Search results for: all stage universe
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3567

Search results for: all stage universe

327 Microalgae Technology for Nutraceuticals

Authors: Weixing Tan

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Production of nutraceuticals from microalgae—a virtually untapped natural phyto-based source of which there are 200,000 to 1,000,000 species—offers a sustainable and healthy alternative to conventionally sourced nutraceuticals for the market. Microalgae can be grown organically using only natural sunlight, water and nutrients at an extremely fast rate, e.g. 10-100 times more efficiently than crops or trees. However, the commercial success of microalgae products at scale remains limited largely due to the lack of economically viable technologies. There are two major microalgae production systems or technologies currently available: 1) the open system as represented by open pond technology and 2) the closed system such as photobioreactors (PBR). Each carries its own unique features and challenges. Although an open system requires a lower initial capital investment relative to a PBR, it conveys many unavoidable drawbacks; for example, much lower productivity, difficulty in contamination control/cleaning, inconsistent product quality, inconvenience in automation, restriction in location selection, and unsuitability for cold areas – all directly linked to the system openness and flat underground design. On the other hand, a PBR system has characteristics almost entirely opposite to the open system, such as higher initial capital investment, better productivity, better contamination and environmental control, wider suitability in different climates, ease in automation, higher and consistent product quality, higher energy demand (particularly if using artificial lights), and variable operational expenses if not automated. Although closed systems like PBRs are not highly competitive yet in current nutraceutical supply market, technological advances can be made, in particular for the PBR technology, to narrow the gap significantly. One example is a readily scalable P2P Microalgae PBR Technology at Grande Prairie Regional College, Canada, developed over 11 years considering return on investment (ROI) for key production processes. The P2P PBR system is approaching economic viability at a pre-commercial stage due to five ROI-integrated major components. They include: (1) optimum use of free sunlight through attenuation (patented); (2) simple, economical, and chemical-free harvesting (patent ready to file); (3) optimum pH- and nutrient-balanced culture medium (published), (4) reliable water and nutrient recycling system (trade secret); and (5) low-cost automated system design (trade secret). These innovations have allowed P2P Microalgae Technology to increase daily yield to 106 g/m2/day of Chlorella vulgaris, which contains 50% proteins and 2-3% omega-3. Based on the current market prices and scale-up factors, this P2P PBR system presents as a promising microalgae technology for market competitive nutraceutical supply.

Keywords: microalgae technology, nutraceuticals, open pond, photobioreactor PBR, return on investment ROI, technological advances

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326 Analysis of the Barriers and Aids That Lecturers Offer to Students with Disabilities

Authors: Anabel Moriña

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In recent years, advances have been made in disability policy at Spanish universities, especially in terms of creating more inclusive learning environments. Nevertheless, while efforts to foster inclusion at the tertiary level -and the growing number of students with disabilities at university- are clear signs of progress, serious barriers to full participation in learning still exist. The research shows that university responses to diversity tend to be reactive, not proactive; as a result, higher education (HE) environments can be especially disabling. It has been demonstrated that the performance of students with disabilities is closely linked to the good will of university faculty and staff. Lectures are key players when it comes to helping or hindering students throughout the teaching/learning process. This paper presents an analysis of how lecturers respond to students with disabilities, the initial question being: do lecturers aid or hinder students? The general aim is to analyse-by listen to the students themselves-lecturers barriers and support identified as affecting academic performance and overall perception of the higher education (HE) experience. Biographical-narrative methodology was employed. This research analysed the results differentiating by fields of knowledge. The research was conducted in two phases: discussion groups along with individual oral/written interviews were set up with 44 students with disabilities and mini life histories were completed for 16 students who participated in the first stage. The study group consisted of students with disabilities enrolled during three academic years. The results of this paper noted that participating students identified many more barriers than bridges when speaking about the role lecturers play in their learning experience. Findings are grouped into several categories: Faculty attitudes when “dealing with” students with disabilities, teaching methodologies, curricular adaptations, and faculty training in working with students. Faculty does not always display appropriate attitudes towards students with disabilities. Study participants speak of them turning their backs on their problems-or behaving in an awkward manner. In many cases, it seems lecturers feel that curricular adaptations of any kind are a form of favouritism. Positive attitudes, however, often depend almost entirely on the good will of faculty and-although well received by students-are hard to come by. As the participants themselves suggest, this study confirms that good teaching practices not only benefit students with disabilities but the student body as a whole. In this sense, inclusive curricula provide new opportunities for all students. A general coincidence has been the lack of training on behalf of lecturers to adequately attend disabled students, and the need to cover this shortage. This can become a primary barrier and is more often due to deficient faculty training than to inappropriate attitudes on the part of lecturers. In conclusion, based on this research we can conclude that more barriers than bridges exist. That said, students do report receiving a good deal of support from their lecturers-although almost exclusively in a spirit of good will; when lecturers do help, however, it tends to have a very positive impact on students' academic performance.

Keywords: barriers, disability, higher education, lecturers

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325 Belonging in South Africa: Networks among African Immigrants and South African Natives

Authors: Efe Mary Isike

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The variety of relationships between migrants and host communities is an enduring theme of migration studies. On one extreme, there are numerous examples of hostility towards ‘strangers’ who are either ejected from society or denied access to jobs, housing, education, healthcare and other aspects of normal life. More moderate treatments of those identified as different include expectations of assimilation in which host communities expect socially marginalized groups to conform to norms that they define. Both exclusion and assimilation attempt to manage the problem of difference by removing it. South Africa experienced great influx of African immigrants who worked in mines and farms under harsh and exploitative conditions before and after the institutionalization of apartheid. Although these labour migrants contributed a great deal to the economic development of South Africa, they were not given citizenship status. The formal democratization in 1994 came with dreams and expectations of a more inclusive South Africa, where black South Africans hoped to maximize their potential in a more free, fair and equal society. In the same vein, it also opened spaces for an influx of especially African immigrants into the country which set the stage for a new form of contest for belonging between South African citizens and African migrant settlers. One major manifestation of this contest was the violent xenophobic attacks against African immigrants which predate that of May 2008 and has continued with lower intensity across the country since then. While it is doubtless possible to find abundant evidence of antagonism in the relations between South Africans and African immigrants, the purpose of this study is to investigate the everyday realities of migrants in ordinary places who interact with a variety of people through their livelihood activities, marriages and social relationships, moving around towns and cities, in their residential areas, in faith-based organizations and other elements of everyday life. Rather than assuming all relations are hostile, this study intends to look at the breadth of everyday relationships within a specific context. Based on the foregoing, the main task of this study is to holistically examine and explain the nature of interactions between African migrants and South African citizens by analysing the social network ties that connect them in the specific case of Umhlathuze municipality. It will also investigate the variety of networks that exists between African migrants and South Africans and examine the nature of the linkages in the various networks identified between these two groups in Umhlathuze Municipality. Apart from a review of relevant literature, policies and other official documents, this paper will employ a purposive sample survey and in-depth interview of African immigrants and South Africans within their networks in selected suburbs in KwaZulu-Natal.

