Search results for: heart failure patient

Authors: Sujith Rajashekar Swamy, Meghana Rajashekara Swamy

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Although T1-weighted gadolinium-enhanced imaging (T1-Gd) has its established clinical role in diagnosing brain lesions of infectious and metastatic origins, the use of post-contrast susceptibility-weighted imaging (SWI) has been understudied. This observational study aims to explore and compare the prominence of brain parenchymal lesions between T1-Gd and SWI-Gd images. A cross-sectional study design was utilized to analyze 58 patients with brain parenchymal lesions using T1-Gd and SWI-Gd scanning techniques. Our results indicated that SWI-Gd enhanced the conspicuity of metastatic as well as infectious brain lesions when compared to T1-Gd. Consequently, it can be used as an adjunct to T1-Gd for post-contrast imaging, thereby avoiding additional contrast administration. Improved conspicuity of brain lesions translates directly to enhanced patient outcomes, and hence SWI-Gd imaging proves useful to meet that endpoint.

Keywords: susceptibility weighted, T1 weighted, brain lesions, gadolinium contrast

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Authors: Abdul Rashid Ahmadi, Samiullah Paracha, Hamidullah Sokout, Mohammad Hanif Gharana

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Conventional educational practices, do not offer all the required skills for teachers to successfully survive in today’s workplace. Due to poor professional training, a big gap exists across the curriculum plan and the teacher practices in the classroom. As such, raising the quality of teaching through ICT-enabled training and professional development of teachers should be an urgent priority. ‘Mobile Learning’, in that vein, is an increasingly growing field of educational research and practice across schools and work places. In this paper, we propose a novel Mobile learning system that allows the users to learn through an intelligent mobile learning in cooperatively every-time and every-where. The system will reduce the training cost and increase consistency, efficiency, and data reliability. To establish that our system will display neither functional nor performance failure, the evaluation strategy is based on formal observation of users interacting with system followed by questionnaires and structured interviews.

Keywords: computer assisted learning, intelligent tutoring system, learner centered design, mobile mediated learning and teacher education

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Authors: Liliana Gomez Cardona, Mary McComber, Kristyn Brown, Arlene Laliberté, Outi Linnaranta

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The history of colonialism and more contemporary political issues have resulted in the exposure of Kanien'kehá:ka: non (Kanien'kehá:ka of Kahnawake) to challenging and even traumatic experiences. Colonization, religious missions, residential schools as well as economic and political marginalization are the factors that have challenged the wellbeing and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond to how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous people because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Mohawk in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Mohawk population. Qualitative, collaborative, and participatory action research project which respects First Nations protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Mohawks. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Mohawk in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in growth and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Mohawk population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Mohawks, mental health, Quebec

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Authors: Matteo Calabrese, Martin Cimmino, Dimos Kapetis, Martina Manfrin, Donato Concilio, Giuseppe Toscano, Giovanni Ciandrini, Giancarlo Paccapeli, Gianluca Giarratana, Marco Siciliano, Andrea Forlani, Alberto Carrotta

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In this paper we describe a machine learning methodology for Predictive Maintenance (PdM) applied on woodworking industrial machines. PdM is a prominent strategy consisting of all the operational techniques and actions required to ensure machine availability and to prevent a machine-down failure. One of the challenges with PdM approach is to design and develop of an embedded smart system to enable the health status of the machine. The proposed approach allows screening simultaneously multiple connected machines, thus providing real-time monitoring that can be adopted with maintenance management. This is achieved by applying temporal feature engineering techniques and training an ensemble of classification algorithms to predict Remaining Useful Lifetime of woodworking machines. The effectiveness of the methodology is demonstrated by testing an independent sample of additional woodworking machines without presenting machine down event.

Keywords: predictive maintenance, machine learning, connected machines, artificial intelligence

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Authors: Tomas Vampola, Michael Valášek

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On the basis of simulation-generated failure states of structural elements of a turboprop engine suitable for the busy-jet class of aircraft, an algorithm for early prediction of damage or reduction in functionality of structural elements of the engine is designed and verified with real data obtained at dynamometric testing facilities of aircraft engines. Based on an expanding database of experimentally determined data from temperature and pressure sensors during the operation of turboprop engines, this strategy is constantly modified with the aim of using the minimum number of sensors to detect an inadmissible or deteriorated operating mode of specific structural elements of an aircraft engine. The assembled algorithm for the early prediction of reduced functionality of the aircraft engine significantly contributes to the safety of air traffic and to a large extent, contributes to the economy of operation with positive effects on the reduction of the energy demand of operation and the elimination of adverse effects on the environment.

