Search results for: continuous peripheral nerve blocks

Authors: Varun Dongre, Stefan Pirker, Stefan Heinrich

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Over the last decades, the numerical modelling of fluidized bed processes has become feasible even for industrial processes. Commonly, continuous two-fluid models are applied to describe large-scale fluidization. In order to allow for coarse grids novel two-fluid models account for unresolved sub-grid heterogeneities. However, computational efforts remain high – in the order of several hours of compute-time for a few seconds of real-time – thus preventing the representation of long-term phenomena such as heating or particle conversion processes. In order to overcome this limitation, data-based recurrence computational fluid dynamics (rCFD) has been put forward in recent years. rCFD can be regarded as a data-based method that relies on the numerical predictions of a conventional short-term simulation. This data is stored in a database and then used by rCFD to efficiently time-extrapolate the flow behavior in high spatial resolution. This study will compare the numerical predictions of rCFD simulations with those of corresponding full CFD reference simulations for lab-scale and pilot-scale fluidized beds. In assessing the predictive capabilities of rCFD simulations, we focus on solid mixing and secondary gas holdup. We observed that predictions made by rCFD simulations are highly sensitive to numerical parameters such as diffusivity associated with face swaps. We achieved a computational speed-up of four orders of magnitude (10,000 time faster than classical TFM simulation) eventually allowing for real-time simulations of fluidized beds. In the next step, we apply the checkerboarding technique by introducing gas tracers subjected to convection and diffusion. We then analyze the concentration profiles by observing mixing, transport of gas tracers, insights about the convective and diffusive pattern of the gas tracers, and further towards heat and mass transfer methods. Finally, we run rCFD simulations and calibrate them with numerical and physical parameters compared with convectional Two-fluid model (full CFD) simulation. As a result, this study gives a clear indication of the applicability, predictive capabilities, and existing limitations of rCFD in the realm of fluidization modelling.

Keywords: multiphase flow, recurrence CFD, two-fluid model, industrial processes

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Authors: Kirill Filianin, Satu-Pia Reinikainen, Tuomo Sainio

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Frequent measurements of product steam quality create a data overload that becomes more and more difficult to handle. In the current study, plant history data with multiple variables was successfully treated by principal component analysis to detect abnormal process behavior, particularly, in copper solvent extraction. The multivariate model is based on the concentration levels of main process metals recorded by the industrial on-stream x-ray fluorescence analyzer. After mean-centering and normalization of concentration data set, two-dimensional multivariate model under principal component analysis algorithm was constructed. Normal operating conditions were defined through control limits that were assigned to squared score values on x-axis and to residual values on y-axis. 80 percent of the data set were taken as the training set and the multivariate model was tested with the remaining 20 percent of data. Model testing showed successful application of control limits to detect abnormal behavior of copper solvent extraction process as early warnings. Compared to the conventional techniques of analyzing one variable at a time, the proposed model allows to detect on-line a process failure using information from all process variables simultaneously. Complex industrial equipment combined with advanced mathematical tools may be used for on-line monitoring both of process streams’ composition and final product quality. Defining normal operating conditions of the process supports reliable decision making in a process control room. Thus, industrial x-ray fluorescence analyzers equipped with integrated data processing toolbox allows more flexibility in copper plant operation. The additional multivariate process control and monitoring procedures are recommended to apply separately for the major components and for the impurities. Principal component analysis may be utilized not only in control of major elements’ content in process streams, but also for continuous monitoring of plant feed. The proposed approach has a potential in on-line instrumentation providing fast, robust and cheap application with automation abilities.

Keywords: abnormal process behavior, failure detection, principal component analysis, solvent extraction

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Authors: Marini Kristina Situmeang, Siti Hazar Sitorus, Mukhammad Fatkhullah, Arfan Fadli

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This study aims to identify and explain how forms of treatment and community action include parents who have children with mental retardation while undergoing behavioral therapy that leads to habituation processes. Based on observations made there is inappropriate treatment such as labeling that child mental retardation is considered ‘crazy’ by some people in Aceh Besar region. Reflecting on the phenomenon of discriminatory treatment, the existence of children with mental retardation should be realized in concrete actions that can encourage the development of cognitive abilities, language, motor, and social, one of them through behavioral. The purpose of this research is to find out and explain how the social practices of children with mental retardation when undergoing behavioral therapy that leads to habituation process. This study focuses on families or parents who have children with mental retardation and do therapy of behavioral therapy at home or at physiotherapy clinics in Aceh Besar. The research method is qualitative with case study approach. Data collection techniques are conducted with in-depth interviews and Focus Group Discussion (FGD). The results showed that habituation process which is conducted by parents at home and in fisotherapy clinic have a positive effect on the development of children behavior of mental retardation, especially when dealing with the environment of the community around the residence. Habituation processes conducted through behavioral therapy practices are influenced by Habitus (Gestational and childcare at therapy) and Reinforcement (in this case family and social support). Habituation process is done in the form of habituation, the creation of the situation, and strengthening the character. For example, when a child's mental retardation commits a wrong act (disgraceful or inappropriate behavior) then the child gets punishment in accordance with the form of punishment in a normal child generally, and when he performs a good deed, then he is given a prize such as praise or a thing he likes. Through some of these actions, the child with mental retardation can behave in accordance with the character formed and expected by the community. The process of habituation done by parents accompanied by continuous support of physiotherapy can be one of the alternative booster of cognitive and social development of children mental retardation to then out of the ‘crazy’ label that has been given.