Keywords: migration, networks, development, host communities

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324 Optimum Drilling States in Down-the-Hole Percussive Drilling: An Experimental Investigation

Authors: Joao Victor Borges Dos Santos, Thomas Richard, Yevhen Kovalyshen

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Down-the-hole (DTH) percussive drilling is an excavation method that is widely used in the mining industry due to its high efficiency in fragmenting hard rock formations. A DTH hammer system consists of a fluid driven (air or water) piston and a drill bit; the reciprocating movement of the piston transmits its kinetic energy to the drill bit by means of stress waves that propagate through the drill bit towards the rock formation. In the literature of percussive drilling, the existence of an optimum drilling state (Sweet Spot) is reported in some laboratory and field experimental studies. An optimum rate of penetration is achieved for a specific range of axial thrust (or weight-on-bit) beyond which the rate of penetration decreases. Several authors advance different explanations as possible root causes to the occurrence of the Sweet Spot, but a universal explanation or consensus does not exist yet. The experimental investigation in this work was initiated with drilling experiments conducted at a mining site. A full-scale drilling rig (equipped with a DTH hammer system) was instrumented with high precision sensors sampled at a very high sampling rate (kHz). Data was collected while two boreholes were being excavated, an in depth analysis of the recorded data confirmed that an optimum performance can be achieved for specific ranges of input thrust (weight-on-bit). The high sampling rate allowed to identify the bit penetration at each single impact (of the piston on the drill bit) as well as the impact frequency. These measurements provide a direct method to identify when the hammer does not fire, and drilling occurs without percussion, and the bit propagate the borehole by shearing the rock. The second stage of the experimental investigation was conducted in a laboratory environment with a custom-built equipment dubbed Woody. Woody allows the drilling of shallow holes few centimetres deep by successive discrete impacts from a piston. After each individual impact, the bit angular position is incremented by a fixed amount, the piston is moved back to its initial position at the top of the barrel, and the air pressure and thrust are set back to their pre-set values. The goal is to explore whether the observed optimum drilling state stems from the interaction between the drill bit and the rock (during impact) or governed by the overall system dynamics (between impacts). The experiments were conducted on samples of Calca Red, with a drill bit of 74 millimetres (outside diameter) and with weight-on-bit ranging from 0.3 kN to 3.7 kN. Results show that under the same piston impact energy and constant angular displacement of 15 degrees between impact, the average drill bit rate of penetration is independent of the weight-on-bit, which suggests that the sweet spot is not caused by intrinsic properties of the bit-rock interface.

Keywords: optimum drilling state, experimental investigation, field experiments, laboratory experiments, down-the-hole percussive drilling

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323 Islam and Democracy: A Paradoxical Study of Syed Maududi and Javed Ghamidi

Authors: Waseem Makai

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The term ‘political Islam’ now seem to have gained the centre stage in every discourse pertaining to Islamic legitimacy and compatibility in modern civilisations. A never ceasing tradition of the philosophy of caliphate that has kept overriding the options of any alternate political institution in the Muslim world still permeates a huge faction of believers. Fully accustomed with the proliferation of changes and developments in individual, social and natural dispositions of the world, Islamic theologians retaliated to this flux through both conventional and modernist approaches. The so-called conventional approach was quintessential of the interpretations put forth by Syed Maududi, with new comprehensive, academic and powerful vigour, as never seen before. He generated the avant-garde scholarship which would bear testimony to his statements, made to uphold the political institution of Islam as supreme and noble. However, it was not his trait to challenge the established views but to codify them in such a bracket which a man of the 20th century would find captivating to his heart and satisfactory to his rationale. The delicate microcosms like selection of a caliph, implementation of Islamic commandments (Sharia), interest free banking sectors, imposing tax (Jazyah) on non-believers, waging the holy crusade (Jihad) for the expansion of Islamic boundaries, stoning for committing adulteration and capital punishment for apostates were all there in his scholarship which he spent whole of his life defending in the best possible manner. What and where did he went wrong with all this, was supposedly to be notified later, by his once been disciple, Javed Ahmad Ghamidi. Ghamidi is being accused of struggling between Scylla and Charybdis as he tries to remain steadfast to his basic Islamic tenets while modernising their interpretations to bring them in harmony with the Western ideals of democracy and liberty. His blatant acknowledgement of putting democracy at a high pedestal, calling the implementation of Sharia a non-mandatory task and denial to bracket people in the categories of Zimmi and Kaafir fully vindicates his stance against conventional narratives like that of Syed Maududi. Ghamidi goes to the extent of attributing current forms of radicalism and extremism, as exemplified in the operations of organisations like ISIS in Iraq and Syria and Tehreek-e-Taliban in Pakistan, to such a version of political Islam as upheld not only by Syed Maududi but by other prominent theologians like Ibn-Timyah, Syed Qutub and Dr. Israr Ahmad also. Ghamidi is wretched, in a way that his allegedly insubstantial claims gained him enough hostilities to leave his homeland when two of his close allies were brutally murdered. Syed Maududi and Javed Ghamidi, both stand poles apart in their understanding of Islam and its political domain. Who has the appropriate methodology, scholarship and execution in his mode of comprehension, is an intriguing task, worth carrying out in detail.

Keywords: caliphate, democracy, ghamidi, maududi

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322 An Assessment of Suitable Alternative Public Transport System in Mid-Sized City of India

Authors: Sanjeev Sinha, Samir Saurav

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The rapid growth of urban areas in India has led to transportation challenges like traffic congestion and an increase in accidents. Despite efforts by state governments and local administrations to improve urban transport, the surge in private vehicles has worsened the situation. Patna, located in Bihar State, is an example of the trend of increasing reliance on private motor vehicles, resulting in vehicular congestion and emissions. The existing transportation infrastructure is inadequate to meet future travel demands, and there has been a notable increase in the share of private vehicles in the city. Additionally, there has been a surge in economic activities in the region, which has increased the demand for improved travel convenience and connectivity. To address these challenges, a study was conducted to assess the most suitable transit mode for the proposed transit corridor outlined in the Comprehensive Mobility Plan (CMP) for Patna. The study covered four stages: developing screening criteria, evaluating parameters for various alternatives, qualitative and quantitative evaluations of alternatives, and implementation options for the most viable alternative. The study suggests that a mass transit system such as a metro rail is necessary to enhance Patna's urban public transport system. The New Metro Policy 2017 outlines specific prerequisites for submitting a Metro Rail Project Proposal to the Ministry of Housing and Urban Affairs (MoHUA), including the preparation of a CMP, the formation of an Urban Metropolitan Transport Authority (UMTA), the creation of an Alternative Analysis Report, the development of a Detailed Project Report, a Multi-Modal Integration Plan, and a Transit-Oriented Development (TOD) Plan. In 2018, the Comprehensive Mobility Plan for Patna was prepared, setting the stage for the subsequent steps in the metro rail project proposal. The results indicated that from the screening and analysis of qualitative parameters for different alternative modes in Patna, it is inferred that the Metro Rail and Monorail score 82.25 and 70.50, respectively, on a scale of 100. Based on the initial analysis and alternative evaluation in the form of quantitative analysis, the Metro Rail System significantly outperformed the Monorail system. The Metro Rail System has a positive Economic Net Present Value (ENPV) at a 14% internal rate of return, while the Monorail has a negative value. In conclusion, the study recommends choosing metro rail over monorail for the proposed transit corridor in Patna. However, the lack of broad-based technical expertise may result in implementation delays and increased costs for monorail.