Keywords: detectability of malfunction, dynamometric testing, prediction of damage, turboprop engine

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Authors: Saad Ahmed, Sanjeev Khannaa

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Glass fiber reinforced polymers are widely used in structural systems as load-bearing elements at both high and low temperatures. This investigation presents the evaluation of glass fiber reinforced unsaturated polyurethane under harsh conditions of changing temperature and moisture content. This study Explores how these parameters affect the optical properties of the polymer matrix and the composite. Using the hand layup method, the polyurethane resin was modified by E-glass fibers (15 vol. %) to manufacture fiber-reinforced composite. This work includes the preparation of glass-like polyurethane resin sheets and estimates all light transmittance properties at high and very low temperatures and wet conditions. All-optical properties were retested to evaluate the level of improvement or failure. The results found that when comprising reinforced composite fiber to the unreinforced specimens, the reinforced composite shows a fair optical property at high temperatures and good performance at low temperatures.

Keywords: unsaturated polyurethane, extreme temperatures, light transmittance, haze number

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Authors: Eun-Seop Kim, Eun-Ha Jang, Rana R. Kim, Sae-Byul Jang

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Objective: Preterm labor is the most common antecedent of preterm birth(PTB), which is characterized by regular uterine contraction before 37 weeks of pregnancy and cervical change. In acute preterm labor, tocolytics are administered as the first-line medication to suppress uterine contractions but rarely delay pregnancy to 37 weeks of gestation. On the other hand, according to the Korean Traditional Medicine, PTB is caused by the deficiency of Qi and unnecessary energy in the body of the mother. The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of PTB. Methods: It is a case report of a 38-year-old woman (0-0-6-0) hospitalized for irregular uterine contractions and cervical change at 33+3/7 weeks of gestation. Past history includes chemical pregnancies achieved by Artificial Rroductive Technology(ART), one stillbirth (at 7 weeks) and a laparoscopic surgery for endometriosis. After seven trials of IVF and articificial insemination, she had succeeded in conception via in-vitro fertilization (IVF) with help of Traditional Korean Medicine (TKM) treatments. Due to irregular uterine contractions and cervical changes, 2 TKM were prescribed: Gami-Dangguisan, and Antae-eum, known to nourish blood and clear away heat. 120ml of Gami-Dangguisan was given twice a day monring and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: On admission, the cervix of 15mm in length and cervical os with 0.5cm-dilated were observed via ultrasonography. 50% cervical effacement was also detected in physical examination. Tocolysis had been temporarily maintained. As a supportive therapy, TKM herbal preparations(gami-dangguisan and Antae-eum) were concomitantly given. As of 34+2/7 weeks of gestation, however intermittent uterine contractions appeared (5-12min) on cardiotocography and vaginal bleeding was also smeared at 34+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39+3/7 gestational weeks. Conclusions: This is the first successful case report about a preter labor patient administered with conventional tocolytic agents as well as TKM herbal decoctions, delaying delivery to term. This case deserves attention considering it is rare to maintain gestation to term only with tocolytic intervention. Our report implies the potential of herbal medicine as an adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

Keywords: preterm labor, traditional Korean medicine, herbal medicine, integrative treatment, complementary and alternative medicine

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Authors: Timothy Wale Olaosebikan

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The most active resource in any organization is the manpower. Every other resource remains inactive unless there is competent manpower to handle them. Manpower training is needed to enhance productivity and overall performance of the organizations. This is due to the recognition of the important role of manpower training in attainment of organizational goals. Corporate Compliance conjures visions of an incomprehensible matrix of laws and regulations that defy logic and control by even the most seasoned manpower training professionals. Similarly, corporate compliance can be viewed as one of the most significant problems faced in manpower training process for any organization, therefore, commands relevant attention and comprehension. Consequently, this study investigated the nexus between manpower training and corporate compliance. Collection of data for the study was effected through the use of questionnaire with a sample size of 265 drawn by stratified random sampling. The data were analyzed using descriptive and inferential statistics. The findings of the study show that about 75% of the respondents agree that there is a strong relationship between manpower training and corporate compliance, which brings out the organizational attainment from any training process. The findings further show that most organisation do not totally comply with the rules guiding manpower training process thereby making the process less effective on organizational performance, which may affect overall profitability. The study concludes that formulation and compliance of adequate rules and guidelines for manpower trainings will produce effective results for both employees and the organization at large. The study recommends that leaders of organizations, industries, and institutions must ensure total compliance on the part of both the employees and the organization to manpower training rules. Organizations and stakeholders should also ensure that strict policies on corporate compliance to manpower trainings form the heart of their cardinal mission.

