Search results for: travel sharing rate
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9582

Search results for: travel sharing rate

6342 Colorectal Resection in Endometriosis: A Study on Conservative Vascular Approach

Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

Abstract:

Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

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6341 Fluidised Bed Gasification of Multiple Agricultural Biomass-Derived Briquettes

Authors: Rukayya Ibrahim Muazu, Aiduan Li Borrion, Julia A. Stegemann

Abstract:

Biomass briquette gasification is regarded as a promising route for efficient briquette use in energy generation, fuels and other useful chemicals, however, previous research work has focused on briquette gasification in fixed bed gasifiers such as updraft and downdraft gasifiers. Fluidised bed gasifier has the potential to be effectively sized for medium or large scale. This study investigated the use of fuel briquettes produced from blends of rice husks and corn cobs biomass residues, in a bubbling fluidised bed gasifier. The study adopted a combination of numerical equations and Aspen Plus simulation software to predict the product gas (syngas) composition based on briquette's density and biomass composition (blend ratio of rice husks to corn cobs). The Aspen Plus model was based on an experimentally validated model from the literature. The results based on a briquette size of 32 mm diameter and relaxed density range of 500 to 650 kg/m3 indicated that fluidisation air required in the gasifier increased with an increase in briquette density, and the fluidisation air showed to be the controlling factor compared with the actual air required for gasification of the biomass briquettes. The mass flowrate of CO2 in the predicted syngas composition, increased with an increase in the air flow rate, while CO production decreased and H2 was almost constant. The H2/CO ratio for various blends of rice husks and corn cobs did not significantly change at the designed process air, but a significant difference of 1.0 for H2/CO ratio was observed at higher air flow rate, and between 10/90 to 90/10 blend ratio of rice husks to corn cobs. This implies the need for further understanding of biomass variability and hydrodynamic parameters on syngas composition in biomass briquette gasification.

Keywords: aspen plus, briquettes, fluidised bed, gasification, syngas

Procedia PDF Downloads 451
6340 Visual Thinking Routines: A Mixed Methods Approach Applied to Student Teachers at the American University in Dubai

Authors: Alain Gholam

Abstract:

Visual thinking routines are principles based on several theories, approaches, and strategies. Such routines promote thinking skills, call for collaboration and sharing of ideas, and above all, make thinking and learning visible. Visual thinking routines were implemented in the teaching methodology graduate course at the American University in Dubai. The study used mixed methods. It was guided by the following two research questions: 1). To what extent do visual thinking inspire learning in the classroom, and make time for students’ questions, contributions, and thinking? 2). How do visual thinking routines inspire learning in the classroom and make time for students’ questions, contributions, and thinking? Eight student teachers enrolled in the teaching methodology course at the American University in Dubai (Spring 2017) participated in the following study. First, they completed a survey that measured to what degree they believed visual thinking routines inspired learning in the classroom and made time for students’ questions, contributions, and thinking. In order to build on the results from the quantitative phase, the student teachers were next involved in a qualitative data collection phase, where they had to answer the question: How do visual thinking routines inspire learning in the classroom and make time for students’ questions, contributions, and thinking? Results revealed that the implementation of visual thinking routines in the classroom strongly inspire learning in the classroom and make time for students’ questions, contributions, and thinking. In addition, student teachers explained how visual thinking routines allow for organization, variety, thinking, and documentation. As with all original, new, and unique resources, visual thinking routines are not free of challenges. To make the most of this useful and valued resource, educators, need to comprehend, model and spread an awareness of the effective ways of using such routines in the classroom. It is crucial that such routines become part of the curriculum to allow for and document students’ questions, contributions, and thinking.

Keywords: classroom display, student engagement, thinking classroom, visual thinking routines

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6339 Well Log Sequences Stratigraphy and Potential Reservoirs of Wells KF-1and KF-2; Kribi Oil Field, Douala-Kribi-Campo Basin, Cameroon

Authors: Nkwanyang L. Takem, Christopher M. Agyingi

Abstract:

Background and aim: An integrated interpretation of wireline logs and lithology of two selected wells (KF-1 and KF-2) of Kribi oil field within the southeastern offshore Douala/Kribi Campo Basin was carried out for sequence stratigraphic analysis of sediments penetrated by the wells. Methods: The stratigraphic units within the wells were subdivided into depositional sequences using characteristic well log patterns that were deposited between Tertiary Miocene to lower Cretaceous. Results: Nine (9) and eight (8) depositional sequences were identified respectively for KF-1 and KF-2. The sequences comprise LST (progradational packages), TSTs (retrogradational packages) and HSTs (aggradational packages), which reflect depositional systems deposited during different phases of base-level changes. The (LST) consists of Basin Floor Fans (BFF), Slope Fans and Channel Sands deposited when sea level was low and accommodation space lower than rate of sediment influx. TST consists of retrogradational marine shales deposited during high relative sea levels and when accommodation space was higher than rate of sediment influx. HST consisted of shoreface sands displaying mostly aggradational to progradational stacking patterns. Conclusion: The rapid facies changes between successive systems tracts provide potential stratigraphic traps. Reservoir stratification and continuity vary greatly between systems tracts and this enhanced development of stratigraphic traps in the area. Basin floor fans comprise sandstone of good reservoir quality, thus huge accumulation of HC can be trapped in this reservoirs.

