Search results for: non invasive ventilation

Authors: Abdelkarim Ait Brik, Abdelaziz Khoukh, Mustapha Jammali, Hamid Chaikhy

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The energy audit is the essential initial step to ensure a good definition of energy control actions. The in-depth study of the various energy-consuming equipments makes it possible to determine the actions and investments with best cost for the company. The analysis focuses on the energy consumption of production equipment and utilities (lighting, heating, air conditioning, ventilation, transport). Successful implementation of this approach requires, however, to take into account a number of prerequisites. This paper proposes a number of useful recommendations concerning the energy audit in order to achieve better results, and a case study concerning the lighting audit of a Moroccan company by showing the gains that can be made through this audit.

Keywords: energy audit, energy diagnosis, consumption, electricity, energy efficiency, lighting audit

Procedia PDF Downloads 675

Authors: Lucas Bernardes Naves, Luis Almeida

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The paper includes a review concerning the use of some composites including poly(lactide-co-glycolide) (PGLA), zeolite and Gadopentetic acid (Gd-DTPA) loaded chitosan nanoparticles (Gd-nanoCPs) in order to establish a new alternative for the treatment of Melanoma Skin Cancer. The main goal of this paper it to make a review of what scientist have done in the last few years, as well as to propose a less invasive therapy for skin cancer, by using Hydrocolloid, based on PLGA coated with Gd-nanoCPs for Neutron Capture Therapy.

Keywords: cancer therapy, dressing polymers, melanoma, wound healing

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Authors: Kamyar Kabirifar, Majid Azarniush, Behbood Maashkar

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A proper house is a suitable residential area which provides comfort, proper accessibility, security, stability and permanence of structure, enough lighting, Proper initial infrastructures and ventilation for its inhabitants and the most important of all, it should be proportional to the family’s financial power. Saving energy and making optimal usage of it and also taking advantage of stable energies are the bases of green buildings. Making green building will help the health of a person living in it and in its surrounding. It will support the people and provoke their satisfaction. Not only it will bring about the raise of level of the quality of life for building inhabitants, but also it will cause the promotion of quality level of life of the people living in the surrounding area and the society.

Keywords: quality of life, green building, environment pollution, sick building

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Authors: Kishor Prasad Bhatta, Suman Ghimire, Durga Prasad Joshi

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Invasive Alien Species (IAS) are considered waste forest resources in Nepal. The rapid expansion of IAS is one of the nine main drivers of forest degradation, though the extent and distribution of this species are not well known. Further, the knowledge of the impact of IAS removal on forest plant diversity is hardly known, and the possibilities of income generation from them at the grass-root communities are rarely documented. Systematic sampling of 1% with nested circular plots of 500 square meters was performed in IAS removed and non-removed area, each of 30 hectares in Udayapur Community Forest User Group (CFUG), Chitwan, central Nepal to observe whether the removal of IAS contributed to an increase in plant diversity. In addition, ten entrepreneurs of Udaypur CFUG, involved in the charcoal production, briquette making and marketing were interviewed and interacted as well as their record keeping booklets were reviewed to understand if the charcoal production contributed to their income and employment. The average annual precipitation and temperature of the study area is 2100 mm and 34 degree Celsius respectively with Shorea robusta as main tree species and Eupatorium odoratum as dominant IAS. All the interviewed households were from the ̔below-poverty-line’ category as per Community Forestry Guidelines. A higher Shannon-Weiner plant diversity index at regeneration level was observed in IAS removed areas (2.43) than in control site (1.95). Furthermore, the number of tree seedlings and saplings in the IAS harvested blocks were significantly higher (p < 0.005) compared to the unharvested one. The sale of charcoal produced through the pyrolysis of IAS in ̔ Bio-energy kilns’ contributed for an average increased income of 30.95 % (Nepalese rupees 31,000) of the involved households. Despite above factors, some operational policy hurdles related to charcoal transport and taxation existed at field level. This study suggests that plant diversity could be increased through the removal of IAS, and considerable economic benefits could be achieved if charcoal is substantially produced and utilized.

