Search results for: complete heart block
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4205

Search results for: complete heart block

1175 Collapse Load Analysis of Reinforced Concrete Pile Group in Liquefying Soils under Lateral Loading

Authors: Pavan K. Emani, Shashank Kothari, V. S. Phanikanth

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The ultimate load analysis of RC pile groups has assumed a lot of significance under liquefying soil conditions, especially due to post-earthquake studies of 1964 Niigata, 1995 Kobe and 2001 Bhuj earthquakes. The present study reports the results of numerical simulations on pile groups subjected to monotonically increasing lateral loads under design amounts of pile axial loading. The soil liquefaction has been considered through the non-linear p-y relationship of the soil springs, which can vary along the depth/length of the pile. This variation again is related to the liquefaction potential of the site and the magnitude of the seismic shaking. As the piles in the group can reach their extreme deflections and rotations during increased amounts of lateral loading, a precise modeling of the inelastic behavior of the pile cross-section is done, considering the complete stress-strain behavior of concrete, with and without confinement, and reinforcing steel, including the strain-hardening portion. The possibility of the inelastic buckling of the individual piles is considered in the overall collapse modes. The model is analysed using Riks analysis in finite element software to check the post buckling behavior and plastic collapse of piles. The results confirm the kinds of failure modes predicted by centrifuge test results reported by researchers on pile group, although the pile material used is significantly different from that of the simulation model. The extension of the present work promises an important contribution to the design codes for pile groups in liquefying soils.

Keywords: collapse load analysis, inelastic buckling, liquefaction, pile group

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1174 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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1173 Raising Forest Voices: A Cross-Country Comparative Study of Indigenous Peoples’ Engagement with Grassroots Climate Change Mitigation Projects in the Initial Pilot Phase of Community-Based Reducing Emissions from Deforestation and forest Degradation

Authors: Karl D. Humm

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The United Nations’ Community-based REDD+ (Reducing Emissions from Deforestation and forest Degradation) (CBR+) is a programme that directly finances grassroots climate change mitigation strategies that uplift Indigenous Peoples (IPs) and other marginalised groups. A pilot for it in six countries was developed in response to criticism of the REDD+ programme for excluding IPs from dialogues about climate change mitigation strategies affecting their lands and livelihoods. Despite the pilot’s conclusion in 2017, no complete report has yet been produced on the results of CBR+. To fill this gap, this study investigated the experiences with involving IPs in the CBR+ programmes and local projects across all six pilot countries. A literature review of official UN reports and academic articles identified challenges and successes with IP participation in REDD+ which became the basis for a framework guiding data collection. A mixed methods approach was used to collect and analyse qualitative and quantitative data from CBR+ documents and written interviews with CBR+ National Coordinators in each country for a cross-country comparative analysis. The study found that the most frequent challenges were lack of organisational capacity, illegal forest activities, and historically-based contentious relationships in IP and forest-dependent communities. Successful programmes included IPs and incorporated respect and recognition of IPs as major stakeholders in managing sustainable forests. Findings are summarized and shared with a set of recommendations for improvement of future projects.

Keywords: climate change, forests, indigenous peoples, REDD+

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1172 Municipal Solid Waste (MSW) Composition and Generation in Nablus City, Palestine

Authors: Issam A. Al-Khatib

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In order to achieve a significant reduction of waste amount flowing into landfills, it is important to first understand the composition of the solid municipal waste generated. Hence a detailed analysis of municipal solid waste composition has been conducted in Nablus city. The aim is to provide data on the potential recyclable fractions in the actual waste stream, with a focus on the plastic fraction. Hence, waste-sorting campaigns were conducted on mixed waste containers from five districts in Nablus city. The districts vary in terms of infrastructure and average income. The target is to obtain representative data about the potential quantity and quality of household plastic waste. The study has measured the composition of municipal solid waste collected/ transported by Nablus municipality. The analysis was done by categorizing the samples into eight primary fractions (organic and food waste, paper and cardboard, glass, metals, textiles, plastic, a fine fraction (<10 mm), and others). The study results reveal that the MSW stream in Nablus city has a significant bio- and organic waste fraction (about 68% of the total MSW). The second largest fraction is paper and cardboard (13.6%), followed by plastics (10.1%), textiles (3.2%), glass (1.9%), metals (1.8%), a fine fraction (0.5%), and other waste (0.3%). After this complete and detailed characterization of MSW collected in Nablus and taking into account the content of biodegradable organic matter, the composting could be a solution for the city of Nablus where the surrounding areas of Nablus city have agricultural activities and could be a natural outlet to the compost product. Different waste management options could be practiced in the future in addition to composting, such as energy recovery and recycling, which result in a greater possibility of reducing substantial amounts that are disposed of at landfills.

Keywords: developing countries, composition, management, recyclable, waste.

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1171 An Observational Study Assessing the Baseline Communication Behaviors among Healthcare Professionals in an Inpatient Setting in Singapore

Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong

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Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.

Keywords: healthcare communication, healthcare management, nursing, qualitative observational study

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1170 Optimization of Quercus cerris Bark Liquefaction

Authors: Luísa P. Cruz-Lopes, Hugo Costa e Silva, Idalina Domingos, José Ferreira, Luís Teixeira de Lemos, Bruno Esteves