Keywords: Douala-Kribi-Campo Basin, reservoirs, sequence strastigraphyy, system tracks

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6338 Infant and Young Child-Feeding Practices in Mongolia

Authors: Otgonjargal Damdinbaljir

Abstract:

Background: Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. In 2010, Mongolia used WHO 2008 edition of Indicators for assessing infant and young child feeding practices for the first time. Objective: To evaluate the feeding status of infants and young children under 2 years old in Mongolia. Materials and Methods: The study was conducted by cluster random sampling. The data on breastfeeding and complementary food supplement of the 350 infants and young children aged 0-23 months in 21 provinces of the 4 economic regions of the country and capital Ulaanbaatar city were collected through questionnaires. The feeding status was analyzed according to the WHO 2008 edition of Indicators for assessing infant and young child feeding practices. Analysis of data: Survey data was analysed using the PASW statistics 18.0 and EPI INFO 2000 software. For calculation of overall measures for the entire survey sample, analyses were stratified by region. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and socio demographic factors as independent variables. Simple proportions were calculated for each IYCF indicator. The differences in the feeding practices between sexes and age-groups, if any, were noted using chi-square test. Ethics: The Ethics Committee under the auspices of the Ministry of Health approved the study. Results: A total of 350 children aged 0-23 months were investigated. The rate of ever breastfeeding of children aged 0-23 months reached up to 98.2%, while the percentage of early initiation of breastfeeding was only 85.5%. The rates of exclusive breastfeeding under 6 months, continued breastfeeding for 1 year, and continued breastfeeding for 2 years were 71.3%, 74% and 54.6%, respectively. The median time of giving complementary food was the 6th month and the weaning time was the 9th month. The rate of complementary food supplemented from 6th-8th month in time was 80.3%. The rates of minimum dietary diversity, minimum meal frequency, and consumption of iron-rich or iron-fortified foods among children aged 6-23 months were 52.1%, 80.8% (663/813) and 30.1%, respectively. Conclusions: The main problems revealed from the study were inadequate category and frequency of complementary food, and the low rate of consumption of iron-rich or iron-fortified foods were the main issues to be concerned on infant feeding in Mongolia. Our findings have highlighted the need to encourage mothers to enrich their traditional wheat- based complementary foods add more animal source foods and vegetables.

Keywords: complementary feeding, early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency

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6337 Association of Maternal Age, Ethnicity and BMI with Gestational Diabetes Prevalence in Multi-Racial Singapore

Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

Abstract:

Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

Procedia PDF Downloads 223
6336 Monetary Evaluation of Dispatching Decisions in Consideration of Choice of Transport

Authors: Marcel Schneider, Nils Nießen

Abstract:

Microscopic simulation programs enable the description of the two processes of railway operation and the previous timetabling. Occupation conflicts are often solved based on defined train priorities on both process levels. These conflict resolutions produce knock-on delays for the involved trains. The sum of knock-on delays is commonly used to evaluate the quality of railway operations. It is either compared to an acceptable level-of-service or the delays are evaluated economically by linearly monetary functions. It is impossible to properly evaluate dispatching decisions without a well-founded objective function. This paper presents a new approach for evaluation of dispatching decisions. It uses models of choice of transport and considers the behaviour of the end-costumers. These models evaluate the knock-on delays in more detail than linearly monetary functions and consider other competing modes of transport. The new approach pursues the coupling of a microscopic model of railway operation with the macroscopic model of choice of transport. First it will be implemented for the railway operations process, but it can also be used for timetabling. The evaluation considers the possibility to change over to other transport modes by the end-costumers. The new approach first looks at the rail-mounted and road transport, but it can also be extended to air transport. The split of the end-costumers is described by the modal-split. The reactions by the end-costumers have an effect on the revenues of the railway undertakings. Various travel purposes has different pavement reserves and tolerances towards delays. Longer journey times affect besides revenue changes also additional costs. The costs depend either on time or track and arise from circulation of workers and vehicles. Only the variable values are summarised in the contribution margin, which is the base for the monetary evaluation of the delays. The contribution margin is calculated for different resolution decisions of the same conflict. The conflict resolution is improved until the monetary loss becomes minimised. The iterative process therefore determines an optimum conflict resolution by observing the change of the contribution margin. Furthermore, a monetary value of each dispatching decision can also be determined.

Keywords: choice of transport, knock-on delays, monetary evaluation, railway operations

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6335 Knowledge Management Efficiency of Personnel in Rajamangala University of Technology Srivijaya Songkhla, Thailand

Authors: Nongyao Intasaso, Atchara Rattanama, Navarat Pewnual

Abstract:

This research is survey research purposed to study the factor affected to knowledge management efficiency of personnel in Rajamangala University of Technology Srivijaya, and study the problem of knowledge management affected to knowledge development of personnel in the university. The tool used in this study is structures questioner standardize rating scale in 5 levels. The sample selected by purposive sampling and there are 137 participation calculated in 25% of population. The result found that factor affected to knowledge management efficiency in the university included (1) result from the organization factor found that the university provided project or activity that according to strategy and mission of knowledge management affected to knowledge management efficiency in highest level (x̅ = 4.30) (2) result from personnel factor found that the personnel are eager for knowledge and active to learning to develop themselves and work (Personal Mastery) affected to knowledge management efficiency in high level (x̅ = 3.75) (3) result from technological factor found that the organization brought multimedia learning aid to facilitate learning process affected to knowledge management efficiency in high level (x̅ = 3.70) and (4) the result from learning factor found that the personnel communicated and sharing knowledge and opinion based on acceptance to each other affected to knowledge management efficiency in high level (x̅ = 3.78). The problem of knowledge management in the university included the personnel do not change their work behavior, insufficient of collaboration, lack of acceptance in knowledge and experience to each other, and limited budget. The solutions to solve these problems are the university should be support sufficient budget, the university should follow up and evaluate organization development based on knowledge using, the university should provide the activity emphasize to personnel development and assign the committee to process and report knowledge management procedure.