Keywords: briquette, economic benefits, pyrolysis, regeneration

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Authors: Naghmeh M. Bandari, Javad Dargahi, Muthukumaran Packirisamy

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Robot-assisted minimally invasive surgery (RMIS) has been widely performed around the world during the last two decades. RMIS demonstrates significant advantages over conventional surgery, e.g., improving the accuracy and dexterity of a surgeon, providing 3D vision, motion scaling, hand-eye coordination, decreasing tremor, and reducing x-ray exposure for surgeons. Despite benefits, surgeons cannot touch the surgical site and perceive tactile information. This happens due to the remote control of robots. The literature survey identified the lack of force feedback as the riskiest limitation in the existing technology. Without the perception of tool-tissue contact force, the surgeon might apply an excessive force causing tissue laceration or insufficient force causing tissue slippage. The primary use of force sensors has been to measure the tool-tissue interaction force in real-time in-situ. Design of a tactile sensor is subjected to a set of design requirements, e.g., biocompatibility, electrical-passivity, MRI-compatibility, miniaturization, ability to measure static and dynamic force. In this study, a planar optical fiber-based sensor was proposed to mount at the surgical grasper. It was developed based on the light intensity modulation principle. The deflectable part of the sensor was a beam modeled as a cantilever Euler-Bernoulli beam on rigid substrates. A semi-cylindrical indenter was attached to the bottom surface the beam at the mid-span. An optical fiber was secured at both ends on the same rigid substrates. The indenter was in contact with the fiber. External force on the sensor caused deflection in the beam and optical fiber simultaneously. The micro-bending of the optical fiber would consequently result in light power loss. The sensor was simulated and studied using finite element methods. A laser light beam with 800nm wavelength and 5mW power was used as the input to the optical fiber. The output power was measured using a photodetector. The voltage from photodetector was calibrated to the external force for a chirp input (0.1-5Hz). The range, resolution, and hysteresis of the sensor were studied under monotonic and harmonic external forces of 0-2.0N with 0 and 5Hz, respectively. The results confirmed the validity of proposed sensing principle. Also, the sensor demonstrated an acceptable linearity (R2 > 0.9). A minimum external force was observed below which no power loss was detectable. It is postulated that this phenomenon is attributed to the critical angle of the optical fiber to observe total internal reflection. The experimental results were of negligible hysteresis (R2 > 0.9) and in fair agreement with the simulations. In conclusion, the suggested planar sensor is assessed to be a cost-effective solution, feasible, and easy to use the sensor for being miniaturized and integrated at the tip of robotic graspers. Geometrical and optical factors affecting the minimum sensible force and the working range of the sensor should be studied and optimized. This design is intrinsically scalable and meets all the design requirements. Therefore, it has a significant potential of industrialization and mass production.

Keywords: force sensor, minimally invasive surgery, optical sensor, robotic surgery, tactile sensor

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Authors: Kristina Sakalauskiene, Renaldas Raisutis, Gintare Linkeviciute, Skaidra Valiukeviciene

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Cutaneous melanoma is a melanocytic skin tumour, which has a very poor prognosis while is highly resistant to treatment and tends to metastasize. Thickness of melanoma is one of the most important biomarker for stage of disease, prognosis and surgery planning. In this study, we hypothesized that the automatic analysis of spectrophotometric images and high-frequency ultrasonic 2D data can improve differential diagnosis of cutaneous melanoma and provide additional information about tumour penetration depth. This paper presents the novel complex automatic system for non-invasive melanocytic skin tumour differential diagnosis and penetration depth evaluation. The system is composed of region of interest segmentation in spectrophotometric images and high-frequency ultrasound data, quantitative parameter evaluation, informative feature extraction and classification with linear regression classifier. The segmentation of melanocytic skin tumour region in ultrasound image is based on parametric integrated backscattering coefficient calculation. The segmentation of optical image is based on Otsu thresholding. In total 29 quantitative tissue characterization parameters were evaluated by using ultrasound data (11 acoustical, 4 shape and 15 textural parameters) and 55 quantitative features of dermatoscopic and spectrophotometric images (using total melanin, dermal melanin, blood and collagen SIAgraphs acquired using spectrophotometric imaging device SIAscope). In total 102 melanocytic skin lesions (including 43 cutaneous melanomas) were examined by using SIAscope and ultrasound system with 22 MHz center frequency single element transducer. The diagnosis and Breslow thickness (pT) of each MST were evaluated during routine histological examination after excision and used as a reference. The results of this study have shown that automatic analysis of spectrophotometric and high frequency ultrasound data can improve non-invasive classification accuracy of early-stage cutaneous melanoma and provide supplementary information about tumour penetration depth.