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The liquefaction process of cork based tree barks has led to an increase of interest due to its potential innovation in the lumber and wood industries. In this particular study the bark of Quercus cerris (Turkish oak) is used due to its appreciable amount of cork tissue, although of inferior quality when compared to the cork provided by other Quercus trees. This study aims to optimize alkaline catalysis liquefaction conditions, regarding several parameters. To better comprehend the possible chemical characteristics of the bark of Quercus cerris, a complete chemical analysis was performed. The liquefaction process was performed in a double-jacket reactor heated with oil, using glycerol and a mixture of glycerol/ethylene glycol as solvents, potassium hydroxide as a catalyst, and varying the temperature, liquefaction time and granulometry. Due to low liquefaction efficiency resulting from the first experimental procedures a study was made regarding different washing techniques after the filtration process using methanol and methanol/water. The chemical analysis stated that the bark of Quercus cerris is mostly composed by suberin (ca. 30%) and lignin (ca. 24%) as well as insolvent hemicelluloses in hot water (ca. 23%). On the liquefaction stage, the results that led to higher yields were: using a mixture of methanol/ethylene glycol as reagents and a time and temperature of 120 minutes and 200 ºC, respectively. It is concluded that using a granulometry of <80 mesh leads to better results, even if this parameter barely influences the liquefaction efficiency. Regarding the filtration stage, washing the residue with methanol and then distilled water leads to a considerable increase on final liquefaction percentages, which proves that this procedure is effective at liquefying suberin content and lignocellulose fraction.

Keywords: liquefaction, Quercus cerris, polyalcohol liquefaction, temperature

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1169 Comparison of the Results of a Parkinson’s Holter Monitor with Patient Diaries, in Real Conditions of Use: A Sub-Analysis of the MoMoPa-EC Clinical Trial

Authors: Alejandro Rodríguez-Molinero, Carlos Pérez-López, Jorge Hernández-Vara, Àngels Bayes-Rusiñol, Juan Carlos Martínez-Castrillo, David A. Pérez-Martínez

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Background: Monitoring motor symptoms in Parkinson's patients is often a complex and time-consuming task for clinicians, as Hauser's diaries are often poorly completed by patients. Recently, new automatic devices (Parkinson's holter: STAT-ON®) have been developed capable of monitoring patients' motor fluctuations. The MoMoPa-EC clinical trial (NCT04176302) investigates which of the two methods produces better clinical results. In this sub-analysis, the concordance between both methods is analyzed. Methods: In the MoMoPa-EC clinical trial, 164 patients with moderate-severe Parkinson's disease and at least two hours a day of Off will be included. At the time of patient recruitment, all of them completed a seven-day motor fluctuation diary at home (Hauser’s diary) while wearing the Parkinson's holter. In this sub-analysis, 71 patients with complete data for the purpose of this comparison were included. The intraclass correlation coefficient was calculated between the patient diary entries and the Parkinson's holter data in terms of time On, Off, and time with dyskinesias. Results: The intra-class correlation coefficient of both methods was 0.57 (95% CI: 0.3-0.74) for daily time in Off (%), 0.48 (95% CI: 0.14-0.68) for daily time in On (%), and 0.37 (95% CI %: -0.04-0.62) for daily time with dyskinesias (%). Conclusions: Both methods have a moderate agreement with each other. We will have to wait for the results of the MoMoPa-EC project to estimate which of them has the greatest clinical benefits. Acknowledgment: This work is supported by AbbVie S.L.U, the Instituto de Salud Carlos III [DTS17/00195], and the European Fund for Regional Development, 'A way to make Europe'.

Keywords: Parkinson, sensor, motor fluctuations, dyskinesia

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1168 Investigation and Identification of a Number of Precious and Semi-precious Stones Related to Bam Historical Citadel Using Micro Raman Spectroscopy and Scanning Electron Microscopy (SEM/EDX)

Authors: Nazli Darkhal

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The use of gems and ornaments has been common in Iran since the beginning of history. The prosperity of the country, the wealth, and the interest of the people of this land in luxurious and glorious life, combined with beauty, have always attracted the attention of the gems and ornaments of the Iranian people. Iranians are famous in the world for having a long history of collecting and recognizing precious stones. In this case, we can use the unique treasure of national jewelry. Raman spectroscopy method is one of the oscillating spectroscopy methods that is classified in the group of nondestructive study methods, and like other methods, in addition to several advantages, it also has disadvantages and problems. Micro Raman spectroscopy is one of the different types of Raman spectroscopy in which an optical microscope is combined with a Raman device to provide more capabilities and advantages than its original method. In this way, with the help of Raman spectroscopy and a light microscope, while observing more details from different parts of the historical sample, natural or artificial pigments can be identified in a small part of it. The EDX electron microscope also functions as the basis for the interaction of the electron beam with the matter. The beams emitted from this interaction can be used to examine samples. In this article, in addition to introducing the micro Raman spectroscopy method, studies have been conducted on the structure of three samples of existing stones in the historic citadel of Bam. Using this method of study on precious and semi-precious stones, in addition to requiring a short time, can provide us with complete information about the structure and theme of these samples. The results of experiments and gemology of the stones showed that the selected beads are agate and jasper, and they can be placed in the chalcedony group.

Keywords: bam citadel, precious and semi-precious stones, Raman spectroscopy, scanning electron microscope

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1167 The Quantum Theory of Music and Human Languages

Authors: Mballa Abanda Luc Aurelien Serge, Henda Gnakate Biba, Kuate Guemo Romaric, Akono Rufine Nicole, Zabotom Yaya Fadel Biba, Petfiang Sidonie, Bella Suzane Jenifer

