Search results for: bridge stay cables

Authors: Nalluri Lakshmi Ramu, C. Venkat Nihit, Narayana Kumar, Dillep

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Masonry bridges are the iconic heritage transportation infrastructure throughout the world. Continuous increase in traffic loads and speed have kept engineers in dilemma about their structural performance and capacity. Henceforth, research community has an urgent need to propose an effective methodology and validate on real-time bridges. The presented research aims to assess the structural health of an Eighty-year-old masonry railway bridge in India using wireless accelerometer sensors. The bridge consists of 44 spans with length of 24.2 m each and individual pier is 13 m tall laid on well foundation. To calculate the dynamic characteristic properties of the bridge, ambient vibrations were recorded from the moving traffic at various speeds and the same are compared with the developed three-dimensional numerical model using finite element-based software. The conclusions about the weaker or deteriorated piers are drawn from the comparison of frequencies obtained from the experimental tests conducted on alternative spans. Masonry is a heterogeneous anisotropic material made up of incoherent materials (such as bricks, stones, and blocks). It is most likely the earliest largely used construction material. Masonry bridges, which were typically constructed of brick and stone, are still a key feature of the world's highway and railway networks. There are 1,47,523 railway bridges across India and about 15% of these bridges are built by masonry, which are around 80 to 100 year old. The cultural significance of masonry bridges cannot be overstated. These bridges are considered to be complicated due to the presence of arches, spandrel walls, piers, foundations, and soils. Due to traffic loads and vibrations, wind, rain, frost attack, high/low temperature cycles, moisture, earthquakes, river overflows, floods, scour, and soil under their foundations may cause material deterioration, opening of joints and ring separation in arch barrels, cracks in piers, loss of brick-stones and mortar joints, distortion of the arch profile. Few NDT tests like Flat jack Tests are being employed to access the homogeneity, durability of masonry structure, however there are many drawbacks because of the test. A modern approach of structural health assessment of masonry structures by vibration analysis, frequencies and stiffness properties is being explored in this paper.

Keywords: masonry bridges, condition assessment, wireless sensors, numerical analysis modal frequencies

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Authors: Sacha Joseph-Mathews, Leili Javadpour

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In the tourism industry, hoteliers spend millions annually on marketing and positioning efforts for their respective hotels, all in an effort to create a specific image in the minds of the consumer. Yet despite extensive efforts to seduce potential hotel guests with sophisticated advertising messages generated by hotel entities, consumers continue to mistrust corporate branding, preferring instead to place their trust in the reviews of their consumer peers. In today’s complex and cluttered marketplace, online reviews can serve as a mediator for consumers who do not have actual knowledge and experiences with the brand, but are in the process of deciding whether or not to engage in a consumption exercise. Traditionally, consumers have used online reviews as a source of comfort and confirmation of a product/service’s positioning. But today, very few customers make any purchase decisions without first researching existing user reviews, making reviews more of a necessity, rather than a luxury in the purchase decision process. The influence of user generated content (UGC) is amplified in the tourism industry; as more than a third of potential hotel guests will not book a room without first reading a review. As corporate branding becomes less relevant and online reviews become more important, how much of the consumer’s stay expectations are being dictated by existing UGC? Moreover, as hotel guest experience a hotel through the lens of an existing review, how much of their stay and in turn their review, would have been influenced by those reviews that they read? Ultimately, there is the potential for UGC to dictate what potential guests will be most critical about, and or most focused on during their stay. If UGC is a stronger influencer in the purchase decision process than corporate branding, doesn’t it have the potential to dictate, the entire stay experience by influencing the expectations of the guest prior to them arriving on the property? For example, if a hotel is an eco-destination and they focus their branding on their website around sustainability and the retreat nature of the hotel. Yet, guest reviews constantly discuss how dissatisfactory the service and food was with no mention of nature or sustainability, will future reviews then focus primarily on the food? Using text analysis software to examine over 25,000 online reviews, we explore the extent to which new reviews are influenced by wording used in previous reviews for a hotel property, versus content generated by corporate positioning. Additionally, we investigate how distinct hotel related UGC is across different types of tourism destinations. Our findings suggest that UGC can have a greater impact on future reviews, than corporate branding and there is more cohesiveness across UGC of different types of hotel properties than anticipated. A model of User Generated Content Influence is presented and the managerial impact of the power of online reviews to trump corporate branding and shape future user experiences is discussed.