Keywords: knowledge management, efficiency, personnel, learning process

Procedia PDF Downloads 295
6334 Management of Interdependence in Manufacturing Networks

Authors: Atour Taghipour

Abstract:

In the real world each manufacturing company is an independent business unit. These business units are linked to each other through upstream and downstream linkages. The management of these linkages is called coordination which, could be considered as a difficult engineering task. The degree of difficulty of coordination depends on the type and the nature of information exchanged between partners as well as the structure of relationship from mutual to the network structure. The literature of manufacturing systems comprises a wide range of varieties of methods and approaches of coordination. In fact, two main streams of research can be distinguished: central coordination versus decentralized coordination. In the centralized systems a high degree of information exchanges is required. The high degree of information exchanges sometimes leads to difficulties when independent members do not want to share information. In order to address these difficulties, decentralized approaches of coordination of operations planning decisions based on some minimal information sharing have been proposed in many academic disciplines. This paper first proposes a framework of analysis in order to analyze the proposed approaches in the literature, based on this framework which includes the similarities between approaches we categorize the existing approaches. This classification can be used as a research map for future researches. The result of our paper highlights several opportunities for future research. First, it is proposed to develop more dynamic and stochastic mechanisms of planning coordination of manufacturing units. Second, in order to exploit the complementarities of approaches proposed by diverse science discipline, we propose to integrate the techniques of coordination. Finally, based on our approach we proposed to develop coordination standards to guaranty both the complementarity of these approaches as well as the freedom of companies to adopt any planning tools.

Keywords: network coordination, manufacturing, operations planning, supply chain

Procedia PDF Downloads 277
6333 Mammotome Vacuum-Assisted Breast Biopsy versus Conventional Open Surgery: A Meta-Analysis

Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

Abstract:

Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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6332 Estimation of Soil Erosion Potential in Herat Province, Afghanistan

Authors: M. E. Razipoor, T. Masunaga, K. Sato, M. S. Saboory

Abstract:

Estimation of soil erosion is economically and environmentally important in Herat, Afghanistan. Degradation of soil has negative impact (decreased soil fertility, destroyed soil structure, and consequently soil sealing and crusting) on life of Herat residents. Water and wind are the main erosive factors causing soil erosion in Herat. Furthermore, scarce vegetation cover, exacerbated by socioeconomic constraint, and steep slopes accelerate soil erosion. To sustain soil productivity and reduce soil erosion impact on human life, due to sustaining agricultural production and auditing the environment, it is needed to quantify the magnitude and extent of soil erosion in a spatial domain. Thus, this study aims to estimate soil loss potential and its spatial distribution in Herat, Afghanistan by applying RUSLE in GIS environment. The rainfall erosivity factor ranged between values of 125 and 612 (MJ mm ha-1 h-1 year-1). Soil erodibility factor varied from 0.036 to 0.073 (Mg h MJ-1 mm-1). Slope length and steepness factor (LS) values were between 0.03 and 31.4. The vegetation cover factor (C), derived from NDVI analysis of Landsat-8 OLI scenes, resulting in range of 0.03 to 1. Support practice factor (P) were assigned to a value of 1, since there is not significant mitigation practices in the study area. Soil erosion potential map was the product of these factors. Mean soil erosion rate of Herat Province was 29 Mg ha-1 year-1 that ranged from 0.024 Mg ha-1 year-1 in flat areas with dense vegetation cover to 778 Mg ha-1 year-1 in sharp slopes with high rainfall but least vegetation cover. Based on land cover map of Afghanistan, areas with soil loss rate higher than soil loss tolerance (8 Mg ha-1 year-1) occupies 98% of Forests, 81% rangelands, 64% barren lands, 60% rainfed lands, 28% urban area and 18% irrigated Lands.

Keywords: Afghanistan, erosion, GIS, Herat, RUSLE

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6331 Self-Regulated Learning: A Required Skill for Web 2.0 Internet-Based Learning

Authors: Pieter Conradie, M. Marina Moller

Abstract:

Web 2.0 Internet-based technologies have intruded all aspects of human life. Presently, this phenomenon is especially evident in the educational context, with increased disruptive Web 2.0 technology infusions dramatically changing educational practice. The most prominent of these Web 2.0 intrusions can be identified as Massive Open Online Courses (Coursera, EdX), video and photo sharing sites (Youtube, Flickr, Instagram), and Web 2.0 online tools utilize to create Personal Learning Environments (PLEs) (Symbaloo (aggregator), Delicious (social bookmarking), PBWorks (collaboration), Google+ (social networks), Wordspress (blogs), Wikispaces (wiki)). These Web 2.0 technologies have supported the realignment from a teacher-based pedagogy (didactic presentation) to a learner-based pedagogy (problem-based learning, project-based learning, blended learning), allowing greater learner autonomy. No longer is the educator the source of knowledge. Instead the educator has become the facilitator and mediator of the learner, involved in developing learner competencies to support life-long learning (continuous learning) in the 21st century. In this study, the self-regulated learning skills of thirty first-year university learners were explored by utilizing the Online Self-regulated Learning Questionnaire. Implementing an action research method, an intervention was affected towards improving the self-regulation skill set of the participants. Statistical significant results were obtained with increased self-regulated learning proficiency, positively impacting learner performance. Goal setting, time management, environment structuring, help seeking, task (learning) strategies and self-evaluation skills were confirmed as determinants of improved learner success.