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The main hypotheses proposed around the definition of the syllable and of music, of the common origin of music and language, should lead the reader to reflect on the cross-cutting questions raised by the debate on the notion of universals in linguistics and musicology. These are objects of controversy, and there lies its interest: the debate raises questions that are at the heart of theories on language. It is an inventive, original, and innovative research thesis. A contribution to the theoretical, musicological, ethno musicological, and linguistic conceptualization of languages, giving rise to the practice of interlocution between the social and cognitive sciences, the activities of artistic creation, and the question of modeling in the human sciences: mathematics, computer science, translation automation, and artificial intelligence. When you apply this theory to any text of a folksong of a world-tone language, you do not only piece together the exact melody, rhythm, and harmonies of that song as if you knew it in advance but also the exact speaking of this language. The author believes that the issue of the disappearance of tonal languages and their preservation has been structurally resolved, as well as one of the greatest cultural equations related to the composition and creation of tonal, polytonal, and random music. The experimentation confirming the theorization, I designed a semi-digital, semi-analog application that translates the tonal languages of Africa (about 2,100 languages) into blues, jazz, world music, polyphonic music, tonal and anatonal music, and deterministic and random music). To test this application, I use music reading and writing software that allows me to collect the data extracted from my mother tongue, which is already modeled in the musical staves saved in the ethnographic (semiotic) dictionary for automatic translation ( volume 2 of the book). The translation is done (from writing to writing, from writing to speech, and from writing to music). Mode of operation: you type a text on your computer, a structured song (chorus-verse), and you command the machine a melody of blues, jazz, and world music or variety, etc. The software runs, giving you the option to choose harmonies, and then you select your melody.

Keywords: language, music, sciences, quantum entenglement

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1166 An Experimental Investigation on the Fuel Characteristics of Nano-Aluminium Oxide and Nano-Cobalt Oxide Particles Blended in Diesel Fuel

Authors: S. Singh, P. Patel, D. Kachhadiya, Swapnil Dharaskar

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The research objective is to integrate nanoparticles into fuels- i.e. diesel, biodiesel, biodiesel blended with diesel, plastic derived fuels, etc. to increase the fuel efficiency. The metal oxide nanoparticles will reduce the carbon monoxide emissions by donating oxygen atoms from their lattices to catalyze the combustion reactions and to aid complete combustion; due to this, there will be an increase in the calorific value of the blend (fuel + metal nanoparticles). Aluminium oxide and cobalt oxide nanoparticles have been synthesized by sol-gel method. The characterization was done by Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Diffraction (XRD), Scanning Electron Microscope (SEM) and Energy Dispersive X-ray Spectroscopy (EDS). The size of the particles was determined by XRD to be 28.6 nm and 28.06 nm for aluminium oxide and cobalt oxide nanoparticles respectively. Different concentration blends- 50, 100, 150 ppm were prepared by adding the required weight of metal oxides in 1 liter of diesel and sonicating for 30 minutes at 500W. The blend properties- calorific value, viscosity, and flash point were determined by bomb calorimeter, Brookfield viscometer and pensky-martin apparatus. For the aluminum oxide blended diesel, there was a maximum increase of 5.544% in the calorific value, but at the same time, there was an increase in the flash point from 43°C to 58.5°C and an increase in the viscosity from 2.45 cP to 3.25 cP. On the other hand, for the cobalt oxide blended diesel there was a maximum increase of 2.012% in the calorific value while the flash point increased from 43°C to 51.5°C and the viscosity increased from 2.45 cP to 2.94 cP. There was a linear increase in the calorific value, viscosity and flash point when the concentration of the metal oxide nanoparticles in the blend was increased. For the 50 ppm Al₂O₃ and 50 ppm Co₃O₄ blend the increasing the calorific value was 1.228 %, and the viscosity changed from 2.45 cP to 2.64 cP and the flash point increased from 43°C to 50.5°C. Clearly the aluminium oxide nanoparticles increase the calorific value but at the cost of flash point and viscosity, thus it is better to use the 50 ppm aluminium oxide, and 50 ppm cobalt oxide blended diesel.

Keywords: aluminium oxide nanoparticles, cobalt oxide nanoparticles, fuel additives, fuel characteristics

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1165 Adenoid Cystic Carcinoma of the Lacrimal Gland (About a Case)

Authors: H. Hadjeris, R. B. Ghoul, Lekhlaf, M. Nebbal

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Introduction: Adenoid cystic carcinomas of the lacrimal gland or orbital cylindroma constitute the second cause of epithelial tumors of this gland. It is a malignant tumor usually developed at the expense of the salivary glands; its orbital location is exceptional. It is a rare clinical entity, formidable by its malignancy and local aggressiveness; the recurrence rate is high. Materials and methods: Clinical case: 63 years old woman who presents with irreducible no pulsatile painful left exophthalmos with inflammatory chemosis and a decrease in visual acuity with a moderate intracranial hypertension syndrome that has been evolving for 03 months. Antecedent; a biopsy of the tumor was made; the histological examination was in favor of an adenoid cystic carcinoma of the lacrimal gland. Lesion assessment: computed tomography and brain MRI: show an intra and extra-conical mass; with sinus (ethmoido-frontal) and cerebral (left frontal) extension strongly enhanced after injection of contrast product surrounded by edema around the lesion, associated with left frontal bone lysis extension assessment: unremarkable treatment: Patient operated by left frontotemporal approach, a total exenteration was performed with macroscopically complete excision of the frontal lesion and wide frontal craniectomy with craniofacial reconstruction, followed by complementary radiotherapy. Results: The patient was seen again after 3 months in consultation; she does not present any signs in favor of a recurrence. Conclusion: Adenoid cystic carcinomas of the lacrimal gland are rare malignant tumors; they are very infiltrating and invasive. The prognosis is strongly linked to the treatment time.

