aims to provide a better understanding of the current situation of urban tourism with referring to the experiences of the Arab World. By using bibliographic documentation and descriptive-analytic method, this paper addresses the main opportunities, impediments, and challenges of urban tourism in three Arab cities (Dubai, Cairo and Amman). This paper indicates that the three cities have many opportunities stemming from their location and their rich tourism resources. Moreover, urban tourism in these cities should confront some internal (country based) and external (global and regional) challenges such as seasonality, pollution, congestion, competition, funding and instability. Some recommendations and policy implications were suggested. The paper concludes, by arguing, that common internal and external challenges need to be addressed in a systematic manner within the broader cultural and tourism policy context in which urban tourism is now implicated. There is a lack of literature on urban tourism within the Arab countries, which is attributed to that tourism in the Arab world is heritage dominated type. Therefore, this research also attempts to bridge the gap in the existing literature about urban tourism in the Arab cities

Efficient Hardware Implementation Of Haar Wavelet Transform With Line-Based And Dual-Scan Image Memory Accesses

Image compression is of great importance in multimedia systems and applications because it drastically reduces bandwidth requirements for transmission and memory requirements for storage. An image compression algorithm JPEG2000 isbased on Discrete Wavelet Transform. In the hardware implementation of DiscreteWavelet Transform (DWT) and inverse DiscreteWavelet Transform (IDWT),the main problems are storage memory, internal processing buffer, and the limitation of the FPGA resources. Based on non-separable 2-D DWT, the method used to access the image memory has a direct impact on the internal buffer size,the power consumption and, the transformation speed. The need for internal buffer reduces the image memory access time. The main objectives of this thesis are as follows; to implement a 2-D Haar wavelet transform for large gray-scale image, to reduce the number of image memory access by implementing the 2- D Haar wavelet transform with a suitable combination between using external memory and internal memory, and targeting a low-power and high-speed architecture based on multi-levels non-separable discrete Haar wavelet transform. In this work, the proposed two architectures reduce the number of image memory access. The line-based architecture reduces the internal buffer by 2 x 0.5 x N where N presents the image size. This happens for the low-pass coefficients and for the high-pass coefficients. The dual-scan architecture does not use the internal memory. Overall both architectures work well on the Altera FPGA board at frequency 100 MHz

Characterization and uncertainty analysis of siliciclastic aquifer-fault system

The complex siliciclastic aquifer system underneath the Baton Rouge area, Louisiana, USA, is fluvial in origin. The east-west trending Baton Rouge fault and Denham Springs-Scotlandville fault cut across East Baton Rouge Parish and play an important role in groundwater flow and aquifer salinization. To better understand the salinization underneath Baton Rouge, it is imperative to study the hydrofacies architecture and the groundwater flow field of the Baton Rogue aquifer-fault system. This is done through developing multiple detailed hydrofacies architecture models and multiple groundwater flow models of the aquifer-fault system, representing various uncertain model propositions. The hydrofacies architecture models focus on the Miocene-Pliocene depth interval that consists of the “1,200-foot” sand, “1,500-foot” sand, “1,700-foot” sand and the “2,000-foot” sand, as these aquifer units are classified and named by their approximate depth below ground level. The groundwater flow models focus only on the “2,000-foot” sand. The study reveals the complexity of the Baton Rouge aquifer-fault system where the sand deposition is non-uniform, different sand units are interconnected, the sand unit displacement on the faults is significant, and the spatial distribution of flow pathways through the faults is sporadic. The identified locations of flow pathways through the Baton Rouge fault provide useful information on possible windows for saltwater intrusion from the south. From the results we learn that the “1,200-foot” sand, “1,500-foot” sand and the “1,700-foot” sand should not be modeled separately since they are very well connected near the Baton Rouge fault, while the “2,000-foot” sand between the two faults is a separate unit. Results suggest that at the “2,000-foot” sand the Denham Springs-Scotlandville fault has much lower permeability in comparison to the Baton Rouge fault, and that the Baton Rouge fault plays an important role in the aquifer salinization

FLOW ANALYSIS OF OVERTAKING VEIDCLES: CFD STUDY

The aerodynamic forces occurring when one road vehicle overtakes another are to be investigated using two-dimensional (2D) computational fluid dynamics. Although a lot of researches have been carried on the aerodynamics of the flow of overtaking vehicles, very little information is available on flow around full scale vehicles. Increasing the size of models I 0 times would results in the increase of the mesh size, making it more expensive and requires higher performance hardware. This research studied the aerodynamic forces by the quasi static approach using CFD analysis; it also laid the grounds for further transient and 3D investigation on the full scale model and discussed their feasibility. The purpose of this report is to discuss the outcomes of my final year project with some guidance on how to reach these results for further investigations