Keywords: behaviour therapy, habituation, habitus, mental retardation

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Authors: Zeina Bou Diab, Arij Daou

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The neural mechanisms of sequential behaviors are intensively studied, with songbirds a focus for learned vocal production. We are studying the premotor nucleus HVC at a nexus of multiple pathways contributing to song learning and production. The HVC consists of multiple classes of neuronal populations, each has its own cellular, electrophysiological and functional properties. During singing, a large subset of motor cortex analog-projecting HVCRA neurons emit a single 6-10 ms burst of spikes at the same time during each rendition of song, a large subset of basal ganglia-projecting HVCX neurons fire 1 to 4 bursts that are similarly time locked to vocalizations, while HVCINT neurons fire tonically at average high frequency throughout song with prominent modulations whose timing in relation to song remains unresolved. This opens the opportunity to define models relating explicit HVC circuitry to how these neurons work cooperatively to control learning and singing. We developed conductance-based Hodgkin-Huxley models for the three classes of HVC neurons (based on the ion channels previously identified from in vitro recordings) and connected them in several physiologically realistic networks (based on the known synaptic connectivity and specific glutaminergic and gabaergic pharmacology) via different architecture patterning scenarios with the aim to replicate the in vivo firing patterning behaviors. We are able, through these networks, to reproduce the in vivo behavior of each class of HVC neurons, as shown by the experimental recordings. The different network architectures developed highlight different mechanisms that might be contributing to the propagation of sequential neural activity (continuous or punctate) in the HVC and to the distinctive firing patterns that each class exhibits during singing. Examples of such possible mechanisms include: 1) post-inhibitory rebound in HVCX and their population patterns during singing, 2) different subclasses of HVCINT interacting via inhibitory-inhibitory loops, 3) mono-synaptic HVCX to HVCRA excitatory connectivity, and 4) structured many-to-one inhibitory synapses from interneurons to projection neurons, and others. Replication is only a preliminary step that must be followed by model prediction and testing.

Keywords: computational modeling, neural networks, temporal neural sequences, ionic currents, songbird

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Authors: Claire Harrison, Raajit K. Rampal, Vikas Gupta, Srdan Verstovsek, Moshe Talpaz, Jean-Jacques Kiladjian, Ruben Mesa, Andrew Kuykendall, Alessandro Vannucchi, Francesca Palandri, Sebastian Grosicki, Timothy Devos, Eric Jourdan, Marielle J. Wondergem, Haifa Kathrin Al-Ali, Veronika Buxhofer-Ausch, Alberto Alvarez-Larrán, Sanjay Akhani, Rafael Muñoz-Carerras, Yury Sheykin, Gozde Colak, Morgan Harris, John Mascarenhas

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Myelofibrosis (MF) is characterized by bone marrow fibrosis, anemia, splenomegaly and constitutional symptoms. Progressive bone marrow fibrosis results from aberrant megakaryopoeisis and expression of proinflammatory cytokines, both of which are heavily influenced by bromodomain and extraterminal domain (BET)-mediated gene regulation and lead to myeloproliferation and cytopenias. Pelabresib (CPI-0610) is an oral small-molecule investigational inhibitor of BET protein bromodomains currently being developed for the treatment of patients with MF. It is designed to downregulate BET target genes and modify nuclear factor kappa B (NF-κB) signaling. MANIFEST-2 was initiated based on data from Arm 3 of the ongoing Phase 2 MANIFEST study (NCT02158858), which is evaluating the combination of pelabresib and ruxolitinib in Janus kinase inhibitor (JAKi) treatment-naïve patients with MF. Primary endpoint analyses showed splenic and symptom responses in 68% and 56% of 84 enrolled patients, respectively. MANIFEST-2 (NCT04603495) is a global, Phase 3, randomized, double-blind, active-control study of pelabresib and ruxolitinib versus placebo and ruxolitinib in JAKi treatment-naïve patients with primary MF, post-polycythemia vera MF or post-essential thrombocythemia MF. The aim of this study is to evaluate the efficacy and safety of pelabresib in combination with ruxolitinib. Here we report updates from a recent protocol amendment. The MANIFEST-2 study schema is shown in Figure 1. Key eligibility criteria include a Dynamic International Prognostic Scoring System (DIPSS) score of Intermediate-1 or higher, platelet count ≥100 × 10^9/L, spleen volume ≥450 cc by computerized tomography or magnetic resonance imaging, ≥2 symptoms with an average score ≥3 or a Total Symptom Score (TSS) of ≥10 using the Myelofibrosis Symptom Assessment Form v4.0, peripheral blast count <5% and Eastern Cooperative Oncology Group performance status ≤2. Patient randomization will be stratified by DIPSS risk category (Intermediate-1 vs Intermediate-2 vs High), platelet count (>200 × 10^9/L vs 100–200 × 10^9/L) and spleen volume (≥1800 cm^3 vs <1800 cm^3). Double-blind treatment (pelabresib or matching placebo) will be administered once daily for 14 consecutive days, followed by a 7 day break, which is considered one cycle of treatment. Ruxolitinib will be administered twice daily for all 21 days of the cycle. The primary endpoint is SVR35 response (≥35% reduction in spleen volume from baseline) at Week 24, and the key secondary endpoint is TSS50 response (≥50% reduction in TSS from baseline) at Week 24. Other secondary endpoints include safety, pharmacokinetics, changes in bone marrow fibrosis, duration of SVR35 response, duration of TSS50 response, progression-free survival, overall survival, conversion from transfusion dependence to independence and rate of red blood cell transfusion for the first 24 weeks. Study recruitment is ongoing; 400 patients (200 per arm) from North America, Europe, Asia and Australia will be enrolled. The study opened for enrollment in November 2020. MANIFEST-2 was initiated based on data from the ongoing Phase 2 MANIFEST study with the aim of assessing the efficacy and safety of pelabresib and ruxolitinib in JAKi treatment-naïve patients with MF. MANIFEST-2 is currently open for enrollment.

Keywords: CPI-0610, JAKi treatment-naïve, MANIFEST-2, myelofibrosis, pelabresib

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Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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Authors: Yogesh Rai, Saurabh Singh, Sanjay Pandey, Dhananjay K. Sah, B. G. Roy, B. S. Dwarakanath, Anant N. Bhatt