Keywords: comprehensive mobility plan, alternative analysis, mobility corridors, mass transit system

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321 The Need for Sustaining Hope during Communication of Unfavourable News in the Care of Children with Palliative Care Needs: The Experience of Mothers and Health Professionals in Jordan

Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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320 Strategies to Mitigate Disasters at the Hajj Religious Festival Using GIS and Agent Based Modelling

Authors: Muteb Alotaibi, Graham Clarke, Nick Malleson

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The Hajj religious festival at Mina in Saudi Arabia has always presented the opportunity for injuries or deaths. For example, in 1990, a stampede killed 1426 pilgrims, whilst in 1997, 343 people were killed and 1500 injured due to a fire fuelled by high winds sweeping through the tent city in Mina.Many more minor incidents have occurred since then. It is predicted that 5 million pilgrims will soon perform the ritual at Mina (which is, in effect, a temporary city built each year in the desert), which might lead in the future to severe congestion and accidents unless the research is conducted on actions that contribute positively to improving the management of the crowd and facilitating the flow of pilgrims safely and securely. To help prevent further disasters, it is important to first plan better, more accessible locations for emergency services across Mina to ensure a good service for pilgrims. In this paper, we first use a Location Allocation Model (LAM) within a network GIS to examine the optimal locations for key services in the temporary city of Mina. This has been undertaken in relation to the location and movement of the pilgrims during the six day religious festival. The results of various what-if scenarios have been compared against the current location of services. A major argument is that planners should be flexible and locate facilities at different locations throughout the day and night. The use of location-allocation models in this type of comparative static mode has rarely been operationalised in the literature. Second, we model pilgrim movements and behaviours along with the most crowded parts of the network. This has been modelled using an agent-based model. This model allows planners to understand the key bottlenecks in the network and at what usage levels the paths become critically congested. Thus the paper has important implications and recommendations for future disaster planning strategies. This will enable planners to see at what stage in the movements of pilgrims problems occur in terms of potential crushes and trampling incidents. The main application of this research was only customised for pedestrians as the concentration only for pedestrians who move to Jamarat via foot. Further, the network in the middle of Mina was only dedicated for pedestrians for safety, so no Buses, trains and private cars were allowed in this area to prevent the congestion within this network. Initially, this research focus on Mina city as ‘temporary city’ and also about service provision in temporary cities, which is not highlighted in literature so far. Further, it is the first study which use the dynamic demand to optimise the services in the case of day and night time. Moreover, it is the first study which link the location allocation model for optimising services with ABM to find out whether or not the service location is located in the proper location in which it’s not affecting on crowd movement in mainstream flow where some pilgrims need to have health services.

Keywords: ABM, crowd management, hajj, temporary city

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319 Anaerobic Soil Disinfestation: Feasible Alternative to Soil Chemical Fumigants

Authors: P. Serrano-Pérez, M. C. Rodríguez-Molina, C. Palo, E. Palo, A. Lacasa

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Phytophthora nicotianae is the principal causal agent of root and crown rot disease of red pepper plants in Extremadura (Western Spain). There is a need to develop a biologically-based method of soil disinfestation that facilitates profitable and sustainable production without the use of chemical fumigants. Anaerobic Soil Disinfestation (ASD), as well know as biodisinfestation, has been shown to control a wide range of soil-borne pathogens and nematodes in numerous crop production systems. This method implies soil wetting, incorporation of a easily decomposable carbon-rich organic amendment and covering with plastic film for several weeks. ASD with rapeseed cake (var. Tocatta, a glucosinolates-free variety) used as C-source was assayed in spring 2014, before the pepper crop establishment. The field experiment was conducted at the Agricultural Research Centre Finca La Orden (Southwestern Spain) and the treatments were: rapeseed cake (RCP); rapeseed cake without plastic cover (RC); control non-amendment (CP) and control non-amendment without plastic cover (C). The experimental design was a randomized complete block design with four replicates and a plot size of 5 x 5 m. On 26 March, rapeseed cake (1 kg·m-2) was incorporated into the soil with a rotovator. Biological probes with the inoculum were buried at 15 and 30-cm depth (biological probes were previously prepared with 100 g of disinfected soil inoculated with chlamydospores (chlam) of P. nicotianae P13 isolate [100 chlam·g-1 of soil] and wrapped in agryl cloth). Sprinkler irrigation was run until field capacity and the corresponding plots were covered with transparent plastic (PE 0.05 mm). On 6 May plastics were removed, the biological probes were dug out and a bioassay was established. One pepper seedling at the 2 to 4 true-leaves stage was transplanted in the soil from each biological probe. Plants were grown in a climatic chamber and disease symptoms were recorded every week during 2 months. Fragments of roots and crown of symptomatic plants were analyzed on NARPH media and soil from rizospheres was analyzed using carnation petals as baits. Results of “survival” were expressed as the percentage of soil samples where P. nicotianae was detected and results of “infectivity” were expressed as the percentage of diseased plants. No differences were detected in deep effect. Infectivity of P. nicotianae chlamydospores was successfully reduced in RCP treatment (4.2% of infectivity) compared with the controls (41.7% of infectivity). The pattern of survival was similar to infectivity observed by the bioassay: 21% of survival in RCP; 79% in CP; 83% in C and 87% in RC. Although ASD may be an effective alternative to chemical fumigants to pest management, more research is necessary to show their impact on the microbial community and chemistry of the soil.

Keywords: biodisinfestation, BSD, soil fumigant alternatives, organic amendments

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318 Predictors of Sexually Transmitted Infection of Korean Adolescent Females: Analysis of Pooled Data from Korean Nationwide Survey

Authors: Jaeyoung Lee, Minji Je

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Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.

Keywords: adolescent, coitus, female, sexually transmitted diseases

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317 The Effect of TiO₂ Nanoparticles on Zebrafish Embryos

Authors: Elena Maria Scalisi

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Currently, photodegradation by nanoparticles (NPs) is a common solution for wastewater treatment. Nanoparticles are efficient for removing organic and inorganic pollutants, heavy metals from wastewater and killing microorganisms through environmentally friendly. In this context, the major representative of photocatalytic technology for industrial wastewater treatment are TiO₂ nanoparticles (TiO₂-NPs). TiO₂-NPs have a strong catalytic activity that depends to their physicochemical properties. Thanks to their small size (between 1-100 nm), nanoparticles occupy less volume, then their surface area increases. The increase in the surface-to-volume ratio results in the increase of the particle surface energy, which improve their reactivity potential. However, these unique properties represent risks to the ecosystems and organisms when unintentionally TiO₂-NPs are release into the environment and absorbed by living organisms. Several studies confirm that there is a high level of interest concerning the safety of TiO₂-NPs in the aquatic environment, furthermore, ecotoxicological tools are useful to correctly evaluate their toxicity. In the current study, we aimed to characterize potential toxic effects of TiO₂-NP suspension to zebrafish during embryo-larval stages to evaluate parameters such as survival rates, malformation, hatching, the overall length of the larvae heartbeat, and biochemical biomarkers that reflect the acute toxicity and sublethal effects of TiO₂-NPs. Zebrafish embryos were exposed to titanium dioxide nanoparticles (TiO₂-NPs at 1mg/L, 2mg/L, and 4mg/L) from fertilization to the free swimming stage (144hpf). Every day, we recorded the toxicological endpoints, moreover, immunohistochemical analysis has been performed at the end of the exposure. In particular, we have evaluate the expression of the following biomarkers: Heat Shock Protein 70 (HSP70), Poly ADP-Ribose Polymerase-1 (PARP-1), Metallothioneins (MTs). Our results have shown that hatch ability, survival, and malformation rate were not affected by TiO₂ NPs at these exposure levels. However, TiO₂-NPs caused an increase of heartbeat and reduction of body length; at the same time, TiO₂-NPs have inducted the production of ROS and the expression of oxidative stress biomarkers HSP70 and PARP-1. Hight positivity for PARP-1 at all concentration tested was observed. As regards MT, positivity was found in the expression of this biomarker in the whole body of the embryo, with the exception of the end of the tail. Metallothioneins (MT) are biomarkers widely used in environmental monitoring programs for aquatic creatures. At the light of our results i.e. no death until the end of the experiment (144hpf), no malformation and expression of the biomarkers mentioned, it is evident that zebrafish larvae with their natural detoxification pathways are able to resist the presence of toxic substances and then they can tolerate the presence of metal concentrations. However, an excessive oxidative state can compromise cell function, therefore the uncontrolled release of nanoparticles into the environment is severe and must be constantly monitored.