Keywords: user generated content, UGC, corporate branding, online reviews, hotels and tourism

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Authors: Magdalena Kostova-Panayotova, Neda-Maria Panayotova

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The article is focused on a problem that tends to be extremely characteristic and essential to European literature – the relations between the Balkan Peninsula and Europe and the stereotypes the Balkans evoke – a melting pot, a powder keg, a bridge, a crossroads, along with other negative definitions. The stereotypes and visions are examined as the layered images of a particular nation. The work deals with the Balkan writers’ way of confronting stereotypes by reversing the image of the ‘dark’ Balkans and the ‘bright’ Europe and thus establishing the Balkans as a place of beauty, music, and poetry. In many aspects, the European image of the Balkans (the so-called Balkanism) is comparable to the European attitude to the Orient (the so-called Orientalism). On the basis of the analysis of specific texts by Balkan authors, the article proves that the identity of the person of the late 20th and early 21st century is something individual and much more complicated than a patriotic self-definition because the identity of the contemporary person is multilayered. It is not flattering to be a bridge, a crossroads or a corner. However, a person is a creature of transition. Our idea demonstrates that the state of transition always brings both weakness and strength – it is the Balkans that connect Europe to the world.

Keywords: image, Slavs, Balkans, identity of the modern Balkan person

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Authors: A. Duncan, A. Blake, A. O'Gara, J. Fitzgerald

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Introduction: Acute traumatic rib fractures have significant morbidity and mortality and are a commonly seen injury in trauma patients. Rib fracture pain can often be acute and can prove challenging to manage. We performed an audit on patients with acute traumatic rib fractures with the aim of composing a referral and treatment pathway for such patients. Methods: From January 2021 to January 2022, the pain medicine service encouraged early referral of all traumatic rib fractures to the pain service for a multi-modal management approach. A retrospective audit of analgesic management was performed on a select cohort of 24 patients, with a mean age of 67, of which 19 had unilateral rib fractures. Results: 17 of 24 patients (71%) underwent local, regional block as part of a multi-modal analgesia regime. Only one regional complication was observed, seen with hypotension occurring in one patient with a thoracic epidural. The group who did not undergo regional block had a length of stay (LOS) 17 days longer than those who did (27 vs. 10) and higher rates of pneumonia (29% vs. 18%). Conclusion: Early referral to pain specialists is an important component of the effective management of acute traumatic rib fractures. From our audit, it is evident that regional blocks can be effectively used in these cases as part of a multi-modal analgesia regime and may confer benefits in terms of respiratory complications and length of stay.

Keywords: rib fractures, regional blocks, thoracic epidural, erector spina block

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Authors: Renu Saini, Deepak Agrawal

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Background: Patients with head and spinal cord injury frequently have deranged coagulation profiles and require blood products transfusion perioperatively. Thromboelastography (TEG) is a ‘bedside’ global test of coagulation which may have role in deciding the need of transfusion in such patients. Aim: To assess the usefulness of TEG in department of neurosurgery in decreasing transfusion rates and coagulation-related mortality in traumatic head and spinal cord injury. Method and Methodology: A retrospective comparative study was carried out in the department of neurosurgery over a period of 1 year. There are two groups in this study. ‘Control’ group constitutes the patients in whom data was collected over 6 months (1/6/2009-31/12/2009) prior to installation of TEG machine. ‘Test’ group includes patients in whom data was collected over 6months (1/1/2013-30/6/2013) post TEG installation. Total no. of platelet, FFP, and cryoprecipitate transfusions were noted in both groups along with in hospital mortality and length of stay. Result: Both groups were matched in age and sex of patients, number of head and spinal cord injury cases, number of patients with thrombocytopenia and number of patients who underwent operation. Total 178 patients (135 head injury and 43 spinal cord injury patents) were admitted in neurosurgery department during time period June 2009 to December 2009 i.e. prior to TEG installation and after TEG installation a total of 243 patients(197 head injury and 46 spinal cord injury patents) were admitted. After TEG introduction platelet transfusion significantly reduced (p=0.000) compare to control group (67 units to 34 units). Mortality rate was found significantly reduced after installation (77 patients to 57 patients, P=0.000). Length of stay was reduced significantly (Prior installation 1-211days and after installation 1-115days, p=0.02). Conclusion: Bedside TEG can dramatically reduce platelet transfusion components requirement in department of neurosurgery. TEG also lead to a drastic decrease in mortality rate and length of stay in patients with traumatic head and spinal cord injuries. We recommend its use as a standard of care in the patients with traumatic head and spinal cord injuries.