Keywords: andragogy, online self-regulated learning questionnaire, self-regulated learning, web 2.0

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6330 Effects of Inlet Filtration Pressure Loss on Single and Two-Spool Gas Turbine

Authors: Enyia James Diwa, Dodeye Ina Igbong, Archibong Archibong Eso

Abstract:

Gas turbine operators have been faced with the dramatic financial setback resulting from compressor fouling. In a highly deregulated power industry where there is stiffness in the market competition, has made it imperative to improvise means of reducing maintenance cost in other to yield maximum profit. Compressor fouling results from the deposition of contaminants in the presence of oil and moisture on the compressor blade or annulus surfaces, which leads to a loss in flow capacity and compressor efficiency. These combined effects reduce power output, increase heat rate and cause creep life reduction. This paper also contains a model of two gas turbine engines via Cranfield University software known as TURBOMATCH, which is simulation software for detecting engine fouling rate. The model engines are of different configurations and capacities, and are operating in two different modes of constant output power and turbine inlet temperature for a two and three stage filter system. The idea is to investigate the more economically viable filtration systems by gas turbine users based on performance only. It has been demonstrated in the results that the two spool engine is a little more beneficial compared to the single spool. This is as a result of a higher pressure ratio of the two spools as well as the deceleration of the high-pressure compressor and high-pressure turbine speed in a constant TET. Meanwhile, the inlet filtration system was properly designed and balanced with a well-timed and economical compressor washing regime/scheme to control compressor fouling. The different technologies of inlet air filtration and compressor washing are considered and an attempt at optimization with respect to the cost of a combination of both control measures are made.

Keywords: inlet filtration, pressure loss, single spool, two spool

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6329 Use of Smartwatches for the Emotional Self-Regulation of Individuals with Autism Spectrum Disorder (ASD)

Authors: Juan C. Torrado, Javier Gomez, Guadalupe Montero, German Montoro, M. Dolores Villalba

Abstract:

One of the most challenging aspects of the executive dysfunction of people with Autism Spectrum Disorders is the behavior control. This is related to a deficit in their ability to regulate, recognize and manage their own emotions. Some researchers have developed applications for tablets and smartphones to practice strategies of relaxation and emotion recognition. However, they cannot be applied to the very moment of temper outbursts, anger episodes or anxiety, since they require to carry the device, start the application and be helped by caretakers. Also, some of these systems are developed for either obsolete technologies (old versions of tablet devices, PDAs, outdated operative systems of smartphones) or specific devices (self-developed or proprietary ones) that create differentiation between the users and the rest of the individuals in their context. For this project we selected smartwatches. Focusing on emergent technologies ensures a wide lifespan of the developed products, because the derived products are intended to be available in the same moment the very technology gets popularized, not later. We also focused our research in commercial versions of smartwatches, since this way differentiation is easily avoided, so the users’ abandonment rate lowers. We have developed a smartwatch system along with a smartphone authoring tool to display self-regulation strategies. These micro-prompting strategies are conformed of pictograms, animations and temporizers, and they are designed by means of the authoring tool: When both devices synchronize their data, the smartwatch holds the self-regulation strategies, which are triggered when the smartwatch sensors detect a remarkable rise of heart rate and movement. The system is being currently tested in an educational center of people with ASD of Madrid, Spain.

Keywords: assistive technologies, emotion regulation, human-computer interaction, smartwatches

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6328 Hemodynamic Effects of Magnesium Sulphate Therapy in Critically Ill Infants and Children with Wheezy Chest

Authors: Yasmin Sayed, Hala Hamdy, Hafez Bazaraa, Hanaa Rady, Sherif Elanwary

Abstract:

Intravenous and inhaled magnesium sulfate (MgSO₄) had been recently used as an adjuvant therapy in cases suffering from the wheezy chest. Objective: We aimed to determine the possible change in the hemodynamic state in cases received intravenous or inhaled MgSO₄ in comparison to cases received standard treatment in critically ill infants and children with the wheezy chest. Methods: A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSO₄ was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSO₄. The hemodynamic state was determined by assessment of blood pressure, heart rate, capillary refill time and the need for shock therapy or inotropic support just before and 24 hours after receiving treatment in 3 groups. Results: There was no significant difference in the hemodynamic state of the studied groups before and after treatment. Means of blood pressure were 102.2/63.2, 105.1/64.8 before and after inhaled MgSO₄; respectively. Means of blood pressure were 105.5/64.2, 104.1/64.9 before and after intravenous MgSO₄; respectively. Means of blood pressure were 107.4/62.8, 104.4/62.1 before and after standard treatment, respectively. There was a statistically insignificant reduction of the means of the heart rate in group A and group B after treatment rather than group C. There was no associated prolongation in capillary refill time and/or the need for inotropic support or shock therapy after treatment in the studied groups. Conclusion: MgSO₄ is a safe adjuvant therapy and not associated with significant alteration in the hemodynamic state in critically ill infants and children with the wheezy chest.