Keywords: corporate compliance, manpower training, nexus, rules and guidelines

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Authors: A. Chenafa, S. Boulenouar, M. Zitouni, M. Boukouria

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The sterilization of medical devices constitutes for all the medical professions, an inescapable obligation. It has for objective to prevent the infectious risk, both for the patient and for the medical team. The Dental surgeon as every healthcare professional has to master perfectly this subject and to train his staff to the various techniques of sterilization. It is the only way to assure the patients all the security for which they are entitled to wait when they undergo a dental care. It’s for it, that we undertook to lead an investigation aiming at estimating the sterilization practice at the dental surgeon of Sidi bel Abbes. The survey result showed a youth marked with the profession with a majority use of autoclave with cycle B and an almost total absence of the sterilization controls (test of Bowie and Dick). However, the majority of the dentists control and validate their sterilizers. Finally, our survey allowed us to describe some practices which must be improved regarding control, regarding qualification and regarding staff training. And suggestions were made in this sense.

Keywords: dental surgeon, medical devices, sterilization, survey

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Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz

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We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.

Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation

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Authors: Fahad Suleiman

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Queuing, in medical system is the process of moving patients in a specific sequence to a specific service according to the patients’ nature of illness. The term scheduling stands for the process of computing a schedule. This may be done by a queuing based scheduler. This paper focuses on the medical consultancy system, the different queuing algorithms that are used in healthcare system to serve the patients, and the average waiting time. The aim of this paper is to build automatic queuing system for organizing the medical queuing system that can analyses the queue status and take decision which patient to serve. The new queuing architecture model can switch between different scheduling algorithms according to the testing results and the factor of the average waiting time. The main innovation of this work concerns the modeling of the average waiting time is taken into processing, in addition with the process of switching to the scheduling algorithm that gives the best average waiting time.

Keywords: queuing systems, queuing system models, scheduling algorithms, patients

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Authors: Mouhoubi Nedjima, Sassi Boudemagh Souad

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In the framework of the modernization of the city of Constantine, and in order to restore its status as a regional metropolis and introduce it into the network of cities international metropolises, a major urban project was launched: project of modernization and of metropolitanization of the city of Constantine (PMMC). Our research project focuses on the management of the project for the modernization of the city of Constantine (PMMC) focusing on the management of some aspects of the urban project whose participation, with the objective assessment of the managerial approach business. Among the cases revealing taken into account in our research work on the question of participation of actors and their organizations, the operation relating to "the urban improvement in the city of the Brothers FERRAD in the district of Zouaghi". This operation with the objective of improving the living conditions of citizens has faced several challenges and obstacles that have been in major part the factors of its failure. Through this study, we examine the management process and the mode of organization of the actors of the project as well as the level of participation of the citizen to finally propose managerial solutions to conflict situations observed.

Keywords: the urban project, the urban improvement, participation, Constantine

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Authors: Abeer Rababa'h, Ragad Bsoul, Mohammad Alkhatatbeh, Karem Alzoubi

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Introduction: Tobacco use is one of the main risk factors to cardiovascular diseases (CVD) and atherosclerosis in particular. WPS contains several toxic materials such as: nicotine, carcinogens, tar, carbon monoxide and heavy metals. Thus, WPS is considered to be as one of the toxic environmental factors that should be investigated intensively. Therefore, the aim of this study is to investigate the effect of WPS on several cardiovascular biological markers that may cause atherosclerosis in mice. The study also conducted to study the temporal effects of WPS on the atherosclerotic biomarkers upon short (2 weeks) and long-term (8 weeks) exposures. Methods: mice were exposed to WPS and heart homogenates were analyzed to elucidate the effects of WPS on matrix metalloproteinase (MMPs), endothelin-1 (ET-1) and, myeloperoxidase (MPO). Following protein estimation, enzyme-linked immunosorbent assays were done to measure the levels of MMPs (isoforms 1, 3, and 9), MPO, and ET-1 protein expressions. Results: our data showed that acute exposure to WPS significantly enhances the levels of MMP-3, MMP- 9, and MPO expressions (p < 0.05) compared to their corresponding control. However, the body was capable to normalize the level of expressions for such parameters following continuous exposure for 8 weeks (p > 0.05). Additionally, we showed that the level of ET-1 expression was significantly higher upon chronic exposure to WPS compared to both control and acute exposure groups (p < 0.05). Conclusion: Waterpipe exposure has a significant negative effect on atherosclerosis and the enhancement of the atherosclerotic biomarkers expression (MMP-3 and 9, MPO, and ET-1) might represent an early scavenger of compensatory efforts to maintain cardiac function after WP exposure.