Keywords: blood component transfusion, mortality, neurosurgery ICU, thromboelastography

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Authors: Morteza Gharibi, Abdolghader Pakniat, Somayeh Bahrampouri

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Introduction: Emergency department (E.R.) crowding is a serious widespread problem in hospitals that leads to irregularities, a slower rate of delivery of services to patients, and a long-term stay. In addition, the long-term stay in the E.D. reduces the possibility of providing services with appropriate quality to other patients who are undergoing medical emergencies, which leads to dissatisfaction among patients. This study aimed to determine the relationship between ED-crowding and the mortality rate of the patients referred to the E.D. In a retrospective cohort study, all patients who expired in first 24 hours of admission were enrolled in the study. Crowding index at the moment of admission was calculated using Edwin Score. The data including history and physical examination, time of arrival in the E.D., diagnosis (using ICD 10 code), time of death, cause of death, demographic information was recoded based on triage forms on admission and patients’ medical files. Data analysis was performed by using descriptive statistics and chi square test, ANOVA tests using SPSS ver. 19. The time of arrival in E.D. to death in crowded E.D. conditions, with an average of five hours and 25 minutes, was significantly higher than the average admission Time of arrival in E.D. to death in active and crowded E.D. conditions. More physicians and nurses can be employed during crowded times to reduce staff fatigue and improve their performance during these hours.

Keywords: mortality, emergency, department, crowding

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Authors: Minho Kwon, Jeonghee Lim, Yeongseok Jeong, Jongyoon Moon, Donghoon Shin, Kiyoung Kim

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In the past, the criteria and procedures for the design of concrete structures were mainly based on the stresses allowed for structural components. However, although the frequency of earthquakes has increased and the risk has increased recently, it has been difficult to determine the safety factor for earthquakes in the safety assessment of structures based on allowable stresses. Recently, limit state design method has been introduced for reinforced concrete structures, and limit state-based approach has been recognized as a more effective technique for seismic design. Therefore, in this study, the limit state of the bridge, which is a structure requiring higher stability against earthquakes, was evaluated. The finite element program LS-DYNA and twenty ground motion were used for time history analysis. The fracture caused by tensile and compression of the pier were set to the limit state. In the concrete tensile fracture, the limit state arrival rate was 100% at peak ground acceleration 0.4g. In the concrete compression fracture, the limit state arrival rate was 100% at peak ground acceleration 0.2g.

Keywords: allowable stress, limit state, safety factor, peak ground acceleration

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Authors: A. Kamel Abd Elaziz Mohamed, B. Sameh Kamal el Maraghi

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Introduction: Adaptive support ventilation (ASV) is an improved closed-loop ventilation mode that provides both pressure-controlled ventilation and PSV according to the patient’s needs. Aim of the work: To compare the short-term effects of Adaptive support ventilation (ASV), with conventional Pressure support ventilation (PSV) in weaning of intubated COPD patients. Patients and methods: Fifty patients admitted in the intensive care with acute exacerbation of COPD and needing intubation were included in the study. All patients were initially ventilated with control/assist control mode, in a stepwise manner and were receiving standard medical therapy. Patients were randomized into two groups to receive either ASV or PSV. Results: Out of fifty patients included in the study forty one patients in both studied groups were weaned successfully according to their ABG data and weaning indices. APACHE II score showed no significant difference in both groups. There were statistically significant differences between the groups in term of, duration of mechanical ventilation, weaning hours and length of ICU stay being shorter in (group 1) weaned by ASV. Re-intubation and mortality rate were higher in (group 11) weaned by conventional PSV, however the differences were not significant. Conclusion: ASV can provide automated weaning and achieve shorter weaning time for COPD patients hence leading to reduction in the total duration of MV, length of stay, and hospital costs.