Keywords: critically ill infants and children, inhaled MgSO₄, intravenous MgSO₄, wheezy chest

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6327 Development and Characterization Self-Nanoemulsifying Drug Delivery Systems of Poorly Soluble Drug Dutasteride

Authors: Rajinikanth Siddalingam, Poonguzhali Subramanian

Abstract:

The present study aims to prepare and evaluate the self-nano emulsifying drug delivery (SNEDDS) system to enhance the dissolution rate of a poorly soluble drug dutasteride. The formulation was prepared using capryol PGMC, Cremophor EL, and polyethylene glycol (PEG) 400 as oil, surfactant and co-surfactant, respectively. The pseudo-ternary phase diagrams with presence and absence of drug were plotted to find out the nano emulsification range and also to evaluate the effect of dutasteride on the emulsification behavior of the phases. Prepared SNEDDS formulations were evaluated for its particle size distribution, nano emulsifying properties, robustness to dilution, self-emulsification time, turbidity measurement, drug content and in-vitro dissolution. The optimized formulations are further evaluated for heating cooling cycle, centrifugation studies, freeze-thaw cycling, particle size distribution and zeta potential were carried out to confirm the stability of the formed SNEDDS formulations. The particle size, zeta potential and polydispersity index of the optimized formulation found to be 35.45 nm, -15.45 and 0.19, respectively. The in vitro results are revealed that the prepared formulation enhanced the dissolution rate of dutasteride significantly as compared with pure drug. The in vivo studies in was conducted using rats and the results are revealed that SNEDDS formulation has enhanced the bioavailability of dutasteride drug significantly as compared with raw drug. Based the results, it was concluded that the dutasteride-loaded SNEDDS shows potential to enhance the dissolution of dutasteride, thus improving the bioavailability and therapeutic effects.

Keywords: self-emulsifying drug delivery system, dutasteride, enhancement of bioavailability, dissolution enhancement

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6326 Experimental Research on Neck Thinning Dynamics of Droplets in Cross Junction Microchannels

Authors: Yilin Ma, Zhaomiao Liu, Xiang Wang, Yan Pang

Abstract:

Microscale droplets play an increasingly important role in various applications, including medical diagnostics, material synthesis, chemical engineering, and cell research due to features of high surface-to-volume ratio and tiny scale, which can significantly improve reaction rates, enhance heat transfer efficiency, enable high-throughput parallel studies as well as reduce reagent usage. As a mature technique to manipulate small amounts of liquids, droplet microfluidics could achieve the precise control of droplet parameters such as size, uniformity, structure, and thus has been widely adopted in the engineering and scientific research of multiple fields. Necking processes of the droplet in the cross junction microchannels are experimentally and theoretically investigated and dynamic mechanisms of the neck thinning in two different regimes are revealed. According to evolutions of the minimum neck width and the thinning rate, the necking process is further divided into different stages and the main driving force during each stage is confirmed. Effects of the flow rates and the cross-sectional aspect ratio on the necking process as well as the neck profile at different stages are provided in detail. The distinct features of the two regimes in the squeezing stage are well captured by the theoretical estimations of the effective flow rate and the variations of the actual flow rates in different channels are reasonably reflected by the channel width ratio. In the collapsing stage, the quantitative relation between the minimum neck width and the remaining time is constructed to identify the physical mechanism.

Keywords: cross junction, neck thinning, force analysis, inertial mechanism

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6325 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

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

Abstract:

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

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

Procedia PDF Downloads 182
6324 Effect of Flux Salts on the Recovery Extent and Quality of Metal Values from Spent Rechargeable Lead Batteries

Authors: Mahmoud A Rabah, Sabah M. Abelbasir

Abstract:

Lead-calcium alloy containing up to 0.10% calcium was recovered from spent rechargeable sealed acid lead batteries. Two techniques were investigated to explore the effect of flux salts on the extent and quality of the recovered alloy, pyro-metallurgical and electrochemical methods. About 10 kg of the spent batteries were collected for testing. The sample was washed with hot water and dried. The plastic cases of the batteries were mechanically cut, and the contents were dismantled manually, the plastic containers were shredded for recycling. The electrode plates were freed from the loose powder and placed in SiC crucible and covered with alkali chloride salts. The loaded crucible was heated in an electronically controlled chamber furnace type Nabertherm C3 at temperatures up to 800 °C. The obtained metals were analyzed. The effect of temperature, rate of heating, atmospheric conditions, composition of the flux salts on the extent and quality of the recovered products were studied. Results revealed that the spent rechargeable batteries contain 6 blocks of 6 plates of Pb-Ca alloy each. Direct heating of these plates in a silicon carbide crucible under ambient conditions produces lead metal poor in calcium content ( < 0.07%) due to partial oxidation of the alloying calcium element. Rate of temperature increase has a considerable effect on the yield of the lead alloy extraction. Flux salts composition benefits the recovery process. Sodium salts are more powerful as compared to potassium salts. Lead calcium alloy meeting the standard specification was successfully recovered from the spent rechargeable acid lead batteries with a very competitive cost to the same alloy prepared from primary resources.

Keywords: rechargeable lead batteries, lead-calcium alloy, waste recovery, flux salts, thermal recovery

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6323 Factors Influencing Violence Experienced by Medical Staff in Primary Health Care Centers, Taif City

Authors: Turki Adnan Kamal, Abdulmajeed Ahmad Alsofiany, Nemer Khidhran Husain Alghamdi, Ali Eissa Hassan Al-Rajhi

Abstract:

Background:- Health care workers are ranked as one of the most vulnerable groups experiencing violence and aggressive behavior compared to other occupational groups. Objectives:- To estimate the prevalence rate and characteristics and assess the avoidance measures, and notification of the violence among medical staff working in primary health care centers in Taif city. Subject and methods:- A cross-sectional study design was applied among all physicians and a representative sample of nurses working in primary health care centers affiliated with the Ministry of Health (MOH) in Taif city. A predesigned Arabic/English validated self-administered questionnaire was used. Results:- In this study, 56 physicians and 145 nurses responded, giving a response rate of 77.6%. Their age ranged from 25 and 60 years (36.2±8.2), with 59.7% of them aged between 25 and 35 years. Males represent 55.7% of them. More than half of them (52.2%) were Saudis. The prevalence of workplace violence was 30.3%. Verbal abuse was the commonest reported type (86.9%). The absence of security, training on the procedures that must be followed and special uniforms at the workplace were significantly associated with workplace violence. We concluded that workplace violence is a significant problem facing a considerable proportion of HCWs in primary health care centers in Taif, Saudi Arabia. Most violence incidents were verbal. Conclusion:- Findings of this study revealed that HCWs who were dealing with male patients only were at high risk of workplace violence and the absence of measures to avoid workplace violence, particularly security, training on the procedures that must be followed and special uniform at the workplace was significantly associated with workplace violence.