Keywords: cutaneous melanoma, differential diagnosis, high-frequency ultrasound, melanocytic skin tumours, spectrophotometric imaging

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Authors: Yusuf Bulale, Mark Prince, Geoff Tansley, Peter Brett

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Cochlear Implantation (CI) which became a routine procedure for the last decades is an electronic device that provides a sense of sound for patients who are severely and profoundly deaf. Today, cochlear implantation technology uses electrode array (EA) implanted manually into the cochlea. The optimal success of this implantation depends on the electrode technology and deep insertion techniques. However, this manual insertion procedure may cause mechanical trauma which can lead to a severe destruction of the delicate intracochlear structure. Accordingly, future improvement of the cochlear electrode implant insertion needs reduction of the excessive force application during the cochlear implantation which causes tissue damage and trauma. This study is examined tool-tissue interaction of large prototype scale digit embedded with distributive tactile sensor based upon cochlear electrode and large prototype scale cochlea phantom for simulating the human cochlear which could lead to small-scale digit requirements. The digit, distributive tactile sensors embedded with silicon-substrate was inserted into the cochlea phantom to measure any digit/phantom interaction and position of the digit in order to minimize tissue and trauma damage during the electrode cochlear insertion. The digit has provided tactile information from the digit-phantom insertion interaction such as contact status, tip penetration, obstacles, relative shape and location, contact orientation and multiple contacts. The tests demonstrated that even devices of such a relative simple design with low cost have a potential to improve cochlear implant surgery and other lumen mapping applications by providing tactile sensory feedback information and thus controlling the insertion through sensing and control of the tip of the implant during the insertion. In that approach, the surgeon could minimize the tissue damage and potential damage to the delicate structures within the cochlear caused by current manual electrode insertion of the cochlear implantation. This approach also can be applied to other minimally invasive surgery applications as well as diagnosis and path navigation procedures.

Keywords: cochlear electrode insertion, distributive tactile sensory feedback information, flexible digit, minimally invasive surgery, tool/tissue interaction

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Authors: Man-Yun Liu, Emily Chia-Yu Su

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Alzheimer's disease (AD) is the public health crisis of the 21st century. AD is a degenerative brain disease and the most common cause of dementia, a costly disease on the healthcare system. Unfortunately, the cause of AD is poorly understood, furthermore; the treatments of AD so far can only alleviate symptoms rather cure or stop the progress of the disease. Currently, there are several ways to diagnose AD; medical imaging can be used to distinguish between AD, other dementias, and early onset AD, and cerebrospinal fluid (CSF). Compared with other diagnostic tools, blood (plasma) test has advantages as an approach to population-based disease screening because it is simpler, less invasive also cost effective. In our study, we used blood biomarkers dataset of The Alzheimer’s disease Neuroimaging Initiative (ADNI) which was funded by National Institutes of Health (NIH) to do data analysis and develop a prediction model. We used independent analysis of datasets to identify plasma protein biomarkers predicting early onset AD. Firstly, to compare the basic demographic statistics between the cohorts, we used SAS Enterprise Guide to do data preprocessing and statistical analysis. Secondly, we used logistic regression, neural network, decision tree to validate biomarkers by SAS Enterprise Miner. This study generated data from ADNI, contained 146 blood biomarkers from 566 participants. Participants include cognitive normal (healthy), mild cognitive impairment (MCI), and patient suffered Alzheimer’s disease (AD). Participants’ samples were separated into two groups, healthy and MCI, healthy and AD, respectively. We used the two groups to compare important biomarkers of AD and MCI. In preprocessing, we used a t-test to filter 41/47 features between the two groups (healthy and AD, healthy and MCI) before using machine learning algorithms. Then we have built model with 4 machine learning methods, the best AUC of two groups separately are 0.991/0.709. We want to stress the importance that the simple, less invasive, common blood (plasma) test may also early diagnose AD. As our opinion, the result will provide evidence that blood-based biomarkers might be an alternative diagnostics tool before further examination with CSF and medical imaging. A comprehensive study on the differences in blood-based biomarkers between AD patients and healthy subjects is warranted. Early detection of AD progression will allow physicians the opportunity for early intervention and treatment.

