Search results for: never pressure injury

Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

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Authors: Neelu Raina, Parvez Singh Slathia, Deepali Bhagat, Preeti Sharma

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Pretreatment of lignocellulosic biomass for generating suitable substrates (starch/ sugars) for conversion to bioethanol is the most crucial step. In present study waste from furniture industry i.e sawdust from softwood Cedrus deodara (deodar) and hardwood Shorea robusta (sal) was used as lignocellulosic biomass. Thermochemical pretreatment was given by autoclaving at 121°C temperature and 15 psi pressure. Acids (H2SO4,HCl,HNO3,H3PO4), alkali (NaOH,NH4OH,KOH,Ca(OH)2) and organic acids (C6H8O7,C2H2O4,C4H4O4) were used at 0.1%, 0.5% and 1% concentration without giving any residence time. 1% HCl gave maximum sugar yield of 3.6587g/L in deodar and 6.1539 g/L in sal. For biological pretreatment a fungi isolated from decaying wood was used , sawdust from deodar tree species was used as a lignocellulosic substrate and before thermochemical pretreatment sawdust was treated with fungal culture at 37°C under submerged conditions with a residence time of one week followed by a thermochemical pretreatment methodology. Higher sugar yields were obtained with sal tree species followed by deodar tree species, i.e., 6.0334g/L in deodar and 8.3605g/L in sal was obtained by a combined biological and thermochemical pretreatment. Use of acids along with biological pretreatment is a favourable factor for breaking the lignin seal and thus increasing the sugar yield. Sugar estimation was done using Dinitrosalicyclic assay method. Result validation is being done by statistical analysis.

Keywords: lignocellulosic biomass, bioethanol, pretreatment, sawdust

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Authors: Jiang Zhenbo, Ishikura Ryohei, Yasufuku Noriyuki

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Improvement of soft clay deposits by the combination of surface stabilization and floating type cement-treated columns is one of the most popular techniques worldwide. On the basis of one dimensional consolidation model, a time-dependent skin friction model for the column-soil interaction is proposed. The nonlinear relationship between column shaft shear stresses and effective vertical pressure of the surrounding soil can be described in this model. The influence of column-soil surface roughness can be represented using a roughness coefficient R, which plays an important role in the design of column length. Based on the homogenization method, a part of floating type improved ground will be treated as an unimproved portion, which with a length of αH1 is defined as a time-dependent equivalent skin friction length. The compression settlement of this unimproved portion can be predicted only using the soft clay parameters. Apart from calculating the settlement of this composited ground, the load transfer mechanism is discussed utilizing model tests. The proposed model is validated by comparing with calculations and laboratory results of model and ring shear tests, which indicate the suitability and accuracy of the solutions in this paper.

Keywords: floating type improved foundation, time-dependent skin friction, roughness, consolidation

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Authors: Perminderjit Singh, Randeep Singh

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The performance, emission and combustion characteristics of a single cylinder four stroke variable compression ratio multifuel engine when fueled with different blends of rice bran oil methyl ester and ethanol are investigated and compared with the results of standard diesel. Biodiesel produced from rice bran oil by transesterification process has been used in this study. The experiment has been conducted at a fixed engine speed of 1500 rpm, 50% load and at compression ratios of 16.5:1, 17:1, 17.5:1 and 18:1. The impact of compression ratio on fuel consumption, brake thermal efficiency and exhaust gas emissions has been investigated and presented. Optimum compression ratio which gives the best performance has been identified. The results indicate longer ignition delay, the maximum rate of pressure rise, lower heat release rate and higher mass fraction burnt at higher compression ratio for waste cooking oil methyl ester when compared to that of diesel. The brake thermal efficiency at 50% load for rice bran oil methyl ester blends and diesel has been calculated and the blend B40 is found to give maximum thermal efficiency. The blends when used as fuel results in the reduction of carbon monoxide, hydrocarbon and increase in nitrogen oxides emissions.