Keywords: violence, workplace, primary health care, prevalence, avoidance

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6322 Geography Undergraduates 360⁰ Academic Peer Learning And Mentoring 2021 – 2023: A Pilot Study

Authors: N. Ayob, N. C. Nkosi, R. P. Burger, S. J. Piketh, F. Letlaila, O. Maphosa

Abstract:

South African higher tertiary institution have been faced with high dropout rates. About 50 to 60% of first years drop out to due to various reasons one being inadequate academic support. Geography 111 (GEOG 111) module is historically known for having below 50% pass rate, high dropout rate and identified as a first year risk module. For the first time GEOG 111 (2021) on the Mahikeng Campus admitted 150 students pursuing more than 6 different qualifications (BA and BSc) from the Humanities Faculty and FNAS. First year students had difficulties transitioning from secondary to tertiary institutions as we shifted to remote learning while we navigate through the Covid-19 pandemic. The traditional method of teaching does not encourage students to help each other. With remote learning we do not have control over what the students share and perhaps this can be a learning opportunity to embrace peer learning and change the manner in which we assess the students. The purpose of this pilot study was to assist GEOG111 students with academic challenges whilst improving their University experience. This was a qualitative study open to all GEOG111, repeaters, students who are not confident in their Geographical knowledge and never did Geography at high school level. The selected 9 Golden Key International Honour Society Geography mentors attended an academic mentor training program with module lecturers. About 17.6% of the mentees did not have a geography background however, 94% of the mentees passed, 1 mentee had a mark of 38%. 11 of the participants had a mark >60% with one student that excelled 70%. It is evident that mentorship helped students reach their academic potential. Peer learning and mentoring are associated with improved academic performance and allows the students to take charge of their learning and academic experience. Thus an important element as we transform pedagogies at higher learning institutions.

Keywords: geography, risk module, peer mentoring, peer learning

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6321 Effect of Strains and Temperature on the Twinning Behavior of High Purity Titanium Compressed by Split Hopkinson Pressure Bar

Authors: Ping Zhou, Dawu Xiao, Chunli Jiang, Ge Sang

Abstract:

Deformation twinning plays an important role in the mechanical properties of Ti which has high specific strength and excellent corrosion resistance ability. To investigate the twinning behavior of Ti under high strain rate compression, the split Hopkinson pressure bar (SHPB) was adopted to deform samples to different strains at room temperature. In addition, twinning behaviors under varied temperatures of 373K, 573K and 873K were also investigated. The cylindrical-shaped samples with purity 99.995% were annealed at 1073K for 1 hour in vacuum before compression. All the deformation twins were identified by electron backscatter diffraction (EBSD) techniques. The mechanical behavior showed three-stage work hardening in stress-strain curves for samples deformed at temperature 573K and 873K, while only two stages were observed for those deformed at room temperature. For samples compressed at room temperature, the predominant twin types are {10-12}<10-11> (E1), {11-21}<11-26> (E2) and {11-21}<11-23> (C1). The secondary and tertiary twinning was observed inside some E1, E2 and C1 twins. Most of the twin boundaries of E2 acted as the nucleate sites of E1. The densities of twins increase remarkably with increment of strains. For samples compressed at relatively higher temperatures, the migration of twin boundaries of E1, E2 and C1 was observed. All the twin lamellas shorten with temperature, and nearly disappeared at 873K except some remaining E1 twins. Polygonizations of grain boundaries were observed above 573K. The microstructure intended to have a texture with c-axes parallel to compression direction with temperature increment. Factors affecting the dynamic recovery and re-crystallization were discussed.

Keywords: deformation twins, EBSD, mechanical behavior, high strain rate, titanium

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6320 A Village Transformed as Census Town a Case Study of Village Nilpur, Tehsil Rajpura, District Patiala (Punjab, India)

Authors: Preetinder Kaur Randhawa

Abstract:

The rural areas can be differentiated from urban areas in terms of their economic activities as rural areas are primarily involved in agricultural sector and provide natural resources whereas, urban areas are primarily involved in infrastructure sector and provide manufacturing services. Census of India defines a Census Town as an area which satisfies the following three criteria i.e. population exceeds 5000, at least 75 percent of male population engaged in non-agricultural sector and minimum population density of 400 persons per square kilometers. Urban areas can be attributed to the improvement of transport facilities, the massive decline in agricultural, especially male workers and workers shift to non-agricultural activities. This study examines the pattern, process of rural areas transformed into urban areas/ census town. The study has analyzed the various factors which are responsible for land transformation as well as the socio-economic transformation of the village population. Nilpur (CT) which belongs to Rajpura Tehsil in Patiala district, Punjab has been selected for the present study. The methodology adopted includes qualitative and quantitative research design, methods based on secondary data. Secondary data has been collected from unpublished revenue record office of Rajpura Tehsil and Primary Census Abstract of Patiala district, Census of India 2011. The results have showed that rate of transformation of a village to census town in Rajpura Tehsil has been one of highest among other villages. The census town has evolved through the evolutionary process of human settlement which grows in size, population and physical development. There must be a complete economic transformation and attainment of high level of technological development. Urban design and construction of buildings and infrastructure can be carried out better and faster and can be used to aid human habitation with the enhancement of quality of life. The study has concluded that in the selected area i.e Nilpur (CT) literacy rate has increased to 72.1 percent in year 2011 from 67.6 percent in year 2001. Similarly non-agricultural work force has increased to 95.2 percent in year 2011 from 81.1 percent in year 2001. It is very much clear that the increased literacy rate has put a positive impact on the involvement of non-agricultural workers have enhanced. The study has concluded that rural-urban linkages are important tools for understanding complexities of people livelihood and their strategies which involve mobility migration and the diversification of income sources and occupations.