Keywords: nanoparticles, embryo zebrafish, HSP70, PARP-1

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316 Analysis of the Blastocysts Chromosomal Set Obtained after the Use of Donor Oocyte Cytoplasmic Transfer Technology

Authors: Julia Gontar, Natalia Buderatskaya, Igor Ilyin, Olga Parnitskaya, Sergey Lavrynenko, Eduard Kapustin, Ekaterina Ilyina, Yana Lakhno

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Introduction: It is well known that oocytes obtained from older reproductive women have accumulated mitochondrial DNA mutations, which negatively affects the morphology of a developing embryo and may lead to the birth of a child with mitochondrial disease. Special techniques have been developed to allow a donor oocyte cytoplasmic transfer with the parents’ biological nuclear DNA retention. At the same time, it is important to understand whether the procedure affects the future embryonic chromosome sets as the nuclear DNA is the transfer subject in this new complex procedure. Material and Methods: From July 2015 to July 2016, the investigation was carried out in the Medical Centre IGR. 34 donor oocytes (group A) were used for the manipulation with the aim of donating cytoplasm: 21 oocytes were used for zygotes pronuclear transfer and oocytes 13 – for the spindle transfer. The mean age of the oocyte donors was 28.4±2.9 years. The procedure was performed using Nikon Ti Eclipse inverted microscope equipped with the micromanipulators Narishige system (Japan), Saturn 3 laser console (UK), Oosight imaging systems (USA). For the preimplantation genetic screening (PGS) blastocyst biopsy was performed, trophectoderm samples were diagnosed using fluorescent in situ hybridization on chromosomes 9, 13, 15, 16, 17, 18, 21, 22, X, Y. For comparison of morphological characteristics and euploidy, was chosen a group of embryos (group B) with the amount of 121 blastocysts obtained from 213 oocytes, which were gotten from the donor programs of assisted reproductive technologies (ART). Group B was not subjected to donor oocyte cytoplasmic transfer procedure and studied on the above mentioned chromosomes. Statistical analysis was carried out using the criteria t, x^2 at a significance levels p<0.05, p<0.01, p<0.001. Results: After the donor cytoplasm transfer process the amount of the third day developing embryos was 27 (79.4%). In this stage, the group B consisted of 189 (88.7%) developing embryos, and there was no statistically significant difference (SSD) between the two groups (p>0.05). After a comparative analysis of the morphological characteristics of the embryos on the fifth day, we also found no SSD among the studied groups (p>0.05): from 34 oocytes exposed to manipulation, 14 (41.2%) blastocysts was obtained, while the group B blastocyst yield was 56.8% (n=121) from 213 oocytes. The following results were obtained after PGS performing: in group A euploidy in studied chromosomes were 28.6%(n=4) blastocysts, whereas in group B this rate was 40.5%(n=49), 28.6%(n=4) and 21.5%(n=26) of mosaic embryos and 42.8%(n=6) and 38.0%(n=46) aneuploid blastocysts respectively were identified. None of these specified parameters had an SSD (p>0.05). But attention was drawn by the blastocysts in group A with identified mosaicism, which was chaotic without any cell having euploid chromosomal set, in contrast to the mosaic embryos in group B where identified chaotic mosaicism was only 2.5%(n=3). Conclusions: According to the obtained results, there is no direct procedural effect on the chromosome in embryos obtained following donor oocyte cytoplasmic transfer. Thus, the technology introduction will enhance the infertility treating effectiveness as well as avoiding having a child with mitochondrial disease.

Keywords: donor oocyte cytoplasmic transfer, embryos’ chromosome set, oocyte spindle transfer, pronuclear transfer

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315 Mentoring of Health Professionals to Ensure Better Child-Birth and Newborn Care in Bihar, India: An Intervention Study

Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

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AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

Procedia PDF Downloads 161
314 Human Immuno-Deficiency Virus Co-Infection with Hepatitis B Virus and Baseline Cd4+ T Cell Count among Patients Attending a Tertiary Care Hospital, Nepal

Authors: Soma Kanta Baral

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Background: Since 1981, when the first AIDS case was reported, worldwide, more than 34 million people have been infected with HIV. Almost 95 percent of the people infected with HIV live in developing countries. As HBV & HIV share similar routes of transmission by sexual intercourse or drug use by parenteral injection, co-infection is common. Because of the limited access to healthcare & HIV treatment in developing countries, HIV-infected individuals are present late for care. Enumeration of CD4+ T cell count at the time of diagnosis has been useful to initiate the therapy in HIV infected individuals. The baseline CD4+ T cell count shows high immunological variability among patients. Methods: This prospective study was done in the serology section of the Department of Microbiology over a period of one year from august 2012 to July 2013. A total of 13037 individuals subjected for HIV test were included in the study comprising of 4982 males & 8055 females. Blood sample was collected by vein puncture aseptically with standard operational procedure in clean & dry test-tube. All blood samples were screened for HIV as described by WHO algorithm by Immuno-chromatography rapid kits. Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. After informed consent, HIV positive individuals were screened for HBsAg by Immuno-chromatography rapid kits (Hepacard). Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. EDTA blood samples were collected from the HIV sero-positive individuals for baseline CD4+ T count. Then, CD4+ T cells count was determined by using FACS Calibur Flow Cytometer (BD). Results: Among 13037 individuals screened for HIV, 104 (0.8%) were found to be infected comprising of 69(66.34%) males & 35 (33.65%) females. The study showed that the high infection was noted in housewives (28.7%), active age group (30.76%), rural area (56.7%) & in heterosexual route (80.9%) of transmission. Out of total HIV infected individuals, distribution of HBV co-infection was found to be 6(5.7%). All co- infected individuals were married, male, above the age of 25 years & heterosexual route of transmission. Baseline CD4+ T cell count of HIV infected patient was found higher (mean CD4+ T cell count; 283cells/cu.mm) than HBV co-infected patients (mean CD4+ T cell count; 91 cells/cu.mm). Majority (77.2%) of HIV infected & all co-infected individuals were presented in our center late (CD4+ T cell count;< 350/cu. mm) for diagnosis and care. Majority of co- infected 4 (80%) were late presented with advanced AIDS stage (CD4+ count; <200/cu.mm). Conclusions: The study showed a high percentage of HIV sero-positive & co- infected individuals. Baseline CD4+ T cell count of majority of HIV infected individuals was found to be low. Hence, more sustained and vigorous awareness campaigns & counseling still need to be done in order to promote early diagnosis and management.

Keywords: HIV/AIDS, HBsAg, co-infection, CD4+

Procedia PDF Downloads 214
313 Multimodal Analysis of News Magazines' Front-Page Portrayals of the US, Germany, China, and Russia

Authors: Alena Radina

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On the global stage, national image is shaped by historical memory of wars and alliances, government ideology and particularly media stereotypes which represent countries in positive or negative ways. News magazine covers are a key site for national representation. The object of analysis in this paper is the portrayals of the US, Germany, China, and Russia in the front pages and cover stories of “Time”, “Der Spiegel”, “Beijing Review”, and “Expert”. Political comedy helps people learn about current affairs even if politics is not their area of interest, and thus satire indirectly sets the public agenda. Coupled with satirical messages, cover images and the linguistic messages embedded in the covers become persuasive visual and verbal factors, known to drive about 80% of magazine sales. Preliminary analysis identified satirical elements in magazine covers, which are known to influence and frame understandings and attract younger audiences. Multimodal and transnational comparative framing analyses lay the groundwork to investigate why journalists, editors and designers deploy certain frames rather than others. This research investigates to what degree frames used in covers correlate with frames within the cover stories and what these framings can tell us about media professionals’ representations of their own and other nations. The study sample includes 32 covers consisting of two covers representing each of the four chosen countries from the four magazines. The sampling framework considers two time periods to compare countries’ representation with two different presidents, and between men and women when present. The countries selected for analysis represent each category of the international news flows model: the core nations are the US and Germany; China is a semi-peripheral country; and Russia is peripheral. Examining textual and visual design elements on the covers and images in the cover stories reveals not only what editors believe visually attracts the reader’s attention to the magazine but also how the magazines frame and construct national images and national leaders. The cover is the most powerful editorial and design page in a magazine because images incorporate less intrusive framing tools. Thus, covers require less cognitive effort of audiences who may therefore be more likely to accept the visual frame without question. Analysis of design and linguistic elements in magazine covers helps to understand how media outlets shape their audience’s perceptions and how magazines frame global issues. While previous multimodal research of covers has focused mostly on lifestyle magazines or newspapers, this paper examines the power of current affairs magazines’ covers to shape audience perception of national image.