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One of the most common signatures of highly malignant gliomas is their capacity to metabolize more glucose to lactic acid than normal brain tissues, even under normoxic conditions (Warburg effect), indicating that aerobic glycolysis is constitutively upregulated through stable genetic or epigenetic changes. However, oxidative phosphorylation (OxPhos) is also required to maintain the mitochondrial membrane potential for tumor cell survival. In the process of tumorigenesis, tumor cells during fastest growth rate exhibit both high glycolytic and high OxPhos. Therefore, metabolically reprogrammed cancer cells with combination of both aerobic glycolysis and altered OxPhos develop a robust metabolic phenotype, which confers a selective growth advantage. In our study, we grew the high glycolytic BMG-1 (glioma) cells with continuous exposure of mitochondrial uncoupler 2, 4, dinitro phenol (DNP) for 10 passages to obtain a phenotype of high glycolysis with enhanced altered OxPhos. We found that OxPhos modified BMG (OPMBMG) cells has similar growth rate and cell cycle distribution but high mitochondrial mass and functional enzymatic activity than parental cells. In in-vitro studies, OPMBMG cells showed enhanced invasion, proliferation and migration properties. Moreover, it also showed enhanced angiogenesis in matrigel plug assay. Xenografted tumors from OPMBMG cells showed reduced latent period, faster growth rate and nearly five folds reduction in the tumor take in nude mice compared to BMG-1 cells, suggesting that robust metabolic phenotype facilitates tumor formation and growth. OPMBMG cells which were found radio-resistant, showed enhanced radio-sensitization by 2-DG as compared to the parental BMG-1 cells. This study suggests that metabolic reprogramming in cancer cells enhances the potential of migration, invasion and proliferation. It also strengthens the cancer cells to escape the death processes, conferring resistance to therapeutic modalities. Our data also suggest that combining metabolic inhibitors like 2-DG with conventional therapeutic modalities can sensitize such metabolically aggressive cancer cells more than the therapies alone.

Keywords: 2-DG, BMG, DNP, OPM-BMG

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Authors: V. Reyes, P. Ferreira

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In response to high levels of competitiveness, industrial systems have evolved to improve productivity. As a consequence, a rapid increase in volume production and simultaneously, a customization process require lower costs, more variety, and accurate quality of products. Reducing time-cycle production, enabling customizability, and ensure continuous quality improvement are key features in advance intelligent industry. In this scenario, customers and producers will be able to participate in the ongoing production life cycle through real-time interaction. To achieve this vision, transparency, predictability, and adaptability are key features that provide the industrial systems the capability to adapt to customer demands modifying the manufacturing process through an autonomous response and acting preventively to avoid errors. The industrial system incorporates a diversified number of components that in advanced industry are expected to be decentralized, end to end communicating, and with the capability to make own decisions through feedback. The evolving process towards advanced intelligent industry defines a set of stages to empower components of intelligence and enhancing efficiency to achieve the decision-making stage. The integrated system follows an industrial cyber-physical system (CPS) architecture whose real-time integration, based on a set of enabler technologies, links the physical and virtual world generating the digital twin (DT). This instance allows incorporating sensor data from real to virtual world and the required transparency for real-time monitoring and control, contributing to address important features of the advanced intelligent industry and simultaneously improve sustainability. Assuming the industrial CPS as the core technology toward the latest advanced intelligent industry stage, this paper reviews and highlights the correlation and contributions of the enabler technologies for the operationalization of each stage in the path toward advanced intelligent industry. From this research, a real-time integration architecture for a cyber-physical system with applications to collaborative robotics is proposed. The required functionalities and issues to endow the industrial system of adaptability are identified.

Keywords: cyber-physical systems, digital twin, sensor data, system integration, virtual model

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Authors: S. Lertsakulpasuk, S. Athichanagorn

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As depletion-drive gas reservoirs are abandoned when there is insufficient production rate due to pressure depletion, waterflooding has been proposed to increase the reservoir pressure in order to prolong gas production. Due to high cost, water injection may not be economically feasible. Water dumpflood into gas reservoirs is a new promising approach to increase gas recovery by maintaining reservoir pressure with much cheaper costs than conventional waterflooding. Thus, a simulation study of water dumpflood into multiple nearly abandoned or already abandoned thin-bedded gas reservoirs commonly found in the Gulf of Thailand was conducted to demonstrate the advantage of the proposed method and to determine the most suitable operational parameters for reservoirs having different system parameters. A reservoir simulation model consisting of several thin-layered depletion-drive gas reservoirs and an overlying aquifer was constructed in order to investigate the performance of the proposed method. Two producers were initially used to produce gas from the reservoirs. One of them was later converted to a dumpflood well after gas production rate started to decline due to continuous reduction in reservoir pressure. The dumpflood well was used to flow water from the aquifer to increase pressure of the gas reservoir in order to drive gas towards producer. Two main operational parameters which are wellhead pressure of producer and the time to start water dumpflood were investigated to optimize gas recovery for various systems having different gas reservoir dip angles, well spacings, aquifer sizes, and aquifer depths. This simulation study found that water dumpflood can increase gas recovery up to 12% of OGIP depending on operational conditions and system parameters. For the systems having a large aquifer and large distance between wells, it is best to start water dumpflood when the gas rate is still high since the long distance between the gas producer and dumpflood well helps delay water breakthrough at producer. As long as there is no early water breakthrough, the earlier the energy is supplied to the gas reservoirs, the better the gas recovery. On the other hand, for the systems having a small or moderate aquifer size and short distance between the two wells, performing water dumpflood when the rate is close to the economic rate is better because water is more likely to cause an early breakthrough when the distance is short. Water dumpflood into multiple nearly-depleted or depleted gas reservoirs is a novel study. The idea of using water dumpflood to increase gas recovery has been mentioned in the literature but has never been investigated. This detailed study will help a practicing engineer to understand the benefits of such method and can implement it with minimum cost and risk.

Keywords: dumpflood, increase gas recovery, low-pressure gas reservoir, multiple gas reservoirs

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Sergio Rapagnà, Alessandro Antonio Papa, Armando Vitale, Andre Di Carlo