Keywords: adenoid cystic, lacrimal gland, orbital location, fronto-temporal approac

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1164 A Modelling of Main Bearings in the Two-Stroke Diesel Engine

Authors: Marcin Szlachetka, Rafal Sochaczewski, Lukasz Grabowski

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This paper presents the results of the load simulations of main bearings in a two-stroke Diesel engine. A model of an engine lubrication system with connections of its main lubrication nodes, i.e., a connection of its main bearings in the engine block with the crankshaft, a connection of its crankpins with its connecting rod and a connection of its pin and its piston has been created for our calculations performed using the AVL EXCITE Designer. The analysis covers the loads given as a pressure distribution in a hydrodynamic oil film, a temperature distribution on the main bush surfaces for the specified radial clearance values as well as the impact of the force of gas on the minimum oil film thickness in the main bearings depending on crankshaft rotational speeds and temperatures of oil in the bearings. One of the main goals of the research has been to determine whether the minimum thickness of the oil film at which fluid friction occurs can be achieved for each value of crankshaft speed. Our model calculates different oil film parameters, i.e., its thickness, a pressure distribution there, the change in oil temperature. Additional enables an analysis of an oil temperature distribution on the surfaces of the bearing seats. It allows verifying the selected clearances in the bearings of the main engine under normal operation conditions and extremal ones that show a significant increase in temperature above the limit value. The research has been conducted for several engine crankshaft speeds ranging from 1000 rpm to 4000 rpm. The oil pressure in the bearings has ranged 2-5 bar according to engine speeds and the oil temperature has ranged 90-120 °C. The main bearing clearance has been adopted for the calculation and analysis as 0.025 mm. The oil classified as SAE 5W-30 has been used for the simulations. The paper discusses the selected research results referring to several specific operating points and different temperatures of the lubricating oil in the bearings. The received research results show that for the investigated main bearing bushes of the shaft, the results fall within the ranges of the limit values despite the increase in the oil temperature of the bearings reaching 120˚C. The fact that the bearings are loaded with the maximum pressure makes no excessive temperature rise on the bush surfaces. The oil temperature increases by 17˚C, reaching 137˚C at a speed of 4000 rpm. The minimum film thickness at which fluid friction occurs has been achieved for each of the operating points at each of the engine crankshaft speeds. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A.’ and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: diesel engine, main bearings, opposing pistons, two-stroke

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1163 Acupoint Injection of High Concentration of Glucose Attenuates Mice Chronic Pain and Depression Comorbidity

Authors: Chanya Inprasit, Yi-Wen Lin

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Inflammation causes changes of peripheral and central nervous system properties, affecting both neuronal and non-neuronal cells, resulting in inflammatory pain. Acupoint injection (AI) was developed in the 1950s and has been widely used for relieving pain. It is an acupoint-stimulating technique that utilizes anatomically based meridians derived from Chinese medicine theory. AI has been accepted as an effective treatment and is thought to display superior results when compared to traditional acupuncture methods. However, the mechanism of AI needs to be ratified by more scientific evidence in order to support the theory and its therapeutic development. In this study, we explored the effect of AI on the comorbidity of chronic pain and depression. Mice hindpaw was injected by complete Freund’s adjuvant (CFA) to induce the condition of chronic pain. Measurements of mechanical and thermal hyperalgesia and depression-like behavior were analyzed. The results indicated a positive tendency to AI treatment. The comorbidity of chronic pain and depression was investigated with relation to transient receptor potential V1 (TRPV1) mechanism through the use of TRPV1 gene deletion. The expression of nociceptors such as voltage-gated sodium channels (Navs) or TRPV1, was significantly down-regulated by AI. The expression of inflammation-activated molecules: astrocytic marker glial fibrillary acidic protein (GFAP), the microglial marker Iba-1, S100B, and related kinases, were reversed by AI in both the peripheral and central nervous system. Taken together, these data provided a detailed molecular mechanism of AI-induced analgesia and anti-inflammatory properties. This finding may be utilized for clinical practice to treat chronic pain and depression comorbidity.

Keywords: inflammatory pain, acupoint injection, TRPV1, GFAP, S100B

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1162 Soil-Less Misting System: A Technology for Hybrid Seed Production in Tomato (Lycopersicon esculentum Mill.).

Authors: K. D. Rajatha, S. Rajendra Prasad, N. Nethra

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Aeroponics is one of the advanced techniques to cultivate plants without soil with minimal water and nutrient consumption. This is the technology which could bring the vertical growth in agriculture. It is an eco-friendly approach widely used for commercial cultivation of vegetables to obtain the supreme quality and yield. In this context, to harvest potentiality of the technology, an experiment was designed to evaluate the suitability of the aeroponics method over the conventional method for hybrid seed production of tomato. The experiment was carried out under Completely Randomized Design with Factorial (FCRD) concept with three replications during the year 2017-18 at UAS, GKVK Bengaluru. Nutrients and pH were standardized; among the six different nutrient solutions, the crop performance was better in Hoagland’s solution with pH between 5.5-7. The results of the present study revealed that between TAG1F and TAG2F parental lines, TAG1F performed better in both the methods of seed production. Among the methods, aeroponics showed better performance for the quality parameters except for plant spread, due to better availability of nutrients and aeration, huge root biomass in aeroponics. Aeroponics method showed significantly higher plant length (124.9 cm), plant growth rate (0.669), seedling survival rate (100%), early flowering (27.5 days), highest fruit weight (121.5 g), 100 seed weight (0.373 g) and total seed yield plant⁻¹ (11.68 g) compared to the conventional method. By providing the best environment for plant growth, the genetically best possible plant could be grown, thus complete potentiality of the plant could be harvested. Hence, aeroponics could be a promising tool for quality and healthy hybrid seed production throughout the year within protected cultivation.