Keywords: framing analysis, magazine covers, multimodality, national image, satire

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312 Glycemic Control in Rice Consumption among Households with Diabetes Patients: The Role of Food Security

Authors: Chandanee Wasana Kalansooriya

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Dietary behaviour is a crucial factor affecting diabetes control. With increasing rates of diabetes prevalence in Asian countries, examining their dietary patterns, which are largely based on rice, is timely required. It has been identified that higher consumption of some rice varieties is associated with increased risk of type 2 diabetes. Although diabetes patients are advised to consume healthier rice varieties, which contains low glycemic, several conditions, one of which food insecurity, make them difficult to preserve those healthy dietary guidelines. Hence this study tries to investigate how food security affects on making right decisions of rice consumption within diabetes affected households using a sample from Sri Lanka, a country which rice considered as the staple food and records the highest diabetes prevalence rate in South Asia. The study uses data from the Household Income and Expenditure Survey 2016, a nationally representative sample conducted by the Department of Census and Statistics, Sri Lanka. The survey used a two-stage stratified sampling method to cover different sectors and districts of the country and collected micro-data on demographics, health, income and expenditures of different categories. The study uses data from 2547 households which consist of one or more diabetes patients, based on the self-recorded health status. The Household Dietary Diversity Score (HDDS), which constructed based on twelve food groups, is used to measure the level of food security. Rice is categorized into three groups according to their Glycemic Index (GI), high GI, medium GI and low GI, and the likelihood and impact made by food security on each rice consumption categories are estimated using a Two-part Model. The shares of each rice categories out of total rice consumption is considered as the dependent variable to exclude the endogeneity issue between rice consumption and the HDDS. The results indicate that the consumption of medium GI rice is likely to increase with the increasing household food security, but low GI varieties are not. Households in rural and estate sectors are less likely and Tamil ethnic group is more likely to consume low GI rice varieties. Further, an increase in food security significantly decreases the consumption share of low GI rice, while it increases the share of medium GI varieties. The consumption share of low GI rice is largely affected by the ethnic variability. The effects of food security on the likelihood of consuming high GI rice varieties and changing its shares are statistically insignificant. Accordingly, the study concludes that a higher level of food security does not ensure diabetes patients are consuming healthy rice varieties or reducing consumption of unhealthy varieties. Hence policy attention must be directed towards educating people for making healthy dietary choices. Further, the study provides a room for further studies as it reveals considerable ethnic and sectorial differences in making healthy dietary decisions.

Keywords: diabetes, food security, glycemic index, rice consumption

Procedia PDF Downloads 102
311 Characterization of Anisotropic Deformation in Sandstones Using Micro-Computed Tomography Technique

Authors: Seyed Mehdi Seyed Alizadeh, Christoph Arns, Shane Latham

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Geomechanical characterization of rocks in detail and its possible implications on flow properties is an important aspect of reservoir characterization workflow. In order to gain more understanding of the microstructure evolution of reservoir rocks under stress a series of axisymmetric triaxial tests were performed on two different analogue rock samples. In-situ compression tests were coupled with high resolution micro-Computed Tomography to elucidate the changes in the pore/grain network of the rocks under pressurized conditions. Two outcrop sandstones were chosen in the current study representing a various cementation status of well-consolidated and weakly-consolidated granular system respectively. High resolution images were acquired while the rocks deformed in a purpose-built compression cell. A detailed analysis of the 3D images in each series of step-wise compression tests (up to the failure point) was conducted which includes the registration of the deformed specimen images with the reference pristine dry rock image. Digital Image Correlation (DIC) technique based on the intensity of the registered 3D subsets and particle tracking are utilized to map the displacement fields in each sample. The results suggest the complex architecture of the localized shear zone in well-cemented Bentheimer sandstone whereas for the weakly-consolidated Castlegate sandstone no discernible shear band could be observed even after macroscopic failure. Post-mortem imaging a sister plug from the friable rock upon undergoing continuous compression reveals signs of a shear band pattern. This suggests that for friable sandstones at small scales loading mode may affect the pattern of deformation. Prior to mechanical failure, the continuum digital image correlation approach can reasonably capture the kinematics of deformation. As failure occurs, however, discrete image correlation (i.e. particle tracking) reveals superiority in both tracking the grains as well as quantifying their kinematics (in terms of translations/rotations) with respect to any stage of compaction. An attempt was made to quantify the displacement field in compression using continuum Digital Image Correlation which is based on the reference and secondary image intensity correlation. Such approach has only been previously applied to unconsolidated granular systems under pressure. We are applying this technique to sandstones with various degrees of consolidation. Such element of novelty will set the results of this study apart from previous attempts to characterize the deformation pattern in consolidated sands.

Keywords: deformation mechanism, displacement field, shear behavior, triaxial compression, X-ray micro-CT

Procedia PDF Downloads 189
310 Preliminary Results of Psychiatric Morbidity for Oncology Outpatients

Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

Procedia PDF Downloads 146
309 Verification of Geophysical Investigation during Subsea Tunnelling in Qatar

Authors: Gary Peach, Furqan Hameed

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Musaimeer outfall tunnel is one of the longest storm water tunnels in the world, with a total length of 10.15 km. The tunnel will accommodate surface and rain water received from the drainage networks from 270 km of urban areas in southern Doha with a pumping capacity of 19.7m³/sec. The tunnel is excavated by Tunnel Boring Machine (TBM) through Rus Formation, Midra Shales, and Simsima Limestone. Water inflows at high pressure, complex mixed ground, and weaker ground strata prone to karstification with the presence of vertical and lateral fractures connected to the sea bed were also encountered during mining. In addition to pre-tender geotechnical investigations, the Contractor carried out a supplementary offshore geophysical investigation in order to fine-tune the existing results of geophysical and geotechnical investigations. Electric resistivity tomography (ERT) and Seismic Reflection survey was carried out. Offshore geophysical survey was performed, and interpretations of rock mass conditions were made to provide an overall picture of underground conditions along the tunnel alignment. This allowed the critical tunnelling area and cutter head intervention to be planned accordingly. Karstification was monitored with a non-intrusive radar system facility installed on the TBM. The Boring Electric Ahead Monitoring(BEAM) was installed at the cutter head and was able to predict the rock mass up to 3 tunnel diameters ahead of the cutter head. BEAM system was provided with an online system for real time monitoring of rock mass condition and then correlated with the rock mass conditions predicted during the interpretation phase of offshore geophysical surveys. The further correlation was carried by Samples of the rock mass taken from tunnel face inspections and excavated material produced by the TBM. The BEAM data was continuously monitored to check the variations in resistivity and percentage frequency effect (PFE) of the ground. This system provided information about rock mass condition, potential karst risk, and potential of water inflow. BEAM system was found to be more than 50% accurate in picking up the difficult ground conditions and faults as predicted in the geotechnical interpretative report before the start of tunnelling operations. Upon completion of the project, it was concluded that the combined use of different geophysical investigation results can make the execution stage be carried out in a more confident way with the less geotechnical risk involved. The approach used for the prediction of rock mass condition in Geotechnical Interpretative Report (GIR) and Geophysical Reflection and electric resistivity tomography survey (ERT) Geophysical Reflection surveys were concluded to be reliable as the same rock mass conditions were encountered during tunnelling operations.