Keywords: Alzheimer's disease, blood-based biomarkers, diagnostics, early detection, machine learning

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Authors: Jeena R. S., Sukesh Kumar A.

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Stroke is one of the major reasons of adult disability and morbidity in many of the developing countries like India. Early diagnosis of stroke is essential for timely prevention and cure. Various conventional statistical methods and computational intelligent models have been developed for predicting the risk and outcome of stroke. This research work focuses on a multilevel approach for predicting the occurrence of stroke based on various risk factors and invasive techniques like retinal imaging. This risk prediction model can aid in clinical decision making and help patients to have an improved and reliable risk prediction.

Keywords: prediction, retinal imaging, risk factors, stroke

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Authors: Vasudha Govil, Suresh Singhal

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Introduction: Patients with oropharyngeal masses pose a challenge for an anaesthetist in terms of ventilation and tracheal intubation. Thus, preoperative assessment and preparation become an integral part of managing such anticipated difficult airway cases. Case report: A 45- year old female presented with growth in the oropharynx causing dysphagia and hoarseness of voice. Clinical examination and investigations predicted a difficult airway. It was managed with fibreoptic nasotracheal intubation with a successful perioperative outcome. Tracheostomy was kept as plan B in case of the CVCI situation. Conclusion: Careful preoperative examination and assessment is required to prepare oneself for difficult airway. Fibreoptic bronchoscope-guided nasotracheal intubation in a spontaneously breathing patient is a safe and successful airway management technique in difficult airway cases.

Keywords: airway, difficult, mass, oropharyngeal

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Authors: A/Prof Marjan Khajehei

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In the last century, the role of fathers in the birth has changed exponentially. Before the 1970s, the principal view was that birth was a female business and not a man’s place. Changing cultural and professional attitudes around the emotional bond between a man and a woman, family structure and the more proactive involved role of men in the family have encouraged fathers’ attendance at birth. There is evidence that fathers’ support can make birthing less traumatic for some women and can make couples closer. This has made some clinicians to believe the fathers should be more involved throughout the birth process. Some clinicians even go further and ask the fathers to watch the medical procedures, such as inserting vaginal speculum, forceps or vacuum, episiotomy and stitches. Although birth can unfold like a beautiful picture captured by birth photographers, with fathers massaging women’s backs by candle light and the miraculous moment of birth, it can be overshadowed by less attractive images of cervical mucous, emptying bowels and the invasive medical procedures. What happens in the birth room and the fathers’ reaction to the graphic experience of birthing can be unpredictable. Despite the fact that most men are absolutely thrilled to be in the delivery room, for some men, a very intimate body part can become completely desexualised, and they can experience psychological and sexual scarring. They see someone they cherish dramatically sliced open and can then associate their partners with a disturbing scene, and it can dramatically affect their relationships. While most women want the expectant fathers by their side for this life-changing event, not all of them may be happy for their partners to watch the perineum to be cut or stitched or when large blades of forceps are inserted inside the vagina. Anecdotal reports have shown that consent is not sought from the labouring women as to whether they want their partners to watch these procedures. The majority of research1, 2, 3 focuses on men’s and women’s retrospective attitudes towards their birth experience. However, the effect of witnessing invasive procedures during childbirth on a man's attraction to his partner, while she is most vulnerable, and also an increased risk of post-traumatic stress disorder in fathers have not been widely investigated. There is a lack of sufficient research investigating whether women need to be asked for their consent before inviting their partners to closely watch medical procedures during childbirth. Future research is required to provide a basis for better awareness and involve the consumers to understanding the men’s and women’s experience and their expectations for labour and birth.

Keywords: birth, childbirth, father, labour, men, women

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Authors: Kambiz Teimour Najad