Keywords: COPD patients, ASV, PSV, mechanical ventilation (MV)

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Authors: Martin Kartomo

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Though Management Control Systems (MCS) research has evolved beyond intra-organizational boundaries, there is limited understanding of the impact of a functioning MCS being functional beyond intra-organizational boundaries. The purpose of this research is to investigate factors that have an impact on functioning management Control Systems (MCS)becoming (dys-)functional beyond its intra-organizational boundaries. To bridge the theoretical gap, a systematic literature review is conducted to identify inter-and extra-organizational factors that are purposely suggested or unintendingly mentioned by MCS researchers to evaluate functioning MCS becoming (dys-)functional. A conceptual map is rationalized and constructed from five contingent inter-and extra-organizational MCS frameworks illuminating under-investigated MSC research areas and allowing new research avenues based on academically known factors. A multiple case study followed by a co-researcher discussion group with the purpose of identifying academically unknown factors for evaluating MCS (dys-)functionality beyond its intra-organizational boundaries. The study's result will help bridge the gap between what academics know and not know of evaluating MCS being functional beyond intra-organizational boundaries with the opportunity to develop better, more complete theories. Furthermore, it will help organizations to evaluate the impact of their activities beyond intra-organizational boundaries.

Keywords: management control systems, management control systems evaluation, management controls, control system

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Authors: J. Milton, C. Uzoigwe, O. Ayeko, B. Offorha, K. Anderson, R. G. Middleton

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Background: We used the UK National Hip Fracture database to determine the effect of institution hip fracture case volume on hip fracture healthcare outcomes in 2019. Using logistic regression for each healthcare outcome, we compared the best performing 50 units with the poorest performing 50 units in order to determine if the unit volume was associated with performance for each particular outcome. Method: We analysed 175 institutions treating a total of 67,673 patients over the course of a year. Results: The number of hip fractures seen per unit ranged between 86 and 952. Larger units tendered to perform health assessments more consistently and mobilise patients more expeditiously post-operatively. Patients treated at large institutions had shorter lengths of stay. With regard to most other outcomes, there was no association between unit case volume and performance, notably compliance with the Best Practice Tariff, time to surgery, proportion of eligible patients undergoing total hip arthroplasty, length of stay, delirium risk, and pressure sore risk assessments. Conclusion: There is no relationship between unit volume and the majority of health care outcomes. It would seem that larger institutions tend to perform better at parameters that are dependent upon personnel numbers. However, where the outcome is contingent, even partially, on physical infrastructure capacity, there was no difference between larger and smaller units.

Keywords: institution volume, mortality, neck of femur fractures, osteoporosis

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Authors: Sana Ansari, Sirus Mohammadi

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In distribution systems, shunt capacitors are used to reduce power losses, to improve voltage profile, and to increase the maximum flow through cables and transformers. This paper presents a new method to determine the optimal locations and economical sizing of fixed and/or switched shunt capacitors with a view to power losses reduction and voltage stability enhancement. General Algebraic Modeling System (GAMS) has been used to solve the maximization modules using the MINOS optimization software with Linear Programming (LP). The proposed method is tested on 33 node distribution system and the results show that the algorithm suitable for practical implementation on real systems with any size.

Keywords: power losses, voltage stability, radial distribution systems, capacitor

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Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa

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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.

Keywords: ICT, e-health, machine learning, ICU, healthcare

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Authors: Hachmia Faqihi, Maarouf Saad, Khalid Benjelloun, Mohammed Benbrahim, M. Nabil Kabbaj

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This paper investigates and presents a cable-driven robot to lower limb rehabilitation use in sagittal plane. The presented rehabilitation robot is used for a trajectory tracking in joint space. The paper covers kinematic and dynamic analysis, which reveals the tensionability of the used cables as being the actuating source to provide a rehabilitation exercises of the human leg. The desired trajectory is generated to be used in the control system design in joint space. The obtained simulation results is showed to be efficient in this kind of application.