Keywords: aeroponics, Hoagland’s solution, hybrid seed production, Lycopersicon esculentum

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1161 Internet of Health Things as a Win-Win Solution for Mitigating the Paradigm Shift inside Senior Patient-Physician Shared Health Management

Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: health management, internet of health things, remote monitoring, senior patient

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1160 Development and Validation of Employee Trust Scale: Factor Structure, Reliability and Validity

Authors: Chua Bee Seok, Getrude Cosmas, Jasmine Adela Mutang, Shazia Iqbal Hashmi

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The aims of this study were to determine the factor structure and psychometric properties (i.e., reliability and convergent validity) of the employees trust scale, a newly created instrument by the researchers. The employees trust scale initially contained 82 items to measure employee’s trust toward their supervisors. A sample of 818 (343 females, 449 males) employees were selected randomly from public and private organization sectors in Kota Kinabalu, Sabah, Malaysia. Their ages ranged from 19 to 67 years old with the mean of 34.55 years old. Their average tenure with their current employer was 11.2 years (s.d. = 7.5 years). The respondents were asked to complete the employees trust scale, as well as a managerial trust questionnaire from Mishra. The exploratory factor analysis on employee’s trust toward their supervisor’s extracted three factors, labeled 'trustworthiness' (32 items), 'position status' (11 items) and 'relationship' (6 items) which accounted for 62.49% of the total variance. Trustworthiness factors were re-categorized into three sub factors: competency (11 items), benevolence (8 items) and integrity (13 items). All factors and sub factors of the scales demonstrated clear reliability with internal consistency of Cronbach’s Alpha above 0.85. The convergent validity of the Scale was supported by an expected pattern of correlations (positive and significant correlation) between the score of all factors and sub factors of the scale and the score on the managerial trust questionnaire which measured the same construct. The convergent validity of employees trust scale was further supported by the significant and positive inter correlation between the factors and sub factors of the scale. The results suggest that the employees trust scale is a reliable and valid measure. However, further studies need to be carried out in other groups of sample as to further validate the Scale.

Keywords: employees trust scale, psychometric properties, trustworthiness, position status, relationship

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1159 Nursing Documentation of Patients' Information at Selected Primary Health Care Facilities in Limpopo Province, South Africa: Implications for Professional Practice

Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese

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Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.

Keywords: documentation, knowledge, patient care, patient’s information, training

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1158 Human Coronary Sinus Venous System as a Target for Clinical Procedures

Authors: Wiesława Klimek-Piotrowska, Mateusz K. Hołda, Mateusz Koziej, Katarzyna Piątek, Jakub Hołda

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Introduction: The coronary sinus venous system (CSVS), which has always been overshadowed by the coronary arterial tree, has recently begun to attract more attention. Since it is a target for clinicians the knowledge of its anatomy is essential. Cardiac resynchronization therapy, catheter ablation of cardiac arrhythmias, defibrillation, perfusion therapy, mitral valve annuloplasty, targeted drug delivery, and retrograde cardioplegia administration are commonly used therapeutic methods involving the CSVS. The great variability in the course of coronary veins and tributaries makes the diagnostic and therapeutic processes difficult. Our aim was to investigate detailed anatomy of most common clinically used CSVS`s structures: the coronary sinus with its ostium, great cardiac vein, posterior vein of the left ventricle, middle cardiac vein and oblique vein of the left atrium. Methodology: This is a prospective study of 70 randomly selected autopsied hearts dissected from adult humans (Caucasian) aged 50.1±17.6 years old (24.3% females) with BMI=27.6±6.7 kg/m2. The morphology of the CSVS was assessed as well as its precise measurements were performed. Results: The coronary sinus (CS) with its ostium was present in all hearts. The mean CS ostium diameter was 9.9±2.5mm. Considered ostium was covered by its valve in 87.1% with mean valve height amounted 5.1±3.1mm. The mean percentage coverage of the CS ostium by the valve was 56%. The Vieussens valve was present in 71.4% and was unicuspid in 70%, bicuspid in 26% and tricuspid in 4% of hearts. The great cardiac vein was present in all cases. The oblique vein of the left atrium was observed in 84.3% of hearts with mean length amounted 20.2±9.3mm and mean ostium diameter 1.4±0.9mm. The average length of the CS (from the CS ostium to the Vieussens valve) was 31.1±9.5mm or (from the CS ostium to the ostium of the oblique vein of the left atrium) 28.9±10.1mm and both were correlated with the heart weight (r=0.47; p=0.00 and r=0.38; p=0.006 respectively). In 90.5% the ostium of the oblique vein of the left atrium was located proximally to the Vieussens valve, in remaining cases was distally. The middle cardiac vein was present in all hearts and its valve was noticed in more than half of all the cases (52.9%). The posterior vein of the left ventricle was observed in 91.4% of cases. Conclusions: The CSVS is vastly variable and none of basic hearts parameters is a good predictor of its morphology. The Vieussens valve could be a significant obstacle during CS cannulation. Caution should be exercised in this area to avoid coronary sinus perforation. Because of the higher incidence of the presence of the oblique vein of the left atrium than the Vieussens valve, the vein orifice is more useful in determining the CS length.

Keywords: cardiac resynchronization therapy, coronary sinus, Thebesian valve, Vieussens valve

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1157 Challenges of Landscape Design with Tree Species Diversity

Authors: Henry Kuppen

Abstract:

In the last decade, tree managers have faced many threats of pests and diseases and the effects of climate change. Managers will recognize that they have to put more energy and more money into tree management. By recognizing the cause behind this, the opportunity will arise to build sustainable tree populations for the future. More and more, unwanted larvae are sprayed, ash dieback infected trees are pruned or felled, and emerald ash borer is knocking at the door of West Europe. A lot of specific knowledge is needed to produce management plans and best practices. If pest and disease have a large impact, society loses complete tree species and need to start all over again building urban forest. But looking at the cause behind it, landscape design, and tree species selection, the sustainable solution does not present itself in managing these threats. Every pest or disease needs two important basic ingredients to be successful: climate and food. The changing climate is helping several invasive pathogens to survive. Food is often designed by the landscapers and managers of the urban forest. Monocultures promote the success of pathogens. By looking more closely at the basics, tree managers will realise very soon that the solution will not be the management of pathogens. The long-term solution for sustainable tree populations is a different design of our urban landscape. The use of tree species diversity can help to reduce the impact of climate change and pathogens. Therefore landscapers need to be supported. They are the specialists in designing the landscape using design values like canopy volume, ecosystem services, and seasonal experience. It’s up to the species specialist to show what the opportunities are for different species that meet the desired interpretation of the landscape. Based on landscapers' criteria, selections can be made, including tree species related requirements. Through this collaboration and formation of integral teams, sustainable plant design will be possible.