Keywords: tunnel boring machine (TBM), subsea, karstification, seismic reflection survey

Procedia PDF Downloads 244
308 Fuzzy Availability Analysis of a Battery Production System

Authors: Merve Uzuner Sahin, Kumru D. Atalay, Berna Dengiz

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In today’s competitive market, there are many alternative products that can be used in similar manner and purpose. Therefore, the utility of the product is an important issue for the preferability of the brand. This utility could be measured in terms of its functionality, durability, reliability. These all are affected by the system capabilities. Reliability is an important system design criteria for the manufacturers to be able to have high availability. Availability is the probability that a system (or a component) is operating properly to its function at a specific point in time or a specific period of times. System availability provides valuable input to estimate the production rate for the company to realize the production plan. When considering only the corrective maintenance downtime of the system, mean time between failure (MTBF) and mean time to repair (MTTR) are used to obtain system availability. Also, the MTBF and MTTR values are important measures to improve system performance by adopting suitable maintenance strategies for reliability engineers and practitioners working in a system. Failure and repair time probability distributions of each component in the system should be known for the conventional availability analysis. However, generally, companies do not have statistics or quality control departments to store such a large amount of data. Real events or situations are defined deterministically instead of using stochastic data for the complete description of real systems. A fuzzy set is an alternative theory which is used to analyze the uncertainty and vagueness in real systems. The aim of this study is to present a novel approach to compute system availability using representation of MTBF and MTTR in fuzzy numbers. Based on the experience in the system, it is decided to choose 3 different spread of MTBF and MTTR such as 15%, 20% and 25% to obtain lower and upper limits of the fuzzy numbers. To the best of our knowledge, the proposed method is the first application that is used fuzzy MTBF and fuzzy MTTR for fuzzy system availability estimation. This method is easy to apply in any repairable production system by practitioners working in industry. It is provided that the reliability engineers/managers/practitioners could analyze the system performance in a more consistent and logical manner based on fuzzy availability. This paper presents a real case study of a repairable multi-stage production line in lead-acid battery production factory in Turkey. The following is focusing on the considered wet-charging battery process which has a higher production level than the other types of battery. In this system, system components could exist only in two states, working or failed, and it is assumed that when a component in the system fails, it becomes as good as new after repair. Instead of classical methods, using fuzzy set theory and obtaining intervals for these measures would be very useful for system managers, practitioners to analyze system qualifications to find better results for their working conditions. Thus, much more detailed information about system characteristics is obtained.

Keywords: availability analysis, battery production system, fuzzy sets, triangular fuzzy numbers (TFNs)

Procedia PDF Downloads 224
307 Using the Clinical Decision Support Platform, Dem DX, to Assess the ‘Urgent Community Care Team’s Notes Regarding Clinical Assessment, Management, and Healthcare Outcomes

Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

Procedia PDF Downloads 164
306 The Role of Formal and Informal Social Support in Predicting the Involvement of Mothers and Fathers of Young Children with Autism Spectrum Disorder

Authors: Adi Sharabi, Dafna Marom-Golan

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Parents’ involvement in the care of their children with Autism Spectrum Disorder (ASD) and its beneficial effect on the children’s developmental and educational outcomes is well documented. At the same time, parents of children with ASD tend to experience greater psychological distress than parents of children with other developmental disabilities or with typical development. Positive social support is an important resource used by parents to reduce their psychological distress. The goal of the current research was to examine the contribution of formal and informal social support in explaining mothers’ and fathers’ involvement with their young children with ASD. The sample consisted of 107 parents who live in Israel (61 mothers and 46 fathers) of children aged between 2 and 7, all diagnosed with ASD and attending special kindergartens or special day care for children with ASD. Parental involvement and social support perception were assessed. Initial analysis focused on the relations between involvement, support, and demographic variables. In addition, analysis of variance (ANOVA) was conducted to test differences between mothers and fathers. Two hierarchical multiple regression analyses were performed to examine the predicted factors in the involvement model while controlling for group (mothers/fathers). Results indicate that mothers reported significantly higher levels of parenting involvement than fathers. Mothers reported higher levels of general involvement and all sub-types of involvement. For example, mothers reported that they were more interested in and have higher levels of attendance in their child’s educational program. They were also more collaborative in their child’s educational therapeutic program, and socialized with other parents of children from their child’s kindergarten than fathers. Mothers’ involvement was found to be related to their informal support (non-formal relatives). Findings also reveal significant differences between mothers and fathers on the formal support subscale measure of specializes services. Fathers, more than mothers, reported more specializes services support such as social workers or professional therapists. Separate hierarchical multiple regression analyses revealed a unique gender difference in the factors that explained parental involvement. Specifically, informal support only had a unique positive contribution in explaining mothers’, but not fathers’ involvement. This study highlights the central role of mothers in maintaining constant contact with the educational system and the professionals who help care for their child with ASD. At the same time, this research emphasizes the crucial role of both mothers and fathers in their child's development and well-being at every development stage, particularly in early development. Further, different kinds of social support seem to relate to the different kinds of parental involvement. It is in the best interest of educators and family therapists who work with families with children with ASD to support the cohesiveness of the family and the collaboration of the parents by understanding and respecting the way each member addresses the responsibilities of parenting a child with ASD, and her or his need for different types of social support.

Keywords: parental differences, parental involvement, social support, specialized support services

Procedia PDF Downloads 247
305 Chemistry and Biological Activity of Feed Additive for Poultry Farming

Authors: Malkhaz Jokhadze, Vakhtang Mshvildadze, Levan Makaradze, Ekaterine Mosidze, Salome Barbaqadze, Mariam Murtazashvili, Dali Berashvili, Koba sivsivadze, Lasha Bakuridze, Aliosha Bakuridze

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Essential oils are one of the most important groups of biologically active substances present in plants. Due to the chemical diversity of components, essential oils and their preparations have a wide spectrum of pharmacological action. They have bactericidal, antiviral, fungicidal, antiprotozoal, anti-inflammatory, spasmolytic, sedative and other activities. They are expectorant, spasmolytic, sedative, hypotensive, secretion enhancing, antioxidant remedies. Based on preliminary pharmacological studies, we have developed a formulation called “Phytobiotic” containing essential oils, a feed additive for poultry as an alternative to antibiotics. Phytobiotic is a water-soluble powder containing a composition of essential oils of thyme, clary, monarda and auxiliary substances: dry extract of liquorice and inhalation lactose. On this stage of research, the goal was to study the chemical composition of provided phytobiotic, identify the main substances and determine their quantity, investigate the biological activity of phytobiotic through in vitro and in vivo studies. Using gas chromatography-mass spectrometry, 38 components were identified in phytobiotic, representing acyclic-, monocyclic-, bicyclic-, and sesquiterpenes. Together with identification of main active substances, their quantitative content was determined, including acyclic terpene alcohol β-linalool, acyclic terpene ketone linalyl acetate, monocyclic terpenes: D-limonene and γ-terpinene, monocyclic aromatic terpene thymol. Provided phytobiotic has pronounced and at the same time broad spectrum of antibacterial activity. In the cell model, phytobiotic showed weak antioxidant activity, and it was stronger in the ORAC (chemical model) tests. Meanwhile anti-inflammatory activity was also observed. When fowls were supplied feed enriched with phytobiotic, it was observed that gained weight of the chickens in the experimental group exceeded the same data for the control group during the entire period of the experiment. The survival rate of broilers in the experimental group during the growth period was 98% compared to -94% in the control group. As a result of conducted researches probable four different mechanisms which are important for the action of phytobiotics were identified: sensory, metabolic, antioxidant and antibacterial action. General toxic, possible local irritant and allergenic effects of phytobiotic were also investigated. Performed assays proved that formulation is safe.