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In recent years the world population has enormously increased the use of plastic products for their living needs, in particular for transporting and storing consumer goods such as food and beverage. Plastics are widely used in the automotive industry, in construction of electronic equipment, clothing and home furnishings. Over the last 70 years, the annual production of plastic products has increased from 2 million tons to 460 million tons. About 20% of the last quantity is mismanaged as waste. The consequence of this mismanagement is the release of plastic waste into the terrestrial and marine environments which represents a danger to human health and the ecosystem. Recycling all plastics is difficult because they are often made with mixtures of polymers that are incompatible with each other and contain different additives. The products obtained are always of lower quality and after two/three recycling cycles they must be eliminated either by thermal treatment to produce heat or disposed of in landfill. An alternative to these current solutions is to obtain a mixture of gases rich in H₂, CO and CO₂ suitable for being profitably used for the production of chemicals with consequent savings fossil sources. Obtaining a hydrogen-rich syngas can be achieved by gasification process using the fluidized bed reactor, in presence of steam as the fluidization medium. The fluidized bed reactor allows the gasification process of plastics to be carried out at a constant temperature and allows the use of different plastics with different compositions and different grain sizes. Furthermore, during the gasification process the use of steam increase the gasification of char produced by the first pyrolysis/devolatilization process of the plastic particles. The bed inventory can be made with particles having catalytic properties such as olivine, capable to catalyse the steam reforming reactions of heavy hydrocarbons normally called tars, with a consequent increase in the quantity of gases produced. The plant is composed of a fluidized bed reactor made of AISI 310 steel, having an internal diameter of 0.1 m, containing 3 kg of olivine particles as a bed inventory. The reactor is externally heated by an oven up to 1000 °C. The hot producer gases that exit the reactor, after being cooled, are quantified using a mass flow meter. Gas analyzers are present to measure instantly the volumetric composition of H₂, CO, CO₂, CH₄ and NH₃. At the conference, the results obtained from the continuous gasification of polypropylene (PP) particles in a steam atmosphere at temperatures of 840-860 °C will be presented.

Keywords: gasification, fluidized bed, hydrogen, olivine, polypropyle

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Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

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Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

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Authors: Seema Paul, Jesper Oppelstrup, Roger Thunvik, Vladimir Cvetkovic

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Lake Victoria is the second largest fresh water body in the world, located in East Africa with a catchment area of 250,000 km², of which 68,800 km² is the actual lake surface. The hydrodynamic processes of the shallow (40–80 m deep) water system are unique due to its location at the equator, which makes Coriolis effects weak. The paper describes a St.Venant shallow water model of Lake Victoria developed in COMSOL Multiphysics software, a general purpose finite element tool for solving partial differential equations. Depth soundings taken in smaller parts of the lake were combined with recent more extensive data to resolve the discrepancies of the lake shore coordinates. The topography model must have continuous gradients, and Delaunay triangulation with Gaussian smoothing was used to produce the lake depth model. The model shows large-scale flow patterns, passive tracer concentration and water level variations in response to river and tracer inflow, rain and evaporation, and wind stress. Actual data of precipitation, evaporation, in- and outflows were applied in a fifty-year simulation model. It should be noted that the water balance is dominated by rain and evaporation and model simulations are validated by Matlab and COMSOL. The model conserves water volume, the celerity gradients are very small, and the volume flow is very slow and irrotational except at river mouths. Numerical experiments show that the single outflow can be modelled by a simple linear control law responding only to mean water level, except for a few instances. Experiments with tracer input in rivers show very slow dispersion of the tracer, a result of the slow mean velocities, in turn, caused by the near-balance of rain with evaporation. The numerical and hydrodynamical model can evaluate the effects of wind stress which is exerted by the wind on the lake surface that will impact on lake water level. Also, model can evaluate the effects of the expected climate change, as manifest in changes to rainfall over the catchment area of Lake Victoria in the future.

Keywords: bathymetry, lake flow and steady state analysis, water level validation and concentration, wind stress

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Authors: Joachim F. Sartor

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According to German guidelines, external natural catchments are greater sub-catchments without significant portions of impervious areas, which possess a surface drainage system and empty in a sewer network. Basically, such catchments should be disconnected from sewer networks, particularly from combined systems. If this is not possible due to local conditions, their flow hydrographs have to be considered at the design of sewer systems, because the impact may be significant. Since there is a lack of sufficient measurements of storm-runoff events for such catchments and hence verified simulation methods to analyze their design flows, German standards give only general advices and demands special considerations in such cases. Compared to urban sub-catchments, external natural catchments exhibit greatly different flow characteristics. With increasing area size their hydrological behavior approximates that of rural catchments, e.g. sub-surface flow may prevail and lag times are comparable long. There are few observed peak flow values and simple (mostly empirical) approaches that are offered by literature for Central Europe. Most of them are at least helpful to crosscheck results that are achieved by simulation lacking calibration. Using storm-runoff data from five monitored rural watersheds in the west of Germany with catchment areas between 0.33 and 1.07 km2 , the author investigated by multiple event simulation three different approaches to determine the rainfall excess. These are the modified SCS variable run-off coefficient methods by Lutz and Zaiß as well as the soil moisture model by Ostrowski. Selection criteria for storm events from continuous precipitation data were taken from recommendations of M 165 and the runoff concentration method (parallel cascades of linear reservoirs) from a DWA working report to which the author had contributed. In general, the two run-off coefficient methods showed results that are of sufficient accuracy for most practical purposes. The soil moisture model showed no significant better results, at least not to such a degree that it would justify the additional data collection that its parameter determination requires. Particularly typical convective summer events after long dry periods, that are often decisive for sewer networks (not so much for rivers), showed discrepancies between simulated and measured flow hydrographs.

Keywords: external natural catchments, sewer network design, storm-runoff modelling, urban drainage

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Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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Authors: C. C. Alamanjo, A. O. Adepoju, H. Martin, R. N. Baines

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Peri-urban agriculture in Jos Nigeria serves as a major means of livelihood for both urban and peri-urban poor, and constitutes huge commercial inclination with a target market that has spanned beyond Plateau State. Yet, the sustainability of this sector is threatened by intensive application of urban refuse ash contaminated with heavy metals, as a result of the highly heterogeneous materials used in ash production. Hence, this research aimed to understand the current fertilizer employed by farmers, their perception and acceptability in utilization of household sewage sludge for agricultural purposes and their capacity in mitigating risks associated with such practice. Mixed methods approach was adopted, and data collection tools used include survey questionnaire, focus group discussion with farmers, participants and field observation. The study identified that farmers maintain a complex mixture of organic and chemical fertilizers, with mixture composition that is dependent on fertilizer availability and affordability. Also, farmers have decreased the rate of utilization of urban refuse ash due to labor and increased logistic cost and are keen to utilize household sewage sludge for soil fertility improvement but are mainly constrained by accessibility of this waste product. Nevertheless, farmers near to sewage disposal points have commenced utilization of household sewage sludge for improving soil fertility. Farmers were knowledgeable on composting but find their strategic method of dewatering and sun drying more convenient. Irrigation farmers were not enthusiastic for treatment, as they desired both water and sludge. Secondly, household sewage sludge observed in the field is heterogeneous due to nearness between its disposal point and that of urban refuse, which raises concern for possible cross-contamination of pollutants and also portrays lack of extension guidance as regards to treatment and management of household sewage sludge for agricultural purposes. Hence, farmers concerns need to be addressed, particularly in providing extension advice and establishment of decentralized household sewage sludge collection centers, for continuous availability of liquid and concentrated sludge. Urgent need is also required for the Federal Government of Nigeria to increase commitment towards empowering her subsidiaries for efficient discharge of corporate responsibilities.