Keywords: atherosclerotic biomarkers, cardiovascular disease, matrix metalloproteinase, waterpipe

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Authors: Kitti Leangkrua

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This paper presents a risk-based maintenance strategy of a power transformer in order to optimize operating and maintenance costs. The methodology involves the study and preparation of a database for the collection the technical data and test data of a power transformer. An evaluation of the overall condition of each transformer is performed by a program developed as a result of the measured results; in addition, the calculation of the main equipment separation to the overall condition of the transformer (% HI) and the criteria for evaluating the importance (% ImI) of each location where the transformer is installed. The condition assessment is performed by analysis test data such as electrical test, insulating oil test and visual inspection. The condition of the power transformer will be classified from very poor to very good condition. The importance is evaluated from load criticality, importance of load and failure consequence. The risk matrix is developed for evaluating the risk of each power transformer. The high risk power transformer will be focused firstly. The computerized program is developed for practical use, and the maintenance strategy of a power transformer can be effectively managed.

Keywords: asset management, risk-based maintenance, power transformer, health index

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Authors: Adesina Nathaniel Olanrewaju

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The motivation behind this study is the need to see strategic leadership as one of the key driving forces for improving corporate performance. Strategic leadership is seen as a potent source of management development and sustained competitive advantage for both employee and organizational performance. There is currently a charge on leaders as a major cause of organizational failure. Stakeholders give what they can afford, not necessarily what the organization needs and impose operational and financial decisions on the leaders, 200 respondents were fit for the analysis from the six geo-political regions in Nigeria. The selection was done equally among various parastatals through random sampling technique from the south-south, south-east, south-west, north-east, north-west and north-central. A descriptive research of the survey was employed. The data were subjected to t-test analysis and correlation and regression were used for the analysis. The findings revealed that there is a strong relationship and impact between a strategic leader and corporate performance. Recommendations were made based on the findings that strategic leaders should be given the blueprint, company’s policy and the stakeholders’ expectation within a time frame the work is to be carried out.

Keywords: time, strategic, organization, stakeholder, leader, performance

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Authors: Rabie Fadil, Parshuram Aarotale, Shubha Majumder, Bijay Guargain

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Hemorrhage is the loss of blood from the circulatory system and leading cause of battlefield and postpartum related deaths. Early detection of hemorrhage remains the most effective strategy to reduce mortality rate caused by traumatic injuries. In this study, we investigated the physiological changes via non-invasive cardiac signals at rest and under different hemorrhage conditions simulated through graded lower-body negative pressure (LBNP). Simultaneous electrocardiogram (ECG), photoplethysmogram (PPG), blood pressure (BP), impedance cardiogram (ICG), and phonocardiogram (PCG) were acquired from 10 participants (age:28 ± 6 year, weight:73 ± 11 kg, height:172 ± 8 cm). The LBNP protocol consisted of applying -20, -30, -40, -50, and -60 mmHg pressure to the lower half of the body. Beat-to-beat heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean aerial pressure (MAP) were extracted from ECG and blood pressure. Systolic amplitude (SA), systolic time (ST), diastolic time (DT), and left ventricle Ejection time (LVET) were extracted from PPG during each stage. Preliminary results showed that the application of -40 mmHg i.e. moderate stage simulated hemorrhage resulted significant changes in HR (85±4 bpm vs 68 ± 5bpm, p < 0.01), ST (191 ± 10 ms vs 253 ± 31 ms, p < 0.05), LVET (350 ± 14 ms vs 479 ± 47 ms, p < 0.05) and DT (551 ± 22 ms vs 683 ± 59 ms, p < 0.05) compared to rest, while no change was observed in SA (p > 0.05) as a consequence of LBNP application. These findings demonstrated the potential of cardiac signals in detecting moderate hemorrhage. In future, we will analyze all the LBNP stages and investigate the feasibility of other physiological signals to develop a predictive machine learning model for early detection of hemorrhage.