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The basic methodology of GPR involves the use of a transmitting antenna to send electromagnetic waves into the subsurface, which then bounce back to the surface and are detected by a receiving antenna. The transmitter and receiver antennas are typically placed on the ground surface and moved across the area of interest to create a profile of the subsurface. The GPR system consists of a control unit that powers the antennas and records the data, as well as a display unit that shows the results of the survey. The control unit sends a pulse of electromagnetic energy into the ground, which propagates through the soil or rock until it encounters a change in material or structure. When the electromagnetic wave encounters a buried object or structure, some of the energy is reflected back to the surface and detected by the receiving antenna. The GPR data is then processed using specialized software that analyzes the amplitude and travel time of the reflected waves. By interpreting the data, GPR can provide information on the depth, location, and nature of subsurface features and structures. GPR has several advantages over other geophysical survey methods, including its ability to provide high-resolution images of the subsurface and its non-invasive nature, which minimizes disruption to the site. However, the effectiveness of GPR depends on several factors, including the type of soil or rock, the depth of the features being investigated, and the frequency of the electromagnetic waves used. In environmental hazard assessments, GPR can be used to detect buried structures, such as underground storage tanks, pipelines, or utilities, which may pose a risk of contamination to the surrounding soil or groundwater. GPR can also be used to assess soil stability by identifying areas of subsurface voids or sinkholes, which can lead to the collapse of the surface. Additionally, GPR can be used to map the extent and movement of groundwater contamination, which is critical in designing effective remediation strategies. the methodology of GPR in environmental hazard assessments involves the use of electromagnetic waves to create high of the subsurface, which are then analyzed to provide information on the depth, location, and nature of subsurface features and structures. This information is critical in identifying and mitigating environmental hazards, and the non-invasive nature of GPR makes it a valuable tool in this field.

Keywords: GPR, hazard, landslide, rock fall, contamination

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Authors: Sarah Nauwelaerts, Koen De Cremer, Alfred Bernard, Meredith Verlooy, Kristel Heremans, Natalia Bustos Sierra, Katrien Tersago, Tim Nawrot, Jordy Vercauteren, Christophe Stroobants, Sigrid C. J. De Keersmaecker, Nancy Roosens

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Projected climate changes could lead to exacerbation of respiratory disorders associated with reduced air quality. Air pollution and climate changes influence each other through complex interactions. The poor air quality in urban and rural areas includes high levels of particulate matter (PM), ozone (O3) and nitrogen oxides (NOx), representing a major threat to public health and especially for the most vulnerable population strata, and especially young children. In this study, we aim to develop generic standardized policy supporting tools and methods that allow evaluating in future follow-up larger scale epidemiological studies the risks of the combined short-term effects of O3 and PM on the cardiorespiratory system of children. We will use non-invasive indicators of airway damage/inflammation and of genetic or epigenetic variations by using urine or saliva as alternative to blood samples. Therefore, a multi-phase field study will be organized in order to assess the sensitivity and applicability of these tests in large cohorts of children during episodes of air pollution. A first test phase was planned in March 2018, not yet taking into account ‘critical’ pollution periods. Working with non-invasive samples, choosing the right set-up for the field work and the volunteer selection were parameters to consider, as they significantly influence the feasibility of this type of study. During this test phase, the selection of the volunteers was done in collaboration with medical doctors from the Centre for Student Assistance (CLB), by choosing a class of pre-pubertal children of 9-11 years old in a primary school in Flemish Brabant, Belgium. A questionnaire, collecting information on the health and background of children and an informed consent document were drawn up for the parents as well as a simplified cartoon-version of this document for the children. A detailed study protocol was established, giving clear information on the study objectives, the recruitment, the sample types, the medical examinations to be performed, the strategy to ensure anonymity, and finally on the sample processing. Furthermore, the protocol describes how this field study will be conducted in relation with the prevision and monitoring of air pollutants for the future phases. Potential protein, genetic and epigenetic biomarkers reflecting the respiratory function and the levels of air pollution will be measured in the collected samples using unconventional technologies. The test phase results will be used to address the most important bottlenecks before proceeding to the following phases of the study where the combined effect of O3 and PM during pollution peaks will be examined. This feasibility study will allow identifying possible bottlenecks and providing missing scientific knowledge, necessary for the preparation, implementation and evaluation of federal policies/strategies, based on the most appropriate epidemiological studies on the health effects of air pollution. The research leading to these results has been funded by the Belgian Science Policy Office through contract No.: BR/165/PI/PMOLLUGENIX-V2.