Keywords: biodiesel, rice bran oil, transesterification, ethanol, compression ratio

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Authors: Anyeres N. Atehortua Jimenez, J. David Lambraño, Juan Carlos Muñoz

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Navier-Stokes equations (NSE), which describe the dynamics of a fluid, have an important application on modeling waves used for data inversion techniques as full waveform inversion (FWI). In this work a linearized version of NSE and its variables, neglecting deviatoric terms of stress tensor, is presented. In order to get a theoretical modeling of pressure p(x,t) and wave velocity profile c(x,t), a wave equation of visco-acoustic medium (VAE) is written. A change of variables p(x,t)=q(x,t)h(ρ), is made on the equation for the VAE leading to a well known Klein-Gordon equation (KGE) describing waves propagating in variable density medium (ρ) with dispersive term α^2(x). KGE is reduced to a Poisson equation and solved by proposing a specific function for α^2(x) accounting for the energy dissipation and dispersion. Finally, an integral form solution is derived for p(x,t), c(x,t) and kinematics variables like particle velocity v(x,t), displacement u(x,t) and bulk modulus function k_b(x,t). Further, it is compared this visco-acoustic formulation with another form broadly used in the geophysics; it is argued that this formalism is more general and, given its integral form, it may offer several advantages from the modern parallel computing point of view. Applications to minimize the errors in modeling for FWI applied to oils resources in geophysics are discussed.

Keywords: Navier-Stokes equations, modeling, visco-acoustic, inversion FWI

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Authors: Lifar M. S., Tereshchenko A. A., Bulgakov A. N., Guda S. A., Guda A. A., Soldatov A. V.

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Metal nanoparticles are widely used as heterogeneous catalysts to activate adsorbed molecules and reduce the energy barrier of the reaction. Reaction product yield depends on the interplay between elementary processes - adsorption, activation, reaction, and desorption. These processes, in turn, depend on the inlet feed concentrations, temperature, and pressure. At stationary conditions, the active surface sites may be poisoned by reaction byproducts or blocked by thermodynamically adsorbed gaseous reagents. Thus, the yield of reaction products can significantly drop. On the contrary, the dynamic control accounts for the changes in the surface properties and adjusts reaction parameters accordingly. Therefore dynamic control may be more efficient than stationary control. In this work, a reinforcement learning algorithm has been applied to control the simulation of CO oxidation on a catalyst. The policy gradient algorithm is learned to maximize the CO₂ production rate based on the CO and O₂ flows at a given time step. Nonstationary solutions were found for the regime with surface deactivation. The maximal product yield was achieved for periodic variations of the gas flows, ensuring a balance between available adsorption sites and the concentration of activated intermediates. This methodology opens a perspective for the optimization of catalytic reactions under nonstationary conditions.

Keywords: artificial intelligence, catalyst, co oxidation, reinforcement learning, dynamic control

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Authors: T. Maruyama, T. Saida, S. Naritsuka, S. Iijima

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Single-walled carbon nanotubes (SWCNTs) are generally synthesized by chemical vapor deposition (CVD) using Fe, Co, and Ni as catalysts. However, due to the Ostwald ripening of metal catalysts, the diameter distribution of the grown SWCNTs is considerably wide (>2 nm), which is not suitable for electronics applications. In addition, reduction in the growth temperature is desirable for fabricating SWCNT devices compatible with the LSI process. Herein, we performed SWCNT growth by alcohol catalytic CVD using platinum-group metal catalysts (Pt, Rh, and Pd) because these metals have high melting points, and the reduction in the Ostwald ripening of catalyst particles is expected. Our results revealed that web-like SWCNTs were obtained from Pt and Rh catalysts at growth temperature between 500 °C and 600 °C by optimizing the ethanol pressure. The SWCNT yield from Pd catalysts was considerably low. By decreasing the growth temperature, the diameter and chirality distribution of SWCNTs from Pt and Rh catalysts became small and narrow. In particular, the diameters of most SWCNTs grown using Pt catalysts were below 1 nm and their diameter distribution was considerably narrow. On the contrary, SWCNTs can grow from Rh catalysts even at 300 °C by optimizing the growth condition, which is the lowest temperature recorded for SWCNT growth. Our results demonstrated that platinum-group metals are useful for the growth of small-diameter SWCNTs and facilitate low-temperature growth.