Keywords: blood pressure, hemorrhage, lower-body negative pressure, LBNP, machine learning

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Authors: Rudraksh Kesharwani, Ritika Agarkar

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Sexually transmitted diseases are a major public health concern affecting both the mortality and the morbidity of a population. It is among the most serious causes of the diseases affecting the quality of life of a individual leading to a significant decrease in their health. In India, STIs have been a significant public health concern due to various reasons, including a large population, limited access to healthcare in certain areas, stigma around discussing sexual health, and insufficient sex education. Some common STIs in India include HIV/AIDS, syphilis, gonorrhea, chlamydia, and herpes. This research report aims to determine the percentage of people infected with sexually transmitted infections (STI) worrying about it’s impact on their day to day activity, specifically focusing on it’s impact on the mentaland sexual health of the patient infected along with his/her partner.

Keywords: sexual health, mental health, sexually transmitted disease, sexual taboos

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Authors: Indra Komara, Kıvanç Taşkin, Endah Wahyuni, Priyo Suprobo

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A series of connection tests that were composed of Cold-Formed Steel (CFS) sections were made to investigate the capacity of connections in a roof truss frame. The connection is controlled by using the two-different type of connection i.e. screws connection and adhesive. The variation of screws is also added applying 1 screw, 2 screws, and 3 screws. On the other hand, the percentage of adhesively material is increased by the total area of screws connection which is 50%, 75%, and 100%. Behaviors illustrated by each connection are examined, and the design capacities projected from the current CFS design codes are appealed to the experimental results of the connections. This research analyses the principal factors assisting in the ductile response of the CFS truss frame connection measured to propose recommendations for connection design, and novelty so that the connection respond plastically with a significant capacity for no brittle failure. Furthermore, the comparison connection was considered for the analysis of the connection capacity, which was estimated from the specimen’s maximum load capacity and the load-deformation behavior.

Keywords: adhesive, bolts, capacity, cold-formed steel, connections, truss

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Authors: Kenneth Harper

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Blockchain technology presents solutions for managing healthcare data, addressing critical challenges in privacy, integrity, and access. This paper explores how privacy-preserving technologies, such as zero-knowledge proofs (ZKPs) and homomorphic encryption (HE), enhance decentralized healthcare platforms by enabling secure computations and patient data protection. An examination of the mathematical foundations of these methods, their practical applications, and how they meet the evolving demands of healthcare data security is unveiled. Using real-world examples, this research highlights industry-leading implementations and offers a roadmap for future applications in secure, decentralized healthcare ecosystems.

Keywords: blockchain, cryptography, data privacy, decentralized data management, differential privacy, healthcare, healthcare data security, homomorphic encryption, privacy-preserving technologies, secure computations, zero-knowledge proofs

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Authors: Lourenco Camnahas, Eileen Willis, Greg Fisher, Jessie Gunson, Pascale Dettwiller, Charlene Thornton

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Stock-out of pharmaceuticals is a common issue at all level of health services in Timor-Leste, a small post-conflict country. This lead to the research questions: what are the current methods used to quantify pharmaceutical supplies; what factors contribute to the on-going pharmaceutical stock-out? The study examined factors that influence the pharmaceutical supply chain system. Methodology: Privett and Goncalvez dependency model has been adopted for the design of the qualitative interviews. The model examines pharmaceutical supply chain management at three management levels: management of individual pharmaceutical items, health facilities, and health systems. The interviews were conducted in order to collect information on inventory management, logistics management information system (LMIS) and the provision of pharmaceuticals. Andersen' behavioural model for healthcare utilization also informed the interview schedule, specifically factors linked to environment (healthcare system and external environment) and the population (enabling factors). Forty health professionals (bureaucrats, clinicians) and six senior officers from a United Nations Agency, a global multilateral agency and a local non-governmental organization were interviewed on their perceptions of factors (healthcare system/supply chain and wider environment) impacting on stock out. Additionally, policy documents for the entire healthcare system, along with population data were collected. Findings: An analysis using Pozzebon’s critical interpretation identified a range of difficulties within the system from poor coordination to failure to adhere to policy guidelines along with major difficulties with inventory management, quantification, forecasting, and budgetary constraints. Weak logistics management information system, lack of capacity in inventory management, monitoring and supervision are additional organizational factors that also contributed to the issue. There were various methods of quantification of pharmaceuticals applied in the government sector, and non-governmental organizations. Lack of reliable data is one of the major problems in the pharmaceutical provision. Global Fund has the best quantification methods fed by consumption data and malaria cases. There are other issues that worsen stock-out: political intervention, work ethic and basic infrastructure such as unreliable internet connectivity. Major issues impacting on pharmaceutical quantification have been identified. However, current data collection identified limitations within the Andersen model; specifically, a failure to take account of predictors in the healthcare system and the environment (culture/politics/social. The next step is to (a) compare models used by three non-governmental agencies with the government model; (b) to run the Andersen explanatory model for pharmaceutical expenditure for 2 to 5 drug items used by these three development partners in order to see how it correlates with the present model in terms of quantification and forecasting the needs; (c) to repeat objectives (a) and (b) using the government model; (d) to draw a conclusion about the strength.