Keywords: Census Town, India, Nilpur, Punjab

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6319 Elucidation of Leaders' Intrapersonal Competencies in the Workplace

Authors: Prakash Singh

Abstract:

Employees who are satisfied at their place of work rate their leaders’ intrapersonal competencies as being high. They also believe that a leader’s intrapersonal competencies influence their sense of job satisfaction. Employees who indicate that they are unhappy at their place of work rate their leaders’ intrapersonal competencies as being low. They also believe that a leader’s intrapersonal intelligence influence their feeling of job satisfaction. The leader’s appropriate intrapersonal competencies are crucial to the creation of a motivated and satisfied employee team. In this study, the quantitative research method was used to determine the employees’ perceptions of their leaders’ intrapersonal competencies and their influence on their job satisfaction; the six competencies being self-awareness, self-confidence, self-expression, self-control, adaptability, and optimism. All the competencies of leaders identified in this quantitative study can therefore be described as intervening variables that influence an employee’s sense of job satisfaction. The number of responses that indicate that each of the intrapersonal competencies of a leader that will have an influence on an employee’s sense of job satisfaction, ranges from 93% (a leader’s sense of self-awareness) to 99% (a leader’s ability to be adaptable). As the responses are significantly similar, it can be stated that the respondents indicate that all the intrapersonal competencies of a leader can influence an employee’s sense of job satisfaction. The findings of this study strongly suggest that in order to be satisfied at work, employees prefer to be led by leaders who are confident in their leadership roles; who send out clear, unambiguous messages; who maintain self-control; who are adaptable and flexible;, who face the future with optimism and who support the establishment of a collegial working environment. Evidently, the findings corroborate the hypothesis that employees believe that the intrapersonal competencies of leaders have a positive influence on the employees’ sense of job satisfaction. This study’s findings, therefore, confirm that the key to the leaders’ self-knowledge is access to their own feelings and the ability to discriminate among them and draw upon them to guide behaviour in their organisations. This exploratory study makes a contribution to the emerging research being accomplished on leaders’ intrapersonal intelligence with more research still needing to be attempted to determine to what extent these competencies of leaders can reshape the organizational climate and culture.

Keywords: emotional intelligence, employees’ job satisfaction, leaders’ intrapersonal competencies, leaders’ self-knowledge

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6318 Dual Metal Organic Framework Derived N-Doped Fe3C Nanocages Decorated with Ultrathin ZnIn2S4 Nanosheets for Efficient Photocatalytic Hydrogen Generation

Authors: D. Amaranatha Reddy

Abstract:

Highly efficient and stable co-catalysts materials is of great important for boosting photo charge carrier’s separation, transportation efficiency, and accelerating the catalytic reactive sites of semiconductor photocatalysts. As a result, it is of decisive importance to fabricate low price noble metal free co-catalysts with high catalytic reactivity, but it remains very challenging. Considering this challenge here, dual metal organic frame work derived N-Doped Fe3C nanocages have been rationally designed and decorated with ultrathin ZnIn2S4 nanosheets for efficient photocatalytic hydrogen generation. The fabrication strategy precisely integrates co-catalyst nanocages with ultrathin two-dimensional (2D) semiconductor nanosheets by providing tightly interconnected nano-junctions and helps to suppress the charge carrier’s recombination rate. Furthermore, constructed highly porous hybrid structures expose ample active sites for catalytic reduction reactions and harvest visible light more effectively by light scattering. As a result, fabricated nanostructures exhibit superior solar driven hydrogen evolution rate (9600 µmol/g/h) with an apparent quantum efficiency of 3.6 %, which is relatively higher than the Pt noble metal co-catalyst systems and earlier reported ZnIn2S4 based nanohybrids. We believe that the present work promotes the application of sulfide based nanostructures in solar driven hydrogen production.

Keywords: photocatalysis, water splitting, hydrogen fuel production, solar-driven hydrogen

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6317 Developing a Green Information Technology Model in Australian Higher-Educational Institutions

Authors: Mahnaz Jafari, Parisa Izadpanahi, Francesco Mancini, Muhammad Qureshi

Abstract:

The advancement in Information Technology (IT) has been an intrinsic element in the developments of the 21st century bringing benefits such as increased economic productivity. However, its widespread application has also been associated with inadvertent negative impacts on society and the environment necessitating selective interventions to mitigate these impacts. This study responded to this need by developing a Green IT Rating Tool (GIRT) for higher education institutions (HEI) in Australia to evaluate the sustainability of IT-related practices from an environmental, social, and economic perspective. Each dimension must be considered equally to achieve sustainability. The development of the GIRT was informed by the views of interviewed IT professionals whose opinions formed the basis of a framework listing Green IT initiatives in order of their importance as perceived by the interviewed professionals. This framework formed the base of the GIRT, which identified Green IT initiatives (such as videoconferencing as a substitute for long-distance travel) and the associated weighting of each practice. The proposed sustainable Green IT model could be integrated into existing IT systems, leading to significant reductions in carbon emissions and e-waste and improvements in energy efficiency. The development of the GIRT and the findings of this study have the potential to inspire other organizations to adopt sustainable IT practices, positively impact the environment, and be used as a reference by IT professionals and decision-makers to evaluate IT-related sustainability practices. The GIRT could also serve as a benchmark for HEIs to compare their performance with other institutions and to track their progress over time. Additionally, the study's results suggest that virtual and cloud-based technologies could reduce e-waste and energy consumption in the higher education sector. Overall, this study highlights the importance of incorporating Green IT practices into the IT systems of HEI to contribute to a more sustainable future.