Keywords: cable-driven multi-body system, computed-torque controller, lower limb rehabilitation, tracking trajectory

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Authors: R. B. Mishra, Sudhakar Tripathi

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In this paper, the cable model of dendrites have been considered. The dendrites are cylindrical cables of various segments having variable length and reducing radius from start point at synapse and end points. For a particular event signal being received by a neuron in response only some dendrite are active at a particular instance. Initial current signals with different current flows in dendrite are assumed. Due to overlapping and coupling of active dendrite, they induce currents in the dendrite segments of each other at a particular instance. But how these currents are induced in the various segments of active dendrites due to coupling between these dendrites, It is not presented in the literature. Here the paper presents a model for induced currents in active dendrite segments due to mutual coupling at the starting instance of an activity in dendrite. The model is as discussed further.

Keywords: currents, dendrites, induction, simulation

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Authors: R. C. Law, Shirley Kang, T. Y. Hin, M. Z. Abdullah

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LED technology has been evolving aggressively in recent years from incandescent bulb during older days to as small as chip scale package. It will continue to stay bright in future. As such, there is tremendous pressure to stay competitive in the market by optimizing products to next level of performance and reliability with the shortest time to market. This changes the conventional way of product design and development to virtual prototyping by means of Computer Aided Engineering (CAE). It comprises of the deployment of Finite Element Method (FEM) and Computational Fluid Dynamic (CFD). FEM accelerates the investigation for early detection of failures such as crack, improve the thermal performance of system and enhance solder joint reliability. CFD helps to simulate the flow pattern of molding material as a function of different temperature, molding parameters settings to evaluate failures like voids and displacement. This paper will briefly discuss the procedures and applications of FEM in thermal stress, solder joint reliability and CFD of compression molding in LED CSP. Integration of virtual prototyping in product development had greatly reduced the time to market. Many successful achievements with minimized number of evaluation iterations required in the scope of material, process setting, and package architecture variant have been materialized with this approach.

Keywords: LED, chip scale packaging (CSP), computational fluid dynamic (CFD), virtual prototyping

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Authors: Alejandro Adorjan

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Universities are motivated to understand the factor contributing to low retention of engineering undergraduates. While precollege students for engineering increases, the number of engineering graduates continues to decrease and attrition rates for engineering undergraduates remains high. Calculus 1 (C1) is the entry point of most undergraduate Engineering Science and often a prerequisite for Computing Curricula courses. Mathematics continues to be a major hurdle for engineering students and many students who drop out from engineering cite specifically Calculus as one of the most influential factors in that decision. In this context, creating course activities that increase retention and motivate students to obtain better final results is a challenge. In order to develop several competencies in our students of Software Engineering courses, Calculus 1 at Universidad ORT Uruguay focuses on developing several competencies such as capacity of synthesis, abstraction, and problem solving (based on the ACM/AIS/IEEE). Every semester we try to reflect on our practice and try to answer the following research question: What kind of teaching approach in Calculus 1 can we design to retain students and obtain better results? Since 2010, Universidad ORT Uruguay offers a six-week summer noncompulsory bridge course of preparatory math (to bridge the math gap between high school and university). Last semester was the first time the Department of Mathematics offered the course while students were enrolled in C1. Traditional lectures in this bridge course lead to just transcribe notes from blackboard. Last semester we proposed a Hands On Lab course using Geogebra (interactive geometry and Computer Algebra System (CAS) software) as a Math Driven Development Tool. Students worked in a computer laboratory class and developed most of the tasks and topics in Geogebra. As a result of this approach, several pros and cons were found. It was an excessive amount of weekly hours of mathematics for students and, as the course was non-compulsory; the attendance decreased with time. Nevertheless, this activity succeeds in improving final test results and most students expressed the pleasure of working with this methodology. This teaching technology oriented approach strengthens student math competencies needed for Calculus 1 and improves student performance, engagement, and self-confidence. It is important as a teacher to reflect on our practice, including innovative proposals with the objective of engaging students, increasing retention and obtaining better results. The high degree of motivation and engagement of participants with this methodology exceeded our initial expectations, so we plan to experiment with more groups during the summer so as to validate preliminary results.

Keywords: calculus, engineering education, PreCalculus, Summer Program

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Authors: Rade M. Ciric, Sasa Mandic

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Students of Higher Education Technical School of Professional Studies, in Novi Sad follow the subject Maintenance of electric power equipment at the Electrotechnical Department. This paper presents educational plan and program of the subject Maintenance of electric power equipment. The course deals with the problems of preventive and investing maintenance of transformer stations (TS), performing and maintenance of grounding of TS and pillars, as well as tracing and detection the location of the cables failure. There is a special elaborated subject concerning the safe work conditions for the electrician during network maintenance, as well as the basics of making and keeping technical documentation of the equipment.