Keywords: inventory management, pharmaceutical forecasting and quantification, pharmaceutical stock-out, pharmaceutical supply chain management

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Authors: Gustavo Funes, Eduardo Peters, Jose Delpiano

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It is widely known that photovoltaic technology has been massively distributed over the last decade despite its low-efficiency ratio. Dust deposition reduces this efficiency even more, lowering the energy production and module lifespan. In this work, we developed an artificial vision algorithm based on CIELAB color space to identify dust over panels in an autonomous way. We performed several experiments photographing three different types of panels, 30W, 340W and 410W. Those panels were soiled artificially with uniform and non-uniform distributed dust. The algorithm proposed uses statistical tools to provide a simulation with a 100% soiled panel and then performs a comparison to get the percentage of dirt in the experimental data set. The simulation uses a seed that is obtained by taking a dust sample from the maximum amount of dust from the dataset. The final result is the dirt percentage and the possible distribution of dust over the panel. Dust deposition is a key factor for plant owners to determine cleaning cycles or identify nonuniform depositions that could lead to module failure and hot spots.

Keywords: dust detection, photovoltaic, artificial vision, soiling

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Authors: Sandipika Gupta

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Objective: Due to admirably low 30-day mortality rates for paediatric cardiac surgery, it is now pertinent to turn towards more intermediate-length outcomes such as morbidities closely associated with these surgeries. One such morbidity, major adverse events (MAE) comprises a group of adverse outcomes associated with paediatric cardiac surgery (e.g. cardiac arrest, major haemorrhage). Methods: This is a retrospective study that analysed the incidence and impact of MAE which was the primary outcome in the UK population. The data was collected in 5 centres between October 2015 and June 2017, amassing 3090 surgical episodes. The incidence and risk factors for MAE, were assessed through descriptive statistical analyses and multivariate logistic regression. The secondary outcomes of life status at 6 months and the length of hospital stay were also evaluated to understand the impact of MAE on patients. Results: Out of 3090 episodes, 134 (4.3%) had a postoperative MAE. The majority of the episodes were in: neonates (47%, P<0.001), high-risk cardiac diagnosis groups (20.1%, P<0.001), episodes with longer 5mes on the bypass (72.4%, P<0.001) and urgent surgeries (57.9%, P<0.001). Episodes reporting MAE also reported longer lengths of stay in hospital (29 days vs 9 days, P<0.001). Furthermore, patients experiencing MAE were at a higher risk of mortality at the 6-month life status check (mortality rates: 29.2% vs 2%, P<0.001).Conclusions: Key risk factors were identified. An important negative impact of MAE was found for patients. The identified risk factors could be used to profile and flag at-risk patients. Monitoring of MAE rates and closer investigation into the care pathway before and after individual MAEs in children’s heart units may lead to a reduction in these terrible events.

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Authors: Jafar Razmi

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Integral abutment bridges are bridges that do not have joints. If these bridges are subject to large seasonal and daily temperature variations, the expansion and contraction of the bridge slab is transferred to the piles. Since the piles are deep into the soil, displacement induced by slab can cause bending and stresses in piles. These stresses cause fatigue and failure of piles. A complex mechanical interaction exists between the slab, pile, soil and abutment. This complex interaction needs to be understood in order to calculate the stresses in piles. This paper uses a mechanical approach in developing analytical equations for the complex structure to determine the stresses in piles. The solution to these analytical solutions is developed and compared with finite element analysis results and experimental data. Our comparison shows that using analytical approach can accurately predict the displacement in piles. This approach offers a simplified technique that can be utilized without the need for computationally extensive finite element model.