Keywords: ash, farmers, household, peri-urban, refuse, sewage, sludge, urban

Procedia PDF Downloads 135

Authors: Alicia Yanadira Nava Fuentes, Ilse Cervantes Camacho, Amadeo José Argüelles Cruz, Ana María Balboa Verduzco

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Augmented reality promises being present in future driving, with its immersive technology let to show directions and maps to identify important places indicating with graphic elements when the car driver requires the information. On the other side, driving is considered a multitasking activity and, for some people, a complex activity where different situations commonly occur that require the immediate attention of the car driver to make decisions that contribute to avoid accidents; therefore, the main aim of the project is the instrumentation of a platform with biometric sensors that allows evaluating the performance in driving vehicles with the influence of augmented reality devices to detect the level of attention in drivers, since it is important to know the effect that it produces. In this study, the physiological sensors EPOC X (EEG), ECG06 PRO and EMG Myoware are joined in the driving test platform with a Logitech G29 steering wheel and the simulation software City Car Driving in which the level of traffic can be controlled, as well as the number of pedestrians that exist within the simulation obtaining a driver interaction in real mode and through a MSP430 microcontroller achieves the acquisition of data for storage. The sensors bring a continuous analog signal in time that needs signal conditioning, at this point, a signal amplifier is incorporated due to the acquired signals having a sensitive range of 1.25 mm/mV, also filtering that consists in eliminating the frequency bands of the signal in order to be interpretative and without noise to convert it from an analog signal into a digital signal to analyze the physiological signals of the drivers, these values are stored in a database. Based on this compilation, we work on the extraction of signal features and implement K-NN (k-nearest neighbor) classification methods and decision trees (unsupervised learning) that enable the study of data for the identification of patterns and determine by classification methods different effects of augmented reality on drivers. The expected results of this project include are a test platform instrumented with biometric sensors for data acquisition during driving and a database with the required variables to determine the effect caused by augmented reality on people in simulated driving.

Keywords: augmented reality, driving, physiological signals, test platform

Procedia PDF Downloads 141

Authors: Eftychia Kessopoulou, Styliani Xanthopoulou, Ypatia Theodorakioglou, George Tsiotras, Katerina Gotzamani

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Public sector managers frequently herald that implementing best practices as a set of standards, may lead to superior organizational performance. However, recent research questions the objectification of best practices, highlighting: a) the inability of public sector organizations to develop innovative administrative practices, as well as b) the adoption of stereotypical renowned practices inculcated in the public sector by international governance bodies. The process through which organizations construe what a best practice is, still remains a black box that is yet to be investigated, given the trend of continuous changes in public sector performance, as well as the burgeoning interest of sharing popular administrative practices put forward by international bodies. This study aims to describe and understand how organizational best practices are constructed by public sector performance management teams, like benchmarkers, during the benchmarking-mediated performance improvement process and what mechanisms enable this construction. A critical realist action research methodology is employed, starting from a description of various approaches on best practice nature when a benchmarking-mediated performance improvement initiative, such as the Common Assessment Framework, is applied. Firstly, we observed the benchmarker’s management process of best practices in a public organization, so as to map their theories-in-use. As a second step we contextualized best administrative practices by reflecting the different perspectives emerged from the previous stage on the design and implementation of an interview protocol. We used this protocol to conduct 30 semi-structured interviews with “best practice” process owners, in order to examine their experiences and performance needs. Previous research on best practices has shown that needs and intentions of benchmarkers cannot be detached from the causal mechanisms of the various contexts in which they work. Such causal mechanisms can be found in: a) process owner capabilities, b) the structural context of the organization, and c) state regulations. Therefore, we developed an interview protocol theoretically informed in the first part to spot causal mechanisms suggested by previous research studies and supplemented it with questions regarding the provision of best practice support from the government. Findings of this work include: a) a causal account of the nature of best administrative practices in the Greek public sector that shed light on explaining their management, b) a description of the various contexts affecting best practice conceptualization, and c) a description of how their interplay changed the organization’s best practice management.

Keywords: benchmarking, action research, critical realism, best practices, public sector

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Authors: Anna Rudzińska, Katarzyna Szklener, Pola Juchaniuk, Anna Rodzajweska, Katarzyna Machulska-Ciuraj, Monika Rychlik- Grabowska, Michał łOziński, Agnieszka Kolak-Bruks, SłAwomir Mańdziuk

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Introduction: Immune checkpoint inhibition (ICI) belongs to the modern forms of anti-cancer treatment. Due to the constant development and continuous research in the field of ICI, many aspects of the treatment are yet to be discovered. One of the less researched aspects of ICI treatment is the influence of the adverse effects on the treatment success rate. It is suspected that adverse events in the course of the ICI treatment indicate a better response rate and correlate with longer progression-free- survival. Methodology: The research was conducted with the usage of the documentation of the Department of Clinical Oncology and Chemotherapy. Data of the patients with a lung cancer diagnosis who were treated between 2019-2022 and received ICI treatment were analyzed. Results: Out of over 133 patients whose data was analyzed, the vast majority were diagnosed with non-small cell lung cancer. The majority of the patients did not experience adverse effects. Most adverse effects reported were classified as grade 1 or grade 2 according to CTCAE classification. Most adverse effects involved skin, thyroid and liver toxicity. Statistical significance was found for the adverse effect incidence and overall survival (OS) and progression-free survival (PFS) (p=0,0263) and for the time of toxicity onset and OS and PFS (p<0,001). The number of toxicity sites was statistically significant for prolonged PFS (p=0.0315). The highest OS was noted in the group presenting grade 1 and grade 2 adverse effects. Conclusions: Obtained results confirm the existence of the prolonged OS and PFS in the adverse-effects-charged patients, mostly in the group presenting mild to intermediate (Grade 1 and Grade 2) adverse effects and late toxicity onset. Simultaneously our results suggest a correlation between treatment response rate and the toxicity grade of the adverse effects and the time of the toxicity onset. Similar results were obtained in several similar research conducted - with the proven tendency of better survival in mild and moderate toxicity; meanwhile, other studies in the area suggested an advantage in patients with any toxicity regardless of the grade. The contradictory results strongly suggest the need for further research on this topic, with a focus on additional factors influencing the course of the treatment.