Keywords: educational plan and program, electric power equipment, maintenance, technical documentation, safe work

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Authors: Marija Vitanova, Aleksandra Bogdanovic, Kemal Edip, Viktor Hristovski, Vlado Micov

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Bridges represent critical structures in lifeline systems. They provide reliable modes of transportation, so their failure can seriously obstruct relief and rehabilitation work. Earthquake ground motions can cause significant damages in bridges, so during the strong earthquakes, they can easily collapse. The base isolation technique has been quite effective in seismic response mitigation of the bridges in reducing the piers base shear. The effect of soil structure interaction on the dynamic responses of seismically isolated three span girder bridge with viscous dampers is investigated. Viscous dampers are installed in the mid span of the bridge to control bearing displacement. The soil surrounding the foundation of piers has been analyzed by applying different soil densities in order to consider the soil stiffness. The soil medium has been assumed as a four layered infill as dense and loose medium. The boundaries in the soil medium are considered as infinite elements in order to absorb the radiating waves. The formulation of infinite elements is the same as for the finite elements in addition to the mapping of the domain. Based on the iso-parametric concept, the infinite element in global coordinate is mapped onto an element in local coordinate system. In the formulation of the infinite element, only the positive direction extends to infinity thus allowing the waves to propagate outside of the soil medium. Dynamic analyses for two levels of earthquake intensity are performed in time domain using direct integration method. In order to specify the effects of the SSI, the responses of the isolated and controlled isolated bridges are compared. It is observed that the soil surrounding the piers has significant effects on the bearing displacement of the isolated RC bridges. In addition, it is observed that the seismic responses of isolated RC bridge reduced significantly with the installation of the viscous dampers.

Keywords: viscous dampers, reinforced concrete girder bridges, seismic response, SSI

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Authors: Giovanni Menichini, Salvatore Giacomo Morano, Gloria Terenzi, Luca Salvatori, Maurizio Orlando

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The “Guidelines for Risk Classification, Safety Assessment, and Structural Health Monitoring of Existing Bridges” were recently approved by the Italian Government to define technical standards for managing the national network of existing bridges. These guidelines provide a framework for risk mitigation and safety assessment of bridges, which are essential elements of the built environment and form the basis for the operation of transport systems. Within the guideline framework, a workflow based on three main points was proposed: (1) risk-based, i.e., based on typical parameters of hazard, vulnerability, and exposure; (2) multi-level, i.e., including six assessment levels of increasing complexity; and (3) multirisk, i.e., assessing structural/foundational, seismic, hydrological, and landslide risks. The paper focuses on applying the Italian Guidelines to specific case studies, aiming to identify the parameters that predominantly influence the determination of the “class of attention”. The significance of each parameter is determined via sensitivity analysis. Additionally, recommendations for enhancing the process of assigning the class of attention are proposed.

Keywords: bridge safety assessment, Italian guidelines implementation, risk classification, structural health monitoring

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Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: hospital, light fidelity, Li-Fi, medical devices, security

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Minho Kwon, Jeonghee Lim, Yeongseok Jeong, Donghoon Shin, Kiyoung Kim

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Recently, global warming phenomenon has led to natural disasters caused by global environmental changes, and due to abnormal weather events, the frequency and intensity of heavy rain storm typhoons are increasing. Therefore, it is imperative to prepare for future heavy rain storms and typhoons. This study selects arbitrary target bridges and performs numerical analysis to evaluate the safety of bridge piers in the event that the water level changes. The numerical model is based on two-dimensional surface elements. Actual reinforced concrete was simulated by modeling concrete to include reinforcements, and a contact boundary model was applied between the ground and the concrete. The water level applied to the piers was considered at 18 levels between 7.5 m and 16.1 m. The elastic modulus, compressive strength, tensile strength, and yield strength of the reinforced concrete were calculated using 250 random combinations and numerical analysis was carried out for each water level. In the results of analysis, the bridge exceeded the stated limit at 15.0 m. At the maximum water level of 16.1m, the concrete’s failure rate was 35.2%, but the probability that the reinforcement would fail was 61.2%.