Keywords: climate change, landscape design, resilient landscape, tree species selection

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1156 Design and Validation of an Aerodynamic Model of the Cessna Citation X Horizontal Stabilizer Using both OpenVSP and Digital Datcom

Authors: Marine Segui, Matthieu Mantilla, Ruxandra Mihaela Botez

Abstract:

This research is the part of a major project at the Research Laboratory in Active Controls, Avionics and Aeroservoelasticity (LARCASE) aiming to improve a Cessna Citation X aircraft cruise performance with an application of the morphing wing technology on its horizontal tail. However, the horizontal stabilizer of the Cessna Citation X turns around its span axis with an angle between -8 and 2 degrees. Within this range, the horizontal stabilizer generates certainly some unwanted drag. To cancel this drag, the LARCASE proposes to trim the aircraft with a horizontal stabilizer equipped by a morphing wing technology. This technology aims to optimize aerodynamic performances by changing the conventional horizontal tail shape during the flight. As a consequence, this technology will be able to generate enough lift on the horizontal tail to balance the aircraft without an unwanted drag generation. To conduct this project, an accurate aerodynamic model of the horizontal tail is firstly required. This aerodynamic model will finally allow precise comparison between a conventional horizontal tail and a morphed horizontal tail results. This paper presents how this aerodynamic model was designed. In this way, it shows how the 2D geometry of the horizontal tail was collected and how the unknown airfoil’s shape of the horizontal tail has been recovered. Finally, the complete horizontal tail airfoil shape was found and a comparison between aerodynamic polar of the real horizontal tail and the horizontal tail found in this paper shows a maximum difference of 0.04 on the lift or the drag coefficient which is very good. Aerodynamic polar data of the aircraft horizontal tail are obtained from the CAE Inc. level D research aircraft flight simulator of the Cessna Citation X.

Keywords: aerodynamic, Cessna, citation, coefficient, Datcom, drag, lift, longitudinal, model, OpenVSP

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1155 Influence of Thermal Ageing on Microstructural Features and Mechanical Properties of Reduced Activation Ferritic/Martensitic Grades

Authors: Athina Puype, Lorenzo Malerba, Nico De Wispelaere, Roumen Petrov, Jilt Sietsma

Abstract:

Reduced Activation Ferritic/Martensitic (FM) steels like EUROFER are of interest for first wall application in the future demonstration (DEMO) fusion reactor. Depending on the final design codes for the DEMO reactor, the first wall material will have to function in low-temperature mode or high-temperature mode, i.e. around 250-300°C of above 550°C respectively. However, the use of RAFM steels is limited up to a temperature of about 550°C. For the low-temperature application, the material suffers from irradiation embrittlement, due to a shift of ductile-to-brittle transition temperature (DBTT) towards higher temperatures upon irradiation. The high-temperature response of the material is equally insufficient for long-term use in fusion reactors, due to the instability of the matrix phase and coarsening of the precipitates at prolonged high-temperature exposure. The objective of this study is to investigate the influence of thermal ageing for 1000 hrs and 4000 hrs on microstructural features and mechanical properties of lab-cast EUROFER. Additionally, the ageing behavior of the lab-cast EUROFER is compared with the ageing behavior of standard EUROFER97-2 and T91. The microstructural features were investigated with light optical microscopy (LOM), electron back-scattered diffraction (EBSD) and transmission electron microscopy (TEM). Additionally, hardness measurements, tensile tests at elevated temperatures and Charpy V-notch impact testing of KLST-type MCVN specimens were performed to study the microstructural features and mechanical properties of four different F/M grades, i.e. T91, EUROFER97-2 and two lab-casted EUROFER grades. After ageing for 1000 hrs, the microstructures exhibit similar martensitic block sizes independent on the grain size before ageing. With respect to the initial coarser microstructures, the aged microstructures displayed a dislocation structure which is partially fragmented by polygonization. On the other hand, the initial finer microstructures tend to be more stable up to 1000hrs resulting in similar grain sizes for the four different steels. Increasing the ageing time to 4000 hrs, resulted in an increase of lath thickness and coarsening of M23C6 precipitates leading to a deterioration of tensile properties.

Keywords: ageing experiments, EUROFER, ferritic/martensitic steels, mechanical properties, microstructure, T91

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1154 Socioeconomic Inequality in Physical Activity: The CASPIAN-V Study

Authors: Roya Kelishadi, Mostafa Amini-Rarani, Mostafa Qorbani

Abstract:

Introduction: As a health-related behavior, physical activity (PA) has an unequal distribution relating to individual's socioeconomic status. This study aimed to assess socioeconomic inequality in PA among Iranian students and their parents at national level and according to socioeconomic status (SES) of the living regions. Method: This study was conducted as part of a national surveillance program conducted among 14400 Iranian students and their parents. Non-linear principal component analysis was used to construct the households' socioeconomic status, and the concentration index approach was applied to measure inequality in father, mother, and student’s PA. Results: The data of 13313 students and their parents were complete for the current study. At national level and SES regions, students had more PA than their parents (except in the lowest SES region), and fathers have more PA than mothers. The lowest means of mother and student's PA were find in the highest SES region. At national level, the concentration indices of father and mother’s PA were -0.050 (95 % CI: -0.067 ~ -0.030) and -0.028 (95% CI: -0.044 ~ -0.012), respectively; indicating pro-poor inequality and, the CI value of student PA was nearly equal to zero (P > 0.05). At SES regions, father and mother's PA were more concentrated in the poor, except for lower middle region. Regional concentration indices for students reveal that inequality not statistically significant at all regions. Conclusion: This study suggests that reliable evidence that comparing different aspects of inequality of PA, based on socioeconomic status and residence areas of students and their parents, could be used for better planning for health promotion programs. Moreover, given the average of mother's and student’s PA in the richer regions were low, it can be suggested that richer focused-PA planning may further increase the level of PA across higher SES and, consequently, reduce inequality in PA. These findings can be applied in the health system services.