Keywords: green information technology, international higher-educational institution, sustainable solutions, environmentally friendly IT systems

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6316 Blood Pressure Level, Targeted Blood Pressure Control Rate, and Factors Related to Blood Pressure Control in Post-Acute Ischemic Stroke Patients

Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

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Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

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6315 Comparative Study in Treatment of Distal Humerus Fracture with Lateral Column Plate Percutaneous Medial Screw and Intercondylar Screw

Authors: Sameer Gupta, Prant Gupta

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Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

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6314 Application of Ultrasonic Assisted Machining Technique for Glass-Ceramic Milling

Authors: S. Y. Lin, C. H. Kuan, C. H. She, W. T. Wang

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In this study, ultrasonic assisted machining (UAM) technique is applied in side-surface milling experiment for glass-ceramic workpiece material. The tungsten carbide cutting-tool with diamond coating is used in conjunction with two kinds of cooling/lubrication mediums such as water-soluble (WS) cutting fluid and minimum quantity lubricant (MQL). Full factorial process parameter combinations on the milling experiments are planned to investigate the effect of process parameters on cutting performance. From the experimental results, it tries to search for the better process parameter combination which the edge-indentation and the surface roughness are acceptable. In the machining experiments, ultrasonic oscillator was used to excite a cutting-tool along the radial direction producing a very small amplitude of vibration frequency of 20KHz to assist the machining process. After processing, toolmaker microscope was used to detect the side-surface morphology, edge-indentation and cutting tool wear under different combination of cutting parameters, and analysis and discussion were also conducted for experimental results. The results show that the main leading parameters to edge-indentation of glass ceramic are cutting depth and feed rate. In order to reduce edge-indentation, it needs to use lower cutting depth and feed rate. Water-soluble cutting fluid provides a better cooling effect in the primary cutting area; it may effectively reduce the edge-indentation and improve the surface morphology of the glass ceramic. The use of ultrasonic assisted technique can effectively enhance the surface finish cleanness and reduce cutting tool wear and edge-indentation.

Keywords: glass-ceramic, ultrasonic assisted machining, cutting performance, edge-indentation

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6313 The Prevalence and Profile of Extended Spectrum B-Lactamase (ESBL) Producing Enterobacteriaceae Species in the Intensive Care Unit (ICU) Setting of a Tertiary Care Hospital of North India

Authors: Harmeet Pal Singh Dhooria, Deepinder Chinna, UPS Sidhu, Alok Jain

Abstract:

Serious infections caused by gram-negative bacteria are a significant cause of mortality and morbidity in the hospital setting. In acute care facilities like in intensive care units (ICUs), the intensity of antimicrobial use together with a population highly susceptible to infection, creates an environment, which facilitates both emergence and transmission of Extended Spectrum -lactamase (ESBL) producing Enterobacteriaceae species. The study was conducted in the Medical Intensive Care Unit (MICU) and the Pulmonary Critical Care Unit (PCCU) of the Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Out of a total of 1108 samples of urine, blood and respiratory tract secretions received for culture and sensitivity analysis from Medical Intensive Care Unit and Pulmonary Critical Care Unit, a total of 170 isolates of Enterobacteriaceae species were obtained which were then included in our study. Out of these 170 isolates, confirmed ESBL production was seen in 116 (68.24%) cases. E.coli was the most common species isolated (56.47%) followed by Klebsiella (32.94%), Enterobacter (5.88%), Citrobacter (3.53%), Enterobacter (0.59%) and Morganella (0.59%) among the total isolates. The rate of ESBL production was more in Klebsiella (78.57%) as compared to E.coli (60.42%). ESBL producers were found to be significantly more common in patients with prior history of hospitalization, antibiotic use, and prolonged ICU stay. Also significantly increased the prevalence of ESBL related infections was observed in patients with a history of catheterization or central line insertion but not in patients with the history of intubation. Patients who had an underlying malignancy had significantly higher prevalence of ESBL related infections as compared to other co-morbid illnesses. A slightly significant difference in the rate of mortality/LAMA was observed in the ESBL producer versus the non-ESBL producer group. The rate of mortality/LAMA was significantly higher in the ESBL related UTI but not in the ESBL related respiratory tract and bloodstream infections. ESBL producing isolates had significantly higher rates of resistance to Cefepime and Piperacillin/Tazobactum, and to non β-lactum antibiotics like Amikacin and Ciprofloxacin. The level of resistance to Imipenem was lower as compared to other antibiotics. However, it was noted that ESBL producing isolates had higher levels of resistance to Imipenem as compared to non-ESBL producing isolates. Conclusion- The prevalence of ESBL producing organisms was found to be very high (68.24%) among Enterobacteriaceae isolates in our ICU setting as among other ICU care settings around the world.

Keywords: enterobacteriaceae, extended spectrum B-lactamase (ESBL), ICU, antibiotic resistance

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