Keywords: carbon nanotube, chemical vapor deposition, catalyst, platinum, rhodium, palladium

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Authors: Rinku Varghese, S. Chandrakaran, K. Rangaswamy

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The standard one-dimensional consolidation test is used to find the consolidation behaviour of artificially consolidated organic soils. Incremental loading tests were conducted on the clay without and with organic matter. The study was conducted with soil having different organic content keeping all other parameters constant. The tests were conducted on clay and artificially prepared organic soil sample at different vertical pressure. The load increment ratio considered for the test is equal to one. Artificial organic soils are used for the test by adding starch to the clay. The percentage of organic content in starch is determined by adding 5% by weight starch into the clay (inorganic soil) sample and corresponding change in organic content of soil was determined. This was expressed as percentage by weight of starch, and it was found that about 95% organic content in the soil sample. Accordingly percentage of organic content fixed and added to the sample for testing to understand the consolidation behaviour clayey soils with organic content. A detailed study of the results obtained from IL test was investigated. The main items investigated were (i) coefficient of consolidation (cv), (ii) coefficient of volume compression (mv), (iii) coefficient of permeability (k). The consolidation parameter obtained from IL test was used for determining the creep strain and creep parameter and also predicting their variation with vertical stress and organic content.

Keywords: consolidation, secondary compression, creep, starch

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Authors: Jin Song Gui, Han Li, Rui Jin Zhang, Heng Jiang Cai

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There is a large deviation between the measured wave power at the vertical breast wall and the calculated one according to current specification in the case of overtopping. In order to investigate the reasons for the deviation, the wave forces of vertical breast wall under overtopping conditions have been measured through physical model experiment and compared with the calculated results. The effect of water depth, period and the wave height on the wave forces of the vertical breast wall have been also investigated. The distribution of wave pressure under different wave actions was tested based on the force sensor which is installed in the vertical breakwater. By comparing and analyzing the measured values and norms calculated values, the applicability of the existing norms recommended method were discussed and a reference for the design of vertical breakwater was provided. Experiment results show that with the decrease of the water depth, the gap is growing between the actual wave forces and the specification values, and there are no obvious regulations between these two values with the variation of period while wave force greatly reduces with the overtopping reducing. The amount of water depth and wave overtopping has a significant impact on the wave force of overtopping section while the period has no obvious influence on the wave force. Finally, some favorable recommendations for the overtopping wave force design of the vertical breakwater according to the model experiment results are provided.

Keywords: overtopping wave, physical model experiment, vertical breakwater, wave forces

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Authors: H. Selcuk Halkacı, Mevlüt Türköz, Ekrem Öztürk, Murat Dilmec

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Various attempts concerning the low formability issue for lightweight materials like aluminium and magnesium alloys are being investigated in many studies. Advanced forming processes such as hydroforming is one of these attempts. In last decades sheet hydroforming process has an increasing interest, particularly in the automotive and aerospace industries. This process has many advantages such as enhanced formability, the capability to form complex parts, higher dimensional accuracy and surface quality, reduction of tool costs and reduced die wear compared to the conventional sheet metal forming processes. There are two types of sheet hydroforming. One of them is hydromechanical deep drawing (HDD) that is a special drawing process in which pressurized fluid medium is used instead of one of the die half compared to the conventional deep drawing (CDD) process. Another one is sheet hydroforming with die (SHF-D) in which blank is formed with the act of fluid pressure and it takes the shape of die half. In this study, transition of cup height according to cup diameter between the processes was determined by performing simulation of the processes in Finite Element Analysis. Firstly SHF-D process was simulated for 40 mm cup diameter at different cup heights chancing from 10 mm to 30 mm and the cup height to diameter ratio value in which it is not possible to obtain a successful forming was determined. Then the same ratio was checked for a different cup diameter of 60 mm. Then thickness distributions of the cups formed by SHF-D and HDD processes were compared for the cup heights. Consequently, it was found that the thickness distribution in HDD process in the analyses was more uniform.