Keywords: Monte-Carlo method, pier, water level change, limit state

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Authors: Muhanad Al-Jubouri

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A local scour is the most important of the several scours impacting bridge performance and security. Even though scour is widespread in bridges, especially during flood seasons, the experimental tests could not be applied to many standard highway bridges. A computational fluid dynamics numerical model was used to solve the problem of calculating local scouring and deposition for non-cohesive silt and clear water conditions near single and double cylindrical piers with the effect of floating debris. When FLOW-3D software is employed with the Rang turbulence model, the Nilsson bed-load transfer equation and fine mesh size are considered. The numerical findings of single cylindrical piers correspond pretty well with the physical model's results. Furthermore, after parameter effectiveness investigates the range of outcomes based on predicted user inputs such as the bed-load equation, mesh cell size, and turbulence model, the final numerical predictions are compared to experimental data. When the findings are compared, the error rate for the deepest point of the scour is equivalent to 3.8% for the single pier example.

Keywords: local scouring, non-cohesive, clear water, computational fluid dynamics, turbulence model, bed-load equation, debris

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Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

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Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

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Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

Abstract:

Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Marwa Ben Khalifa, Zeineb Ben Salem, Wissem Frikha

Abstract:

This paper presents a case study of “Radès la Goulette” bridge project using the technique of prefabricated vertical drains (PVD) associated with step by step construction of preloading embankments with averaged height of about 6 m. These embankments are founded on a highly compressible layer of Tunis soft soil. The construction steps included extensive soil instrumentation such as piezometers and settlement plates for monitoring the dissipation of excess pore water pressures and settlement during the consolidation of Tunis soft soil. An axisymmetric numerical model using the 2D finite difference code FLAC was developed and calibrated using laboratory tests to predict the soil behavior and consolidation settlements. The constitutive model impact for simulating the soft soil behavior is investigated. The results of analyses show that numerical analysis provided satisfactory predictions for the field performance during the construction of Radès la Goulette embankment. The obtained results show the effectiveness of PVD in the acceleration of the consolidation time. A comparison of numerical results with theoretical analysis was presented.

Keywords: tunis soft soil, radès bridge project, prefabricated vertical drains, FLAC, acceleration of consolidation

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Authors: A. Y. Purnama, N. Yasufuku

Abstract:

The bridge structure is a building that has to be maintained, especially for the elastomeric bearing. The girder of the bridge needs to be lifted upward to maintain this elastomeric bearing, that needs high cost. Nowadays, integral abutment bridges are becoming popular. The integral abutment bridge is less costly because the elastomeric bearings are eliminated, which reduces the construction cost and maintenance costs. However, when this elastomeric bearing removed, the girder movement due to environmental thermal forces directly support by pile foundation, and it needs to be considered in the design. In case of pile foundation in a stiff soil, in the top area of the pile cannot move freely due to the fixed condition by soil stiffness. Pre-bored pile system can be used to increase the flexibility of pile foundation using a pre-bored hole that filled with elastic materials, but the behavior of soil-pile interaction and soil response due to this system is still rarely explained. In this paper, an experimental study using small-scale laboratory model test conducted in a half size model. Single flexible pile model embedded in sandy soil with the pre-bored ring, which filled with the filler material. The testing box made from an acrylic glass panel as observation area of the pile shaft to monitor the displacement of the pile during the lateral loading. The failure behavior of the soil inside the pre-bored ring and around the pile shaft was investigated to determine the point of pile rotation and the movement of this point due to the pre-bored ring system along the pile shaft. Digital images were used to capture the deformations of the soil and pile foundation during the loading from the acrylic glass on the side of the testing box. The results were presented in the form of lateral load resistance charts against the pile shaft displacement. The failure pattern result also established due to the cyclic lateral loading. The movement of the rotational point was measured due to the pre-bored system filled with appropriate filler material. Based on the findings, design considerations for pre-bored pile system due to cyclic lateral loading can be introduced.