Keywords: concentration index, health system services, physical activity, socioeconomic inequality

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1153 Effects of Roughness on Forward Facing Step in an Open Channel

Authors: S. M. Rifat, André L. Marchildon, Mark F. Tachie

Abstract:

Experiments were performed to investigate the effects of roughness on the reattachment and redevelopment regions over a 12 mm forward facing step (FFS) in an open channel flow. The experiments were performed over an upstream smooth wall and a smooth FFS, an upstream wall coated with sandpaper 36 grit and a smooth FFS and an upstream rough wall produced from sandpaper 36 grit and a FFS coated with sandpaper 36 grit. To investigate only the wall roughness effects, Reynolds number, Froude number, aspect ratio and blockage ratio were kept constant. Upstream profiles showed reduced streamwise mean velocities close to the rough wall compared to the smooth wall, but the turbulence level was increased by upstream wall roughness. The reattachment length for the smooth-smooth wall experiment was 1.78h; however, when it is replaced with rough-smooth wall the reattachment length decreased to 1.53h. It was observed that the upstream roughness increased the physical size of contours of maximum turbulence level; however, the downstream roughness decreased both the size and magnitude of contours in the vicinity of the leading edge of the step. Quadrant analysis was performed to investigate the dominant Reynolds shear stress contribution in the recirculation region. The Reynolds shear stress and turbulent kinetic energy profiles after the reattachment showed slower recovery compared to the streamwise mean velocity, however all the profiles fairly collapse on their corresponding upstream profiles at x/h = 60. It was concluded that to obtain a complete collapse several more streamwise distances would be required.

Keywords: forward facing step, open channel, separated and reattached turbulent flows, wall roughness

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1152 Co-Creational Model for Blended Learning in a Flipped Classroom Environment Focusing on the Combination of Coding and Drone-Building

Authors: A. Schuchter, M. Promegger

Abstract:

The outbreak of the COVID-19 pandemic has shown us that online education is so much more than just a cool feature for teachers – it is an essential part of modern teaching. In online math teaching, it is common to use tools to share screens, compute and calculate mathematical examples, while the students can watch the process. On the other hand, flipped classroom models are on the rise, with their focus on how students can gather knowledge by watching videos and on the teacher’s use of technological tools for information transfer. This paper proposes a co-educational teaching approach for coding and engineering subjects with the help of drone-building to spark interest in technology and create a platform for knowledge transfer. The project combines aspects from mathematics (matrices, vectors, shaders, trigonometry), physics (force, pressure and rotation) and coding (computational thinking, block-based programming, JavaScript and Python) and makes use of collaborative-shared 3D Modeling with clara.io, where students create mathematics knowhow. The instructor follows a problem-based learning approach and encourages their students to find solutions in their own time and in their own way, which will help them develop new skills intuitively and boost logically structured thinking. The collaborative aspect of working in groups will help the students develop communication skills as well as structural and computational thinking. Students are not just listeners as in traditional classroom settings, but play an active part in creating content together by compiling a Handbook of Knowledge (called “open book”) with examples and solutions. Before students start calculating, they have to write down all their ideas and working steps in full sentences so other students can easily follow their train of thought. Therefore, students will learn to formulate goals, solve problems, and create a ready-to use product with the help of “reverse engineering”, cross-referencing and creative thinking. The work on drones gives the students the opportunity to create a real-life application with a practical purpose, while going through all stages of product development.

Keywords: flipped classroom, co-creational education, coding, making, drones, co-education, ARCS-model, problem-based learning

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1151 A Histopathological Study on Leech (Hirudo medicinalis) Application in the Management of Vicarcikā (Eczema)

Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

Abstract:

Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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1150 Impact of Totiviridae L-A dsRNA Virus on Saccharomyces Cerevisiae Host: Transcriptomic and Proteomic Approach

Authors: Juliana Lukša, Bazilė Ravoitytė, Elena Servienė, Saulius Serva

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Totiviridae L-A virus is a persistent Saccharomyces cerevisiae dsRNA virus. It encodes the major structural capsid protein Gag and Gag-Pol fusion protein, responsible for virus replication and encapsulation. These features also enable the copying of satellite dsRNAs (called M dsRNAs) encoding a secreted toxin and immunity to it (known as killer toxin). Viral capsid pore presumably functions in nucleotide uptake and viral mRNA release. During cell division, sporogenesis, and cell fusion, the virions remain intracellular and are transferred to daughter cells. By employing high throughput RNA sequencing data analysis, we describe the influence of solely L-A virus on the expression of genes in three different S. cerevisiae hosts. We provide a new perception into Totiviridae L-A virus-related transcriptional regulation, encompassing multiple bioinformatics analyses. Transcriptional responses to L-A infection were similar to those induced upon stress or availability of nutrients. It also delves into the connection between the cell metabolism and L-A virus-conferred demands to the host transcriptome by uncovering host proteins that may be associated with intact virions. To better understand the virus-host interaction, we applied differential proteomic analysis of virus particle-enriched fractions of yeast strains that harboreither complete killer system (L-A-lus and M-2 virus), M-2 depleted orvirus-free. Our analysis resulted in the identification of host proteins, associated with structural proteins of the virus (Gag and Gag-Pol). This research was funded by the European Social Fund under the No.09.3.3-LMT-K-712-19-0157“Development of Competences of Scientists, other Researchers, and Students through Practical Research Activities” measure.