Keywords: finite element analysis, HDD, hydroforming sheet metal forming, SHF-D

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Authors: Raheel Shakoor Siddiqui, Shahbaz Malik, Manikandar Srinivas Cheruvu, Sanjay Narayana Murthy, Livio DiMascio

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Background: elderly traumatic hip fracture patients frequently present to trauma services globally. Rising low energy falls amongst an osteoporotic aging population is the commonest cause for injury. Hip fractures in this population are a major cause for severe pain, morbidity and mortality. The term hip fracture is interchangeable with neck of femur fracture, fractured neck of femur or proximal femur fracture. Hip fracture pain management protocols and guidelines suggest conventional analgesia, nerve block and opioid based treatment as rescue analgesia. There is a current global opioid crisis with overuse, abuse and dependence. Adverse opioid related complications in vulnerable elderly patients further adds to morbidity and mortality. Systematic reviews in literature have evidenced superiority of multimodal analgesia in osteoarthritic primary joint replacements compared to opioids however, this has not yet been conducted for elderly traumatic hip fracture patients. Aims: The primary aim of this systematic review is to provide standardised evidence following Cochrane and PRISMA guidance in determining advantages of perioperative multimodal analgesia over conventional opioid based treatments in elderly traumatic hip fractures. Methods: 5 databases were searched from January 2000-2023 which identified 8 randomised controlled trials and 446 total participants. These trials met defined PICOS eligibility criteria of patient mean age ≥ 65 years presenting with a unilateral traumatic fractured neck of femur for operative intervention. Analgesic intervention with perioperative multimodal analgesia has been compared to conventional opioid based analgesia. Outcomes of interest include, primarily, the change in postoperative opioid consumption within a 0-30 postoperative period and secondarily, the change in postoperative adverse events and complications. A qualitative synthesis has been performed due to clinical heterogenicity and variance amongst trials. Results: GRADE evidence of moderate quality supports perioperative multimodal analgesia leads to a reduction in postoperative opioid consumption however, low quality evidence supports a reduction of adverse effects and complications. Conclusion: Perioperative multimodal analgesia whether used preoperative, intraoperative and/or postoperative leads to a reduction in postoperative opioid consumption for elderly traumatic hip fracture patients. This review recommends the use of perioperative multimodal analgesia as part of hip fracture pain protocols however, caution and clinical judgement should be used as the risk of adverse effects may not be lower.

Keywords: trauma, orthopaedics, hip, fracture, neck of femur fracture, analgesia, multimodal analgesia, opioid

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Authors: Carlos A. Acosta, Amar Bhalla, Ruyan Guo

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Scraped surface heat exchangers (SSHE) use a rotor shaft assembly with scraping blades to homogenize viscous fluids during the heat transfer process. Obtaining in-situ measurements is difficult because the rotor and scraping blades spin continuously inside the mixing chamber, obstructing the instrumentation pathway. Computational fluid dynamics simulations provide useful insight into the flow behavior around the scraper blades for a variety of fluids and blade geometries. However, numerical solutions often focus on the fluid dynamics and heat transfer phenomena of rotating flow, ignoring the glass-transition temperature and freezing point depression. This research studies the multi-phase fluid dynamics and freezing point depression inside the SSHE with non-isothermal conditions in a time dependent process using an aqueous solution that contains 13.5 wt.% high fructose corn syrup and CO₂. The computational results were validated with in-situ pressure, temperature, and optical spectroscopy measurements. Results from the numerical model show good quantitatively agreement with experimental values.

Keywords: computational fluid dynamics, freezing point depression, phase-transition temperature, multi-phase flow

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Authors: A. Aravind, M. Vetrivel, P. Abhimanyu, C. A. Akaash Emmanuel Raj, K. Sundararaj, V. R. S. Kumar

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The choice of high-speed, low budget hatchback car