Keywords: integral abutment bridges, piles, thermo-mechanical stress, stress and strains

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Authors: Erin Brands-Saliba

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In this evaluation study, we explore the efficacy and implementation of the five guiding principles of Bekaadendang “Being Peaceful,” a suite of services facilitated by our Anti-Human Trafficking Team, and a pivotal component of the Holistic Prevention Services department at NCFST. The guiding principles—trauma-informed care, cultural safety, 4-quadrant medicine wheel approach, harm reduction, and after-care peer support—are the foundation of Bekaadendang's mission to support at-risk individuals and survivors of human trafficking. This evaluation is of paramount importance given the profound impact of human trafficking on these communities and aims to ensure that Bekaadendang's principles are not only understood by staff but experienced by community members in a purposeful and meaningful manner. The issues at the heart of this evaluation are deeply entrenched in the historical and contemporary challenges faced by Indigenous communities, with a particular emphasis on Indigenous women and 2SLGBTQQIA+ individuals. Well-documented reports like the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) have cast a glaring light on the disproportionately high rates of violence, exploitation, and trafficking experienced by these communities. The MMIWG report underlines the pressing need for holistic, culturally informed interventions like Bekaadendang. Furthermore, the research efforts of scholars, both Indigenous and non-Indigenous, shed light on the persistent systemic issues that make Indigenous individuals more vulnerable to trafficking and exploitation. Recognizing this broader context is crucial to truly grasp the importance of evaluating the guiding principles that underpin Bekaadendang's service model.

Keywords: human trafficking, indigenous healing, MMIWG, program evaluation

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Authors: Arpan Dwivedi, Yogesh Pahariya

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In this paper, optimal design of hybrid standalone power supply system (SAPS) is done for off grid applications in remote areas where transmission of power is difficult. The hybrid SAPS system uses two primary energy sources, wind and solar, and in addition to these diesel generator is also connected to meet the load demand in case of failure of wind and solar system. This paper presents mathematical modeling of 1.4 MW hybrid SAPS system for rural electrification. This paper firstly focuses on mathematical modeling of PV module connected in a string, secondly focuses on modeling of permanent magnet wind turbine generator (PMWTG). The hybrid controller is also designed for selection of power from the source available as per the load demand. The power output of hybrid SAPS system is analyzed for meeting load demands at urban as well as for rural areas.

Keywords: SAPS, DG, PMWTG, rural area, off-grid, PV module

Procedia PDF Downloads 249

Authors: Hassan Waseem

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Cytomegalovirus (CMV) is ubiquitously distributed viral agent responsible for different clinical manifestations that may vary according to the immunologic status of the patient. CMV can cause morbidity and mortality among fetuses and patients with compromised immune system. A cross-sectional study was carried out in Islamabad to investigate the prevalence and risk factors associated with CMV infection among pregnant women. Blood samples of 172 pregnant women visiting Mother and Child Healthcare, Pakistan Institute of Medical Sciences (PIMS) Islamabad were taken. In present study, serum samples of the women were checked for CMV-specific IgG and IgM antibodies by enzyme linked immunosorbent assay (ELISA). Clinical, obstetrical and socio-demographical characteristics of the women were collected by using structured questionnaires. Out of 172 pregnant women included in the study, 171 (99.4%) were CMV specific IgG positive and 30 (17.4%) were found positive for CMV-IgM antibodies. The CMV has taken an endemic form in Pakistan so, routine screening of CMV among pregnant women is recommended.

Keywords: Cytomegalovirus, blood transfusion, ELISA, seroprevalence

Procedia PDF Downloads 365

Authors: Jeries J. Abou-Hanna

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Several techniques exist for determining stress-intensity factors in linear elastic fracture mechanics analysis. These techniques are based on analytical, numerical, and empirical approaches that have been well documented in literature and engineering handbooks. However, not all techniques share the same merit. In addition to overly-conservative results, the numerical methods that require extensive computational effort, and those requiring copious user parameters hinder practicing engineers from efficiently evaluating stress-intensity factors. This paper investigates the prospects of reducing the complexity and required variables to determine stress-intensity factors through the utilization of the stress gradient and a weighting function. The heart of this work resides in the understanding that fracture emanating from stress concentration locations cannot be explained by a single maximum stress value approach, but requires use of a critical volume in which the crack exists. In order to understand the effectiveness of this technique, this study investigated components of different notch geometry and varying levels of stress gradients. Two forms of weighting functions were employed to determine stress-intensity factors and results were compared to analytical exact methods. The results indicated that the “exponential” weighting function was superior to the “absolute” weighting function. An error band +/- 10% was met for cases ranging from a steep stress gradient in a sharp v-notch to the less severe stress transitions of a large circular notch. The incorporation of the proposed method has shown to be a worthwhile consideration.