Keywords: clary, essential oils, monarda, poultry, phytobiotics, thyme

Procedia PDF Downloads 171
304 Exploring Disengaging and Engaging Behavior of Doctoral Students

Authors: Salome Schulze

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The delay of students in completing their dissertations is a worldwide problem. At the University of South Africa where this research was done, only about a third of the students complete their studies within the required period of time. This study explored the reasons why the students interrupted their studies, and why they resumed their research at a later stage. If this knowledge could be utilised to improve the throughput of doctoral students, it could have significant economic benefits for institutions of higher education while at the same time enhancing their academic prestige. To inform the investigation, attention was given to key theories concerning the learning of doctoral students, namely the situated learning theory, the social capital theory and the self-regulated learning theory, based on the social cognitive theory of learning. Ten students in the faculty of Education were purposefully selected on the grounds of their poor progress, or of having been in the system for too long. The collection of the data was in accordance with a Finnish study, since the two studies had the same aims, namely to investigate student engagement and disengagement. Graphic elicitation interviews, based on visualisations were considered appropriate to collect the data. This method could stimulate the reflection and recall of the participants’ ‘stories’ with very little input from the interviewer. The interviewees were requested to visualise, on paper, their journeys as doctoral students from the time when they first registered. They were to indicate the significant events that occurred and which facilitated their engagement or disengagement. In the interviews that followed, they were requested to elaborate on these motivating or challenging events by explaining when and why they occurred, and what prompted them to resume their studies. The interviews were tape-recorded and transcribed verbatim. Information-rich data were obtained containing visual metaphors. The data indicated that when the students suffered a period of disengagement, it was sometimes related to a lack of self-regulated learning, in particular, a lack of autonomy, and the inability to manage their time effectively. When the students felt isolated from the academic community of practice disengagement also occurred. This included poor guidance by their supervisors, which accordingly deprived them of significant social capital. The study also revealed that situational factors at home or at work were often the main reasons for the students’ procrastinating behaviour. The students, however, remained in the system. They were motivated towards a renewed engagement with their studies if they were self-regulated learners, and if they felt a connectedness with the academic community of practice because of positive relationships with their supervisors and of participation in the activities of the community (e.g., in workshops or conferences). In support of their learning, networking with significant others who were sources of information provided the students with the necessary social capital. Generally, institutions of higher education cannot address the students’ personal issues directly, but they can deal with key institutional factors in order to improve the throughput of doctoral students. It is also suggested that graphic elicitation interviews be used more often in social research that investigates the learning and development of the students.

Keywords: doctoral students, engaging and disengaging experiences, graphic elicitation interviews, student procrastination

Procedia PDF Downloads 193
303 Geomorphology and Flood Analysis Using Light Detection and Ranging

Authors: George R. Puno, Eric N. Bruno

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The natural landscape of the Philippine archipelago plus the current realities of climate change make the country vulnerable to flood hazards. Flooding becomes the recurring natural disaster in the country resulting to lose of lives and properties. Musimusi is among the rivers which exhibited inundation particularly at the inhabited floodplain portion of its watershed. During the event, rescue operations and distribution of relief goods become a problem due to lack of high resolution flood maps to aid local government unit identify the most affected areas. In the attempt of minimizing impact of flooding, hydrologic modelling with high resolution mapping is becoming more challenging and important. This study focused on the analysis of flood extent as a function of different geomorphologic characteristics of Musimusi watershed. The methods include the delineation of morphometric parameters in the Musimusi watershed using Geographic Information System (GIS) and geometric calculations tools. Digital Terrain Model (DTM) as one of the derivatives of Light Detection and Ranging (LiDAR) technology was used to determine the extent of river inundation involving the application of Hydrologic Engineering Center-River Analysis System (HEC-RAS) and Hydrology Modelling System (HEC-HMS) models. The digital elevation model (DEM) from synthetic Aperture Radar (SAR) was used to delineate watershed boundary and river network. Datasets like mean sea level, river cross section, river stage, discharge and rainfall were also used as input parameters. Curve number (CN), vegetation, and soil properties were calibrated based on the existing condition of the site. Results showed that the drainage density value of the watershed is low which indicates that the basin is highly permeable subsoil and thick vegetative cover. The watershed’s elongation ratio value of 0.9 implies that the floodplain portion of the watershed is susceptible to flooding. The bifurcation ratio value of 2.1 indicates higher risk of flooding in localized areas of the watershed. The circularity ratio value (1.20) indicates that the basin is circular in shape, high discharge of runoff and low permeability of the subsoil condition. The heavy rainfall of 167 mm brought by Typhoon Seniang last December 29, 2014 was characterized as high intensity and long duration, with a return period of 100 years produced 316 m3s-1 outflows. Portion of the floodplain zone (1.52%) suffered inundation with 2.76 m depth at the maximum. The information generated in this study is helpful to the local disaster risk reduction management council in monitoring the affected sites for more appropriate decisions so that cost of rescue operations and relief goods distribution is minimized.

Keywords: flooding, geomorphology, mapping, watershed

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302 Regularizing Software for Aerosol Particles

Authors: Christine Böckmann, Julia Rosemann

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We present an inversion algorithm that is used in the European Aerosol Lidar Network for the inversion of data collected with multi-wavelength Raman lidar. These instruments measure backscatter coefficients at 355, 532, and 1064 nm, and extinction coefficients at 355 and 532 nm. The algorithm is based on manually controlled inversion of optical data which allows for detailed sensitivity studies and thus provides us with comparably high quality of the derived data products. The algorithm allows us to derive particle effective radius, volume, surface-area concentration with comparably high confidence. The retrieval of the real and imaginary parts of the complex refractive index still is a challenge in view of the accuracy required for these parameters in climate change studies in which light-absorption needs to be known with high accuracy. Single-scattering albedo (SSA) can be computed from the retrieve microphysical parameters and allows us to categorize aerosols into high and low absorbing aerosols. From mathematical point of view the algorithm is based on the concept of using truncated singular value decomposition as regularization method. This method was adapted to work for the retrieval of the particle size distribution function (PSD) and is called hybrid regularization technique since it is using a triple of regularization parameters. The inversion of an ill-posed problem, such as the retrieval of the PSD, is always a challenging task because very small measurement errors will be amplified most often hugely during the solution process unless an appropriate regularization method is used. Even using a regularization method is difficult since appropriate regularization parameters have to be determined. Therefore, in a next stage of our work we decided to use two regularization techniques in parallel for comparison purpose. The second method is an iterative regularization method based on Pade iteration. Here, the number of iteration steps serves as the regularization parameter. We successfully developed a semi-automated software for spherical particles which is able to run even on a parallel processor machine. From a mathematical point of view, it is also very important (as selection criteria for an appropriate regularization method) to investigate the degree of ill-posedness of the problem which we found is a moderate ill-posedness. We computed the optical data from mono-modal logarithmic PSD and investigated particles of spherical shape in our simulations. We considered particle radii as large as 6 nm which does not only cover the size range of particles in the fine-mode fraction of naturally occurring PSD but also covers a part of the coarse-mode fraction of PSD. We considered errors of 15% in the simulation studies. For the SSA, 100% of all cases achieve relative errors below 12%. In more detail, 87% of all cases for 355 nm and 88% of all cases for 532 nm are well below 6%. With respect to the absolute error for non- and weak-absorbing particles with real parts 1.5 and 1.6 in all modes the accuracy limit +/- 0.03 is achieved. In sum, 70% of all cases stay below +/-0.03 which is sufficient for climate change studies.