Keywords: adverse effects, immunotherapy, lung cancer, PD-1/PD-L1 inhibitors

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Authors: G. Ghamrawi, Y. Abunnasr, M. Fawaz, S. Yazigi

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Coastal cities are constantly exposed to environmental degradation and economic regression fueled by rapid and uncontrolled urban growth as well as continuous resource depletion. This is the case of the City of Mina in Tripoli (Lebanon), where lack of awareness to preserve social, ecological, and historical assets, coupled with the increasing development pressures, are threatening the socioeconomic status of the city residents, the quality of life and accessibility to the coast. To address these challenges, a holistic coastal urban design and planning approach was developed to analyze the environmental, political, legal, and socioeconomic context of the city. This approach aims to investigate the potential of balancing urban development with the protection and enhancement of cultural, ecological, and environmental assets under an integrated coastal zone management approach (ICZM). The analysis of Mina's different sectors adopted several tools that include direct field observation, interviews with stakeholders, analysis of available data, historical maps, and previously proposed projects. The findings from the analysis were mapped and graphically represented, allowing the recognition of character zones that become the design intervention units. Consequently, the thesis proposes an urban, city-scale intervention that identifies 6 different character zones (the historical fishing port, Abdul Wahab island, the abandoned Port Said, Hammam el Makloub, the sand beach, and the new developable area) and proposes context-specific design interventions that capitalize on the main characteristics of each zone. Moreover, the intervention builds on the institutional framework of ICZM as well as other studies previously conducted for the coast and adopts nature-based solutions with hybrid systems for providing better environmental design solutions for developing the coast. This enables the realization of an all-inclusive, well-connected shoreline with easy and free access towards the sea; a developed shoreline with an active local economy, and an improved urban environment.

Keywords: blue green infrastructure, coastal cities, hybrid solutions, integrated coastal zone management, sustainable development, urban planning

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Authors: Bartosz Olszanski, Zbigniew Nosal, Jacek Rokicki

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An experimental study of cold-jet (nitrogen) reaction control jet system has been carried out to investigate the flow control efficiency for low to moderate jet pressure ratios (total jet pressure p0jet over free stream static pressure in the wind tunnel p∞) and different angles of attack for infinite Mach number equal to 2. An investigation of jet influence was conducted on a flat plate geometry placed in the test section of intermittent supersonic wind tunnel of Department of Aerodynamics, WUT. Various convergent jet nozzle geometries to obtain different jet momentum ratios were tested on the same test model geometry. Surface static pressure measurements, Schlieren flow visualizations (using continuous and photoflash light source), load cell measurements gave insight into the supersonic crossflow interaction for different jet pressure and jet momentum ratios and their influence on the efficiency of side jet control as described by the amplification factor (actual to theoretical net force generated by the control nozzle). Moreover, the quasi-steady numerical simulations of flow through the same wind tunnel geometry (convergent-divergent nozzle plus test section) were performed using ANSYS Fluent basing on Reynolds-Averaged Navier-Stokes (RANS) solver incorporated with k-ω Shear Stress Transport (SST) turbulence model to assess the possible spurious influence of test section walls over the jet exit near field area of interest. The strong bow shock, barrel shock, and Mach disk as well as lambda separation region in front of nozzle were observed as images taken by high-speed camera examine the interaction of the jet and the free stream. In addition, the development of large-scale vortex structures (counter-rotating vortex pair) was detected. The history of complex static pressure pattern on the plate was recorded and compared to the force measurement data as well as numerical simulation data. The analysis of the obtained results, especially in the wake of the jet showed important features of the interaction mechanisms between the lateral jet and the flow field.

Keywords: flow visualization techniques, pressure measurements, reaction control jet, supersonic cross flow

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Authors: Amritee Bora, B. S. Mipun

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Land degradation is often used to describe the land environmental phenomena that reduce land’s original productivity both qualitatively and quantitatively. The study of land degradation vulnerability primarily deals with “Environmentally Sensitive Areas” (ESA) and the amount of topsoil loss due to erosion. In many studies, it is observed that the assessment of the existing status of land degradation is used to represent the vulnerability. Moreover, it is also noticed that in most studies, the primary emphasis of land degradation vulnerability is to assess its sensitivity to soil erosion only. However, the concept of land degradation vulnerability can have different objectives depending upon the perspective of the study. It shows the extent to which changes in land use land cover can imprint their effect on the land. In other words, it represents the susceptibility of a piece of land to degrade its productive quality permanently or in the long run. It is also important to mention that the vulnerability of land degradation is not a single factor outcome. It is a probability assessment to evaluate the status of land degradation and needs to consider both biophysical and human induce parameters. To avoid the complexity of the previous models in this regard, the present study has emphasized on to generate a simplified model to assess the land degradation vulnerability in terms of its current human population pressure, land use practices, and existing biophysical conditions. It is a “Mixed-Method” termed as the land degradation vulnerability index (LDVi). It was originally inspired by the MEDALUS model (Mediterranean Desertification and Land Use), 1999, and Farazadeh’s 2007 revised version of it. It has followed the guidelines of Space Application Center, Ahmedabad / Indian Space Research Organization for land degradation vulnerability. The model integrates the climatic index (Ci), vegetation index (Vi), erosion index (Ei), land utilization index (Li), population pressure index (Pi), and cover management index (CMi) by giving equal weightage to each parameter. The final result shows that the very high vulnerable zone primarily indicates three (3) prominent circumstances; land under continuous population pressure, high concentration of human settlement, and high amount of topsoil loss due to surface runoff within the study sites. As all the parameters of the model are amalgamated with equal weightage further with the help of regression analysis, the LDVi model also provides a strong grasp of each parameter and how far they are competent to trigger the land degradation process.

Keywords: population pressure, land utilization, soil erosion, land degradation vulnerability

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Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

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De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

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Authors: Bulcha Belay Etana, Benny Malengier, Debelo Oljira, Janarthanan Krishnamoorthy, Lieva Vanlangenhove

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Electromyography (EMG) is a technique used to measure the electrical activity of muscles. EMG can be used to assess muscle function in a variety of settings, including clinical, research, and sports medicine. The aim of this study was to develop a wearable textile sensor for EMG monitoring. The sensor was designed to be soft, stretchable, and washable, making it suitable for long-term use. The sensor was fabricated using a conductive thread material that was embroidered onto a fabric substrate. The sensor was then connected to a microcontroller unit (MCU) and a Wi-Fi-enabled module. The MCU was programmed to acquire the EMG signal and transmit it wirelessly to the Wi-Fi-enabled module. The Wi-Fi-enabled module then sent the signal to a server, where it could be accessed by a computer or smartphone. The sensor was able to successfully acquire and transmit EMG signals from a variety of muscles. The signal quality was comparable to that of commercial EMG sensors. The development of this sensor has the potential to improve the way EMG is used in a variety of settings. The sensor is soft, stretchable, and washable, making it suitable for long-term use. This makes it ideal for use in clinical settings, where patients may need to wear the sensor for extended periods of time. The sensor is also small and lightweight, making it ideal for use in sports medicine and research settings. The data for this study was collected from a group of healthy volunteers. The volunteers were asked to perform a series of muscle contractions while the EMG signal was recorded. The data was then analyzed to assess the performance of the sensor. The EMG signals were analyzed using a variety of methods, including time-domain analysis and frequency-domain analysis. The time-domain analysis was used to extract features such as the root mean square (RMS) and average rectified value (ARV). The frequency-domain analysis was used to extract features such as the power spectrum. The question addressed by this study was whether a wearable textile sensor could be developed that is soft, stretchable, and washable and that can successfully acquire and transmit EMG signals. The results of this study demonstrate that a wearable textile sensor can be developed that meets the requirements of being soft, stretchable, washable, and capable of acquiring and transmitting EMG signals. This sensor has the potential to improve the way EMG is used in a variety of settings.

Keywords: EMG, electrode position, smart wearable, textile sensor, IoT, IoT-integrated textile sensor

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Authors: Qirat Naz, Abasiokpon Udoakah

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In developed countries, global migration is diversifying. The minority ethnic population, including refugees and asylum seekers who, fled their home countries due to war, terrorism, oppression, or natural disasters, and returning home is dangerous for them. They need sanctuary and peaceful environment in host countries. They begin the process of acculturation, in which a person adopts the social mores and behavioral patterns of the dominant culture, yet they still have unique multicultural needs that the dominant society fails to address. The aim of this research is to provide a holistic understanding of the living experiences of a minority population, particularly migrants, including asylum seekers and refugees, in the health and social care system of South Wales. The purpose of this study is to investigate three research objectives: the multicultural health care needs of minorities, as well as the barriers to seeking health and social care facilities. There are Welsh policies for promoting cultural competence in the health and social care sectors; this research will explore the implications and impact of these policies on the target population. This research study will be conducted using qualitative research methods, tools, and techniques. This research is an inductive approach to coming up with a grounded theory. The sample will be divided into two groups: migrants and professionals providing any kind of services to migrants; each group will contain 30 participants. Interpretive phenomenological analysis would be utilized during the process of coding and developing the main themes of this research. The positionality of the researcher would be minimized by unloaded and open-ended questions, researcher’s work experience in research, continuous evaluation of her positionality, daily base reflection of fieldwork and seeking the help of male and female gatekeepers. The research findings would be based on emic perspective, and by documenting the emic perspective of minorities, this research will contribute to the knowledge of appropriate channels, including organizations, academics, and policymakers, to discover possible solutions and coping mechanisms to deal with the challenges and meet the multicultural demands of minorities. This research will provide a more in-depth understanding of minorities and will help to promote the diversity of health and social care in South Wales.

Keywords: migration, migrants, cultural competence, cultural barriers, healthcare challenges

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Authors: Marilou Cadatal-Raduban, Minh Hong Pham, Duong Van Pham, Tu Nguyen Xuan, Mui Viet Luong, Kohei Yamanoi, Toshihiko Shimizu, Nobuhiko Sarukura, Hung Dai Nguyen

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There is a great deal of interest in developing all-solid-state tunable ultrashort pulsed lasers emitting in the ultraviolet (UV) region for applications such as micromachining, investigation of charge carrier relaxation in conductors, and probing of ultrafast chemical processes. However, direct short-pulse generation is not as straight forward in solid-state gain media as it is for near-IR tunable solid-state lasers such as Ti:sapphire due to the difficulty of obtaining continuous wave laser operation, which is required for Kerr lens mode-locking schemes utilizing spatial or temporal Kerr type nonlinearity. In this work, the transient cavity method, which was reported to generate ultrashort laser pulses in dye lasers, is extended to a solid-state gain medium. Ce:LiCAF was chosen among the rare-earth-doped fluoride laser crystals emitting in the UV region because of its broad tunability (from 280 to 325 nm) and enough bandwidth to generate 3-fs pulses, sufficiently large effective gain cross section (6.0 x10⁻¹⁸ cm²) favorable for oscillators, and a high saturation fluence (115 mJ/cm²). Numerical simulations are performed to investigate the spectro-temporal evolution of the broadband UV laser emission from Ce:LiCAF, represented as a system of two homogeneous broadened singlet states, by solving the rate equations extended to multiple wavelengths. The goal is to find the appropriate cavity length and Q-factor to achieve the optimal photon cavity decay time and pumping energy for resonator transients that will lead to ps UV laser emission from a Ce:LiCAF crystal pumped by the fourth harmonics (266nm) of a Nd:YAG laser. Results show that a single ps pulse can be generated from a 1-mm, 1 mol% Ce³⁺-doped LiCAF crystal using an output coupler with 10% reflectivity (low-Q) and an oscillator cavity that is 2-mm long (short cavity). This technique can be extended to other fluoride-based solid-state laser gain media.

Keywords: rare-earth-doped fluoride gain medium, transient cavity, ultrashort laser, ultraviolet laser

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Authors: Carolinda Douglass

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Institutional Effectiveness (IE) is the purposeful integration of functions that foster student success and support institutional performance. IE is growing rapidly within higher education as it is increasingly viewed by higher education administrators as a beneficial approach for promoting data-informed decision-making in campus-wide strategic planning and execution of strategic initiatives. Specific IE tools, including, but not limited to, project management; impactful collaboration and communication; commitment to continuous quality improvement; and accountability through rigorous evaluation; are gaining momentum under the auspices of IE. This research utilizes a case study approach to examine the use of these IE tools, highlight successes of this use, and identify areas for improvement in the implementation of IE tools within higher education. The research includes three case studies: (1) improving upon academic program review processes including the assessment of student learning outcomes as a core component of program quality; (2) revising an institutional vision, mission, and core values; and (3) successfully navigating an institution-wide re-accreditation process. Several methods of data collection are embedded within the case studies, including surveys, focus groups, interviews, and document analyses. Subjects of these methods include higher education administrators, faculty, and staff. Key findings from the research include areas of success and areas for improvement in the use of IE tools associated with specific case studies as well as aggregated results across case studies. For example, the use of case management proved useful in all of the case studies, while rigorous evaluation did not uniformly provide the value-added that was expected by higher education decision-makers. The use of multiple IE tools was shown to be consistently useful in decision-making when applied with appropriate awareness of and sensitivity to core institutional culture (for example, institutional mission, local environments and communities, disciplinary distinctions, and labor relations). As IE gains a stronger foothold in higher education, leaders in higher education can make judicious use of IE tools to promote better decision-making and secure improved outcomes of strategic planning and the execution of strategic initiatives.

Keywords: accreditation, data-informed decision-making, higher education management, institutional effectiveness tools, institutional mission, program review, strategic planning

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Authors: Adnan Bekhit, Eskedar Lodebo, Ariaya Hymete, Hanan Ragab, Alaa El-Din Bekhit

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Malaria and leishmaniasis have emerged as serious universal health problems throughout history of mankind. According to the WHO 2008 malarial report, half of the world population is at risk of malarial infection with an estimate of 1 million deaths occurring annually mainly in the African region. Furthermore, 12-15 million people are infected with Leishmaniasis worldwide. Despite the continuous introduction of a large number of agents for the treatment of malaria, there is still unmet medical needs due to the emergence of resistance. Resistance has occurred for almost all therapeutic agents approved for the treatment of malaria. Accordingly, it was the aim of this work to design and synthesis a group of antimalarial-antileshmanial agents that would show inhibitory activity against chloroquine-resistant strain of Plasmodium falciparum. The synthesized compounds were designed to contain a pyrazolylpyrazoline moiety having an aromatic group (p-tolyl or p-chlorophenyl) at N1-position of one pyrazoline ring due to the reports of promising activities of such compounds. A formyl or acyl substituent was introduced at the N1-position of the other pyrazoline ring, to investigate the effect of bulkiness of acyl substituents at this position. The synthesized compounds were evaluated for their in-vivo antimalarial activity against Plasmodium berghei infected mice at dose levels of 20 and 30 mg/Kg. the two most active compounds were evaluated for their antimalarial activity against chloroquin-resistant strain (RKL9) of Plasmodium falciparum. In addition, the synthesized compounds were tested for their in-vitro antileshmanial activity against Leishmania aethiopica promastigotes and amastigotes. For both antimalarial and antileishmanial activities, compounds having an N1-p-tolyl group at the first pyrazoline ring did not require bulkiness at the second pyrazoline ring nitrogen where the compound bearing an acetyl group proved to be the most active of the whole series. On the other hand, bulkiness at the N1-position of the second pyazoline ring was necessary in case of compounds carrying the p-chlorophenyl group, where the two derivatives having an N1-butanoyl and an N1-benzoyl moieties at the second pyrazoline showed the best activity. Furthermore, the toxicity of the active compounds were tested and were proved to be non-toxic at 125, 250 and 500 mg/Kg. In addition, docking of the most active compound (having a p-tolyl group at the first pyrazoline-N and an acetyl moiety on the other pyrazoline-N) was performed against dihydrofolate reductase enzyme.

Keywords: pyrazoline derivatives, in-vivo antimalarial activity, docking, dihydrofolate reductase

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Authors: Sangwoo Han, Saeed Khaleghi Rahimian, Ying Liu

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Vehicle electrification is gaining momentum, and many car manufacturers promise to deliver more electric vehicle (EV) models to consumers in the coming years. In controlling the battery pack, the battery management system (BMS) must maintain optimal battery performance while ensuring the safety of a battery pack. Tasks related to battery performance include determining state-of-charge (SOC), state-of-power (SOP), state-of-health (SOH), cell balancing, and battery charging. Safety related functions include making sure cells operate within specified, static and dynamic voltage window and temperature range, derating power, detecting faulty cells, and warning the user if necessary. The BMS often utilizes an RC circuit model to model a Li-ion cell because of its robustness and low computation cost among other benefits. Because an equivalent circuit model such as the RC model is not a physics-based model, it can never be a prognostic model to predict battery state-of-health and avoid any safety risk even before it occurs. A physics-based Li-ion cell model, on the other hand, is more capable at the expense of computation cost. To avoid the high computation cost associated with a full-order model, many researchers have demonstrated the use of a single particle model (SPM) for BMS applications. One drawback associated with the single particle modeling approach is that it forces to use the average current density in the calculation. The SPM would be appropriate for simulating drive cycles where there is insufficient time to develop a significant current distribution within an electrode. However, under a continuous or high-pulse electrical load, the model may fail to predict cell voltage or Li⁺ plating potential. To overcome this issue, a multi-particle reduced-order model is proposed here. The use of multiple particles combined with either linear or nonlinear charge-transfer reaction kinetics enables to capture current density distribution within an electrode under any type of electrical load. To maintain computational complexity like that of an SPM, governing equations are solved sequentially to minimize iterative solving processes. Furthermore, the model is validated against a full-order model implemented in COMSOL Multiphysics.

Keywords: battery management system, physics-based li-ion cell model, reduced-order model, single-particle and multi-particle model

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Authors: Miguel Limbert Ramos, Joseph Amado Galvez

Abstract:

Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

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