Keywords: failure behavior, pre-bored pile system, cyclic lateral loading, sandy soil

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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Authors: Valentin Nickolai, Florian Pfeffel, Christian Louis Kühner

Abstract:

In many industrialized nations, the demand for skilled workers rises, causing the current market for employees to be more candidate-driven than employer-driven. Therefore, losing highly skilled and experienced employees due to early or partial retirement negatively impacts firms. Therefore, finding new ways to incentivize older employees (Silver Workers) to stay longer with the company and in their job can be crucial for the success of a firm. This study analyzes how working remotely can be a valid incentive for experienced Silver Workers to stay in their job and instead work from home with more flexible working hours. An online survey with n = 684 respondents, who are employed in the service sector, has been conducted based on 13 constructs that influence job satisfaction. These have been further categorized into three groups “classic influencing factors,” “influencing factors changed by remote working,” and new remote working influencing factors,” and were analyzed using structural equation modeling (SEM). Here, Cronbach’s alpha of the individual constructs was shown to be suitable. Furthermore, the construct validity of the constructs was confirmed by face validity, content validity, convergent validity (AVE > 0.5: CR > 0.7), and discriminant validity. Additionally, confirmatory factor analysis (CFA) confirmed the model fit for the investigated sample (CMIN/DF: 2.567; CFI: 0.927; RMSEA: 0.048). It was shown in the SEM-analysis that the influencing factor on job satisfaction, “identification with the work,” is the most significant with β = 0.540, followed by “Appreciation” (β = 0.151), “Compensation” (β = 0.124), “Work-Life-Balance” (β = 0.116), and “Communication and Exchange of Information” (β = 0.105). While the significance of each factor can vary depending on the work model, the SEM-analysis also shows that the identification with the work is the most significant factor in all three work models mentioned above and, in the case of the traditional office work model, it is the only significant influencing factor. The study shows that employees between the ages of 56 and 65 years have the highest job satisfaction when working entirely from home or remotely. Furthermore, their job satisfaction score of 5.4 on a scale from 1 (very dissatisfied) to 7 (very satisfied) is the highest amongst all age groups in any of the three work models. Due to the significantly higher job satisfaction, it can be argued that giving Silver Workers the offer to work from home or remotely can incentivize them not to opt for early retirement or partial retirement but to stay in their job full-time Furthermore, these findings can indicate that employees in the Silver Worker age are much more inclined to leave their job for early retirement if they have to entirely work in the office.

Keywords: home office, remote work instead of early or partial retirement, silver worker, structural equation modeling

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Authors: Marwa Ben Khalifa, Zeineb Ben Salem, Wissem Frikha

Abstract:

The purpose of the present work is to study the consolidation behavior of highly compressible Tunis soft soil “TSS” by means of prefabricated vertical drains (PVD’s) associated to preloading based on laboratory and field investigations. In the first hand, the field performance of PVD’s on the layer of Tunis soft soil was analysed based on the case study of the construction of embankments of “Radès la Goulette” bridge project. PVD’s Geosynthetics drains types were installed with triangular grid pattern until 10 m depth associated with step-by-step surcharge. The monitoring of the soil settlement during preloading stage for Radès La Goulette Bridge project was provided by an instrumentation composed by various type of tassometer installed in the soil. The distribution of water pressure was monitored through piezocone penetration. In the second hand, a laboratory reduced tests are performed on TSS subjected also to preloading and improved with PVD's Mebradrain 88 (Mb88) type. A specific test apparatus was designed and manufactured to study the consolidation. Two series of consolidation tests were performed on TSS specimens. The first series included consolidation tests for soil improved by one central drain. In thesecond series, a triangular mesh of three geodrains was used. The evolution of degree of consolidation and measured settlements versus time derived from laboratory tests and field data were presented and discussed. The obtained results have shown that PVD’s have considerably accelerated the consolidation of Tunis soft soil by shortening the drainage path. The model with mesh of three drains gives results more comparative to field one. A longer consolidation time is observed for the cell improved by a single central drain. A comparison with theoretical analysis, basically that of Barron (1948) and Carillo (1942), was presented. It’s found that these theories overestimate the degree of consolidation in the presence of PVD.

Keywords: tunis soft soil, prefabricated vertical drains, acceleration of consolidation, dissipation of excess pore water pressures, radès bridge project, barron and carillo’s theories

Procedia PDF Downloads 112