Keywords: aerosol particles, inverse problem, microphysical particle properties, regularization

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301 Developing a High Performance Cement Based Material: The Influence of Silica Fume and Organosilane

Authors: Andrea Cretu, Calin Cadar, Maria Miclaus, Lucian Barbu-Tudoran, Siegfried Stapf, Ioan Ardelean

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Additives and mineral admixtures have become an integral part of cement-based materials. It is common practice to add silica fume to cement based mixes in order to produce high-performance concrete. There is still a lack of scientific understanding regarding the effects that silica fume has on the microstructure of hydrated cement paste. The aim of the current study is to develop high-performance materials with low permeability and high resistance to flexural stress using silica fume and an organosilane. Organosilane bonds with cement grains and silica fume, influencing both the workability and the final properties of the mix, especially the pore size distributions and pore connectivity. Silica fume is a known pozzolanic agent which reacts with the calcium hydroxide in hydrated cement paste, producing more C-S-H and improving the mechanical properties of the mix. It is believed that particles of silica fume act as capillary pore fillers and nucleation centers for C-S-H and other hydration products. In order to be able to design cement-based materials with added silica fume and organosilane, it is necessary first to understand the formation of the porous network during hydration and to observe the distribution of pores and their connectivity. Nuclear magnetic resonance (NMR) methods in low-fields are non-destructive and allow the study of cement-based materials from the standpoint of their porous structure. Other methods, such as XRD and SEM-EDS, help create a comprehensive picture of the samples, along with the classic mechanical tests (compressive and flexural strength measurements). The transverse relaxation time (T₂) was measured during the hydration of 16 samples prepared with two water/cement ratios (0.3 and 0.4) and different concentrations or organosilane (APTES, up to 2% by mass of cement) and silica fume (up to 6%). After their hydration, the pore size distribution was assessed using the same NMR approach on the samples filled with cyclohexane. The SEM-EDS and XRD measurements were applied on pieces and powders prepared from the samples that were used in mechanical testing, which were kept under water for 28 days. Adding silica fume does not influence the hydration dynamics of cement paste, while the addition of organosilane extends the dormancy stage up to 10 hours. The size distribution of the capillary pores is not influenced by the addition of silica fume or organosilane, while the connectivity of capillary pores is decreased only when there is organosilane in the mix. No filling effect is observed even at the highest concentration of silica fume. There is an apparent increase in flexural strength of samples prepared only with silica fume and a decrease for those prepared with organosilane, with a few exceptions. XRD reveals that the pozzolanic reactivity of silica fume can only be observed when there is no organosilane present and the SEM-EDS method reveals the pore distribution, as well as hydration products and the presence or absence of calcium hydroxide. The current work was funded by the Romanian National Authority for Scientific Research, CNCS – UEFISCDI, through project PN-III-P2-2.1-PED-2016-0719.

Keywords: cement hydration, concrete admixtures, NMR, organosilane, porosity, silica fume

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300 Transducers for Measuring Displacements of Rotating Blades in Turbomachines

Authors: Pavel Prochazka

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The study deals with transducers for measuring vibration displacements of rotating blade tips in turbomachines. In order to prevent major accidents with extensive economic consequences, it shows an urgent need for every low-pressure steam turbine stage being equipped with modern non-contact measuring system providing information on blade loading, damage and residual lifetime under operation. The requirement of measuring vibration and static characteristics of steam turbine blades, therefore, calls for the development and operational verification of both new types of sensors and measuring principles and methods. The task is really demanding: to measure displacements of blade tips with a resolution of the order of 10 μm by speeds up to 750 m/s, humidity 100% and temperatures up to 200 °C. While in gas turbines are used primarily capacitive and optical transducers, these transducers cannot be used in steam turbines. The reason is moisture vapor, droplets of condensing water and dirt, which disable the function of sensors. Therefore, the most feasible approach was to focus on research of electromagnetic sensors featuring promising characteristics for given blade materials in a steam environment. Following types of sensors have been developed and both experimentally and theoretically studied in the Institute of Thermodynamics, Academy of Sciences of the Czech Republic: eddy-current, Hall effect, inductive and magnetoresistive. Eddy-current transducers demand a small distance of 1 to 2 mm and change properties in the harsh environment of steam turbines. Hall effect sensors have relatively low sensitivity, high values of offset, drift, and especially noise. Induction sensors do not require any supply current and have a simple construction. The magnitude of the sensors output voltage is dependent on the velocity of the measured body and concurrently on the varying magnetic induction, and they cannot be used statically. Magnetoresistive sensors are formed by magnetoresistors arranged into a Wheatstone bridge. Supplying the sensor from a current source provides better linearity. The MR sensors can be used permanently for temperatures up to 200 °C at lower values of the supply current of about 1 mA. The frequency range of 0 to 300 kHz is by an order higher comparing to the Hall effect and induction sensors. The frequency band starts at zero frequency, which is very important because the sensors can be calibrated statically. The MR sensors feature high sensitivity and low noise. The symmetry of the bridge arrangement leads to a high common mode rejection ratio and suppressing disturbances, which is important, especially in industrial applications. The MR sensors feature high sensitivity, high common mode rejection ratio, and low noise, which is important, especially in industrial applications. Magnetoresistive transducers provide a range of excellent properties indicating their priority for displacement measurements of rotating blades in turbomachines.

Keywords: turbines, blade vibration, blade tip timing, non-contact sensors, magnetoresistive sensors

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299 Digital Twins in the Built Environment: A Systematic Literature Review

Authors: Bagireanu Astrid, Bros-Williamson Julio, Duncheva Mila, Currie John

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Digital Twins (DT) are an innovative concept of cyber-physical integration of data between an asset and its virtual replica. They have originated in established industries such as manufacturing and aviation and have garnered increasing attention as a potentially transformative technology within the built environment. With the potential to support decision-making, real-time simulations, forecasting abilities and managing operations, DT do not fall under a singular scope. This makes defining and leveraging the potential uses of DT a potential missed opportunity. Despite its recognised potential in established industries, literature on DT in the built environment remains limited. Inadequate attention has been given to the implementation of DT in construction projects, as opposed to its operational stage applications. Additionally, the absence of a standardised definition has resulted in inconsistent interpretations of DT in both industry and academia. There is a need to consolidate research to foster a unified understanding of the DT. Such consolidation is indispensable to ensure that future research is undertaken with a solid foundation. This paper aims to present a comprehensive systematic literature review on the role of DT in the built environment. To accomplish this objective, a review and thematic analysis was conducted, encompassing relevant papers from the last five years. The identified papers are categorised based on their specific areas of focus, and the content of these papers was translated into a through classification of DT. In characterising DT and the associated data processes identified, this systematic literature review has identified 6 DT opportunities specifically relevant to the built environment: Facilitating collaborative procurement methods, Supporting net-zero and decarbonization goals, Supporting Modern Methods of Construction (MMC) and off-site manufacturing (OSM), Providing increased transparency and stakeholders collaboration, Supporting complex decision making (real-time simulations and forecasting abilities) and Seamless integration with Internet of Things (IoT), data analytics and other DT. Finally, a discussion of each area of research is provided. A table of definitions of DT across the reviewed literature is provided, seeking to delineate the current state of DT implementation in the built environment context. Gaps in knowledge are identified, as well as research challenges and opportunities for further advancements in the implementation of DT within the built environment. This paper critically assesses the existing literature to identify the potential of DT applications, aiming to harness the transformative capabilities of data in the built environment. By fostering a unified comprehension of DT, this paper contributes to advancing the effective adoption and utilisation of this technology, accelerating progress towards the realisation of smart cities, decarbonisation, and other envisioned roles for DT in the construction domain.

Keywords: built environment, design, digital twins, literature review

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298 Good Functional Outcome after Late Surgical Treatment for Traumatic Rotator Cuff Tear, a Retrospective Cohort Study

Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

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Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

Procedia PDF Downloads 223