Keywords: fracture mechanics, finite element method, stress intensity factor, stress gradient

Procedia PDF Downloads 135

Authors: Michael Kvopka, Ezekiel Kingston

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A 61-year-old man with no significant past medical history presented to a quaternary ophthalmic referral center with acute right-sided medial canthal pain, periorbital edema, and erythema despite oral antibiotic therapy. CT imaging confirmed the presence of right preseptal cellulitis and lacrimal sac aspiration identified multi-resistant Enterobacter cloacae. A diagnosis of acute right-sided dacryocystitis with preseptal cellulitis was made. He was successfully treated with broadening of antibiotic therapy to intravenous meropenem. The symptomatic resolution was noted on follow-up without evidence of disease recurrence. To the Authors’ best knowledge, this is the first reported case of multi-resistant E. cloacae dacryocystitis and preseptal cellulitis. The management of this patient required a multi-disciplinary approach, so the Authors believe this report is relevant to general ophthalmologists and oculoplastic sub-specialists.

Keywords: enterobacter, dacryocystitis, preseptal cellulitis, antibiotic resistance

Procedia PDF Downloads 223

Authors: Luis F. Caballero-castro, Dirsa Feliciano, Daniela Novoa, Orlando Arroyo, Jesús D. Villalba-morales

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Colombia faces a critical challenge in seismic resilience due to the prevalence of informal housing, which constitutes approximately 70% of residential structures. More than 10 million Colombians (20% of the population), live in homes susceptible to collapse in the event of an earthquake. This, combined with the fact that 83% of the population is in intermediate and high seismic hazard areas, has brought serious consequences to the country. These consequences became evident during the 1999 Armenia earthquake, which affected nearly 100,000 properties and represented economic losses equivalent to 1.88% of that year's Gross Domestic Product (GDP). Despite previous efforts to reinforce informal housing through methods like externally reinforced masonry walls, alternatives related to seismic protection systems (SPDs), such as Buckling-Restrained Braces (BRB), have not yet been explored in the country. BRBs are reinforcement elements capable of withstanding both compression and tension, making them effective in enhancing the lateral stiffness of structures. In this study, the use of low-cost and easily installable BRBs for the retrofit of informal housing in Colombia was evaluated, considering the economic limitations of the communities. For this purpose, a case study was selected involving an informally constructed dwelling in the country, from which field information on its structural characteristics and construction materials was collected. Based on the gathered information, nonlinear models with and without BRBs were created, and their seismic performance was analyzed and compared through incremental static (pushover) and nonlinear dynamic analyses. In the first analysis, the capacity curve was identified, showcasing the sequence of failure events occurring from initial yielding to structural collapse. In the second case, the model underwent nonlinear dynamic analyses using a set of seismic records consistent with the country's seismic hazard. Based on the results, fragility curves were calculated to evaluate the probability of failure of the informal housings before and after the intervention with BRBs, providing essential information about their effectiveness in reducing seismic vulnerability. The results indicate that low-cost BRBs can significantly increase the capacity of informal housing to withstand earthquakes. The dynamic analysis revealed that retrofit structures experienced lower displacements and deformations, enhancing the safety of residents and the seismic performance of informally constructed houses. In other words, the use of low-cost BRBs in the retrofit of informal housing in Colombia is a promising strategy for improving structural safety in seismic-prone areas. This study emphasizes the importance of seeking affordable and practical solutions to address seismic risk in vulnerable communities in earthquake-prone regions in Colombia and serves as a model for addressing similar challenges of informal housing worldwide.

Keywords: buckling-restrained braces, fragility curves, informal housing, incremental dynamic analysis, seismic retrofit

Procedia PDF Downloads 96

Authors: Anurag Savarnya

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The reliability of the various parts of electric mining shovel has been assessed through the application of Weibull Model. The study was initiated to find reliability of components of electric mining shovel. The paper aims to optimize the reliability of components and increase the life cycle of component. A multilevel decomposition of the electric mining shovel was done and maintenance records were used to evaluate the failure data and appropriate system characterization was done to model the system in terms of reasonable number of components. The approach used develops a mathematical model to assess the reliability of the electric mining shovel components. The model can be used to predict reliability of components of the hydraulic mining shovel and system performance. Reliability is an inherent attribute to a system. When the life-cycle costs of a system are being analyzed, reliability plays an important role as a major driver of these costs and has considerable influence on system performance. It is an iterative process that begins with specification of reliability goals consistent with cost and performance objectives. The data were collected from an Indian open cast coal mine and the reliability of various components of the electric mining shovel has been assessed by following a Weibull Model.

Keywords: reliability, Weibull model, electric mining shovel

Procedia PDF Downloads 514