Keywords: air pollution, biomarkers, children, field study, feasibility study, non-invasive

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Authors: Zhao Haoyue

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Due to the combined effects of climate change, urban expansion, and population growth, various environmental issues, such as urban heat islands and pollution, arise. Therefore, reliable information on urban environmental climate is needed to address and mitigate the negative effects. The emergence of urban climate maps provides a practical basis for urban climate regulation and improvement. This article takes Shapingba District, Chongqing City, as an example to study the construction method of urban thermal environment climate maps based on GIS spatial analysis technology. The thermal load, ventilation potential analysis map, and thermal environment comprehensive analysis map were obtained. Based on the classification criteria obtained from the climate map, corresponding protection and planning mitigation measures have been proposed.

Keywords: urban climate, GIS, heat island analysis, urban thermal environment

Procedia PDF Downloads 78

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

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The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot

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Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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Authors: K. Shahril, M. Ridzuan, M. Sabri

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The disc rotor is solid, ventilated or drilled. The ventilated type disc rotor consists of a wider disc with cooling fins cast through the middle to ensure good cooling. The disc brakes use pads that are pressed axially against a rotor or disc. Solid and ventilated disc design are same which it free with any form, unless inside the ventilated disc has several ventilation holes. Different with drilled disc has some construction on the surface which is has six lines of drill hole penetrate the disc and a little bit deep twelve curves. From the thermal analysis that was conducted by using ANSYS Software, temperature distribution and heat transfer rate on the disc were obtained on each design. Temperature occurred on the drilled disc was lowest than ventilated and solid disc, it is 66% better than ventilated while ventilated is 21% good than solid disc.

Keywords: disc brakes, drilled disc, thermal analysis, ANSYS software

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Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

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Authors: Thana Ananacha

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This paper reports the numerical and experimental performances of Double Glass Wall are investigated. Two configurations were considered namely, the Double Clear Glass Wall (DCGW) and the Double Translucent Glass Wall (DTGW). The coupled governing equations as well as boundary conditions are solved using the finite element method (FEM) via COMSOLTM Multiphysics. Temperature profiles and flow field of the DCGW and DTGW are reported and discussed. Different constant heat fluxes were considered namely 400 and 800 W.m-2 the corresponding initial condition temperatures were to 30.5 and 38.5 ºC respectively. The results show that the simulation results are in agreement with the experimental data. Conclusively, the model considered in this study could reasonable be used simulate the thermal and ventilation performance of the DCGW and DTGW configurations.

Keywords: thermal simulation, Double Glass Wall, velocity field, finite element method (FEM)

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Authors: Lexuan Zhong, Chang-Seo Lee, Fariborz Haghighat, Stuart Batterman, John C. Little

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Ultraviolet photocatalytic oxidation (UV-PCO) technology has been recommended as a green approach to health indoor environment when it is integrated into mechanical ventilation systems for inorganic and organic compounds removal as well as energy saving due to less outdoor air intakes. Although much research has been devoted to UV-PCO, limited information is available on the UV-PCO behavior tested by the mixtures in literature. This project investigated UV-PCO performance and by-product generation using a single and a mixture of acetone and MEK at 100 ppb each in a single-pass duct system in an effort to obtain knowledge associated with competitive photochemical reactions involved in. The experiments were performed at 20 % RH, 22 °C, and a gas flow rate of 128 m3/h (75 cfm). Results show that acetone and MEK mutually reduced each other’s PCO removal efficiency, particularly negative removal efficiency for acetone. These findings were different from previous observation of facilitatory effects on the adsorption of acetone and MEK on photocatalyst surfaces.

Keywords: by-products, inhibitory effect, mixture, photocatalytic oxidation

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Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia

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Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.

Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome

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Authors: Rami Jahmani

Abstract:

Closed femoral-shortening osteotomy over an intramedullary nail for the treatment of leg length discrepancy (LLD) is a demanding surgical technique, classically requiring specialized instrumentation (intramedullary saw and chisel). The paper describes a modified surgical technique of performing femoral shortening percutaneously, using a percutaneous multiple drill-hole osteotomy technique to smash the bone, and then, the bone is fixed using intramedullary locked nail. Paper presents the result of performing nine cases of shortening as well.

Keywords: —Femoral shortening, Leg length discrepancy, Minimal invasive, Percutaneous osteotomy.

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Authors: Fangwen Ni, Hongpeng Xu

Abstract:

When disasters occur, it is important to provide temporary shelters to protect victims from their environment and to comfort them with privacy and dignity. However, the commonly used shelters like tents and shanties can not ensure a comfortable condition. Furthermore, the demand for more energy and less pollution has become a major challenge. Focusing on the sustainable of temporary shelters, this study intends to clarify the essential role of temporary shelters before the reconstruction work is done. The paper also identifies the main problems from three aspects including spatial layout, thermal comfort and utilization of passive technology. Moreover, it expounds the passive strategies of ecological design by case study and simulation. It is found that the living condition of shelters can be improved from the perspective of architectural space, ventilation theory and construction techniques. Regardless of being temporary, these shelters are crucial elements in emergency situations and should be taken more seriously.

Keywords: architectural space, construction technique, sustainable strategy, temporary shelter

Procedia PDF Downloads 251

Authors: Jovana Dj. Jovanovic, Svetlana M. Stevovic

Abstract:

The highest priority of so called, projected passive houses is to meet the appropriate energy demand. Every single material and layer which is injected into a dwelling has a certain energy quantity stored. The passive houses include optimized insulation levels with minimal thermal bridges, minimum of air leakage through the building, utilization of passive solar and internal gains, and good circulation of air which leans on mechanical ventilation system. The focus of this paper is on passive house features, benefits and targets, their feasibility and energy demands which are set up during each project. Numerous passive house-standards outline the very significant role of zero-energy dwellings towards the modern label of sustainable development. It is clear that the performance of both built and existing housing stock must be addressed if the population across the world sets out the energy objectives. This scientific article examines passive house features since the many passive house cases are launched.

Keywords: benefits, energy demands, passive houses, sustainable development

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Authors: Simeon E. H. Davies

Abstract:

This study investigated whether selected metabolic responses and the perception of effort varied during four different walk protocols where speed increased progressively 3, 4, 5, 6, and 7 km/hr (progressive treadmill walk (PTW); and progressive land walk (PLW); or where the participant adjusted to random changes of speed e.g. 6, 3, 7, 4, and 5 km/hr during a randomized treadmill walk (RTW); and a randomized land walk (RLW). Mean stature and mass of the seven participants was 1.75m and 70kg respectively, with a mean body fat of 15%. Metabolic measures including heart rate, relative oxygen uptake, ventilation, increased in a linear fashion up to 6 km/hr, however at 7 km/hr there was a significant increase in metabolic response notably during the PLW, and to a similar, although lesser extent in RLW, probably as a consequence of the loss of kinetic energy when turning at each cone in order to maintain the speed during each shuttle. Respiration frequency appeared to be a more sensitive indicator of physical exertion, exhibiting a rapid elevation at 5 km/hr. The perception of effort during each mode and at each speed was largely congruent during each walk protocol.

Keywords: exertion, metabolic, progressive, random, walking

Procedia PDF Downloads 442

Authors: Tebah KH A AlFouzan, Meznah Dahlous Ali Alkreebani, Fatemah Salem Dekheel Alrasheedi, Hanadi Bandar Rughayan AlNomas, Muneerah Mohammad Sulaiman ALOjairi

Abstract:

Article spotlights the heat transfer process based beneath the earth’s surface. The process starts by exchanging the heat found in the building as fluid in the pipes absorbs it, then transports it down the soil consuming cool temperature exchange, recirculating, and rebounding to deliver cool air. This system is a renewable energy that is reliable and sustainable. The analysis showed the disposal of fossil fuels, energy preservation, 400% efficiency, long lifespan, and lower maintenance. Investigation displays the system’s types of design, whether open or closed loop and piping layout. Finally, the geothermal cooling study presents the challenges of creating a prototype in Kuwait, as constraints are applicable due to geography.

Keywords: cooling system, engineering, geothermal cooling, natural ventilation, renewable energy

Procedia PDF Downloads 66

Authors: Turky M. Aldossary, F. R. Almushref

Abstract:

As a component of their heating, ventilation, and air conditioning (HVAC) system, cooling towers are used in almost all buildings. The process of transferring heat in an HVAC system involves water. To avoid pneumatic illnesses, the Occupational Safety and Health Administration (OSHA) has recommended that HVAC systems must be cleaned twice a year. To address the strict environmental requirements at the microscale, a photocatalytic coating, which is hydrophobic and antibacterial, ae used. The effectiveness of water-cooling tower coating systems was examined in this study. The samples were made of stainless steel. In this system, the samples are coated with two different coatings, one with Titanium dioxide (Ti₂O₂) only and the second one with the addition of Copper. The samples were placed in a water splash zone to ensure that there was enough water surrounding them and that there was adequate airflow to prevent them from being constantly immersed. The samples were not tampered with for six months. In conclusion, the addition of copper rendered a better result as the low concentration of other elements such as slates, is observed.

Keywords: biofilm, coating, cooling tower, HVAC

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Authors: Clare Flood, Shareen Forbes

Abstract:

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder affecting >400,000 people in the UK alone, with the global prevalence expected to double in the next decade. Islet transplant offers a minimally-invasive procedure with very low morbidity and almost no mortality, and is now as effective as whole pancreas transplant. The procedure was introduced to the UK in 2011 for patients with the most severe type 1 diabetes mellitus (T1DM) – those with unstable blood glucose, frequently occurring episodes of severe hypoglycemia and impaired awareness of hypoglycemia (IAH). Objectives: To evaluate the effectiveness of islet transplantation in improving glycemic control, reducing the burden of hypoglycemia and improving awareness of hypoglycemia through a single-centre cohort study at the Royal Infirmary of Edinburgh. Glycemic control and degree of hypoglycemic awareness will be determined and monitored pre- and post-transplantation to determine effectiveness of the procedure. Methods: A retrospective analysis of data collected over three years from the 16 patients who have undergone islet transplantation in Scotland. Glycated haemoglobin (HbA1c) was measured and continuous glucose monitoring systems (CGMS) were utilised to assess glycemic control, while Gold and Clarke score questionnaires tested IAH. Results: All patients had improved glycemic control following transplant, with optimal control seen visually at 3 months post-transplant. Glycemic control significantly improved, as illustrated by percentage time in hypoglycemia in the months following transplant (p=0.0211) and HbA1c (p=0.0426). Improved Clarke (p=0.0034) and Gold (p=0.0001) scores indicate improved glycemic awareness following transplant. Conclusion: While the small sample of islet transplant recipients at the Royal Infirmary of Edinburgh prevents definitive conclusions being drawn, it is indicated that through our retrospective, single-centre cohort study of 16 patients, islet transplant is capable of improving glycemic control, reducing the burden of hypoglycemia and IAH post-transplant. Data can be combined with similar trials at other centres to increase statistical power but from research in Edinburgh, it can be suggested that the minimally invasive procedure of islet transplantation offers selected patients with extremely unstable T1DM the incredible opportunity to regain control of their condition and improve their quality of life.

Keywords: diabetes, islet, transplant, CGMS

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Authors: Nanditha Rajamani, Anirudhaa R. Rao, Divya Sriram

Abstract:

One of the greatest difficulties in treating patients with pain is the highly subjective nature of pain sensation. The measurement of pain intensity is primarily dependent on the patient’s report, often with little physical evidence to provide objective corroboration. This is also complicated by the fact that there are only few and expensive existing technologies (Functional Magnetic Resonance Imaging-fMRI). The need is thus clear and urgent for a reliable, non-invasive, non-painful, objective, readily adoptable, and coefficient diagnostic platform that provides additional diagnostic information to supplement its current regime with more information to assist doctors in diagnosing these patients. Thus, our idea of developing a pain detector was conceived to take a step further the detection and diagnosis of chronic and acute pain.

Keywords: pain sensor, microwave radiometery, pain sensation, fMRI

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Authors: Abdullah Erden, Filiz Erden

Abstract:

In the present information society era, a change is seen in every field together with changing technology. Along with this change, importance given to information and human who is the producer of information increased. Work life and working conditions included in these changes have also been affected. The most important factors that disturb employees in offices are lighting, ventilation, noise and office furniture. Upon arrangement of these according to ergonomic principles, performance and efficiency of employees will increase. Fatigue and stress resulting from office environment are harmful for employees. Attention and efficiency of employee who feels bad will decrease. It should be noted that office employees are human and affected from environment. It should be allowed them to work in comfortable, healthy and peaceful environment. As a result, efficiency will increase and target will be reached. In this study, it has been focused on basic concepts such as office management and efficiency, effects of ergonomics on office efficiency has been examined. Also, a place is given to the factors affecting operational efficiency and effects of physical environment on employees.

Keywords: ergonomics, efficiency, office design, office

Procedia PDF Downloads 446