Keywords: totiviridae, killer virus, proteomics, transcriptomics

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1149 Scalable and Accurate Detection of Pathogens from Whole-Genome Shotgun Sequencing

Authors: Janos Juhasz, Sandor Pongor, Balazs Ligeti

Abstract:

Next-generation sequencing, especially whole genome shotgun sequencing, is becoming a common approach to gain insight into the microbiomes in a culture-independent way, even in clinical practice. It does not only give us information about the species composition of an environmental sample but opens the possibility to detect antimicrobial resistance and novel, or currently unknown, pathogens. Accurately and reliably detecting the microbial strains is a challenging task. Here we present a sensitive approach for detecting pathogens in metagenomics samples with special regard to detecting novel variants of known pathogens. We have developed a pipeline that uses fast, short read aligner programs (i.e., Bowtie2/BWA) and comprehensive nucleotide databases. Taxonomic binning is based on the lowest common ancestor (LCA) principle; each read is assigned to a taxon, covering the most significantly hit taxa. This approach helps in balancing between sensitivity and running time. The program was tested both on experimental and synthetic data. The results implicate that our method performs as good as the state-of-the-art BLAST-based ones, furthermore, in some cases, it even proves to be better, while running two orders magnitude faster. It is sensitive and capable of identifying taxa being present only in small abundance. Moreover, it needs two orders of magnitude less reads to complete the identification than MetaPhLan2 does. We analyzed an experimental anthrax dataset (B. anthracis strain BA104). The majority of the reads (96.50%) was classified as Bacillus anthracis, a small portion, 1.2%, was classified as other species from the Bacillus genus. We demonstrate that the evaluation of high-throughput sequencing data is feasible in a reasonable time with good classification accuracy.

Keywords: metagenomics, taxonomy binning, pathogens, microbiome, B. anthracis

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1148 Cardiac Pacemaker in a Patient Undergoing Breast Radiotherapy-Multidisciplinary Approach

Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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1147 Occurrence and Fate of EDCs in Wastewater and Aquatic Environments in the West Bank of Palestine

Authors: Wa`d Odeh, Alon Tal, Alfred Abed Rabbo, Nader Al Khatib, Shai Arnon

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The presence of endocrine disrupting compounds (EDCs) in raw sewage and effluents from wastewater treatment plants (WWTPs) has been increasingly studied in the last few decades. Higher risks are said to characterize situations where raw sewage streams are found to be flowing, or where partial and inadequate wastewater treatment exists. Such conditions are prevalent in the West Bank area of Palestine. To our knowledge, no previous data concerning the occurrence and fate of EDCs in the aquatic environment has ever been systematically evaluated in the region. Hence, the main objective of this study was to identify the occurrence and concentrations of major EDCs in raw sewage, wastewater effluents produced by treatment plants and in the receiving environments, including streams and groundwater in the West Bank, Palestine. Water samples were collected and analyzed for four times during the years of 2013 and 2014. Two large-scale conventional activated sludge WWTPs, two wastewater watercourses, one naturally perennial stream, and five groundwater locations close to wastewater sources were sampled and analyzed by GC/MS following EPA methods (525.2). Five EDCs (estriol, estrone, testosterone, bisphenol A, and octylphenol) were detected in trace concentrations (ng/l) in wastewater streams and at inputs to WWTPs. WWTPs were not able to achieve complete removal of all EDCs, and EDCs were still found in the effluents. In this regard, the most significant environmental estrogenic impact was due to estrone concentrations. Nevertheless, no EDCs were detected in groundwater. Yet, in order for effluents to be reused, significant improvement in treatment infrastructure should be a top priority for environmental managers in the region.

Keywords: endocrine disrupting compounds, raw sewage streams, conventional activated sludge WWTPs, WWTPs effluents

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1146 A Review of Atomization Mechanisms Used for Spray Flash Evaporation: Their Effectiveness and Proposal of Rotary Bell Atomizer for Flashing Application

Authors: Murad A. Channa, Mehdi Khiadani. Yasir Al-Abdeli

Abstract:

Considering the severity of water scarcity around the world and its widening at an alarming rate, practical improvements in desalination techniques need to be engineered at the earliest. Atomization is the major aspect of flashing phenomena, yet it has been paid less attention to until now. There is a need to test efficient ways of atomization for the flashing process. Flash evaporation together with reverse osmosis is also a commercially matured desalination technique commonly famous as Multi-stage Flash (MSF). Even though reverse osmosis is massively practical, it is not economical or sustainable compared to flash evaporation. However, flashing evaporation has its drawbacks as well such as lower efficiency of water production per higher consumption of power and time. Flash evaporation is simply the instant boiling of a subcooled liquid which is introduced as droplets in a well-maintained negative environment. This negative pressure inside the vacuum increases the temperature of the liquid droplets far above their boiling point, which results in the release of latent heat, and the liquid droplets turn into vapor which is collected to be condensed back into an impurity-free liquid in a condenser. Atomization is the main difference between pool and spray flash evaporation. Atomization is the heart of the flash evaporation process as it increases the evaporating surface area per drop atomized. Atomization can be categorized into many levels depending on its drop size, which again becomes crucial for increasing the droplet density (drop count) per given flow rate. This review comprehensively summarizes the selective results relating to the methods of atomization and their effectiveness on the evaporation rate from earlier works to date. In addition, the reviewers propose using centrifugal atomization for the flashing application, which brings several advantages viz ultra-fine droplets, uniform droplet density, and the swirling geometry of the spray with kinetically more energetic sprays during their flight. Finally, several challenges of using rotary bell atomizer (RBA) and RBA Sprays inside the chamber have been identified which will be explored in detail. A schematic of rotary bell atomizer (RBA) integration with the chamber has been designed. This powerful centrifugal atomization has the potential to increase potable water production in commercial multi-stage flash evaporators, where it would be preferably advantageous.

Keywords: atomization, desalination, flash evaporation, rotary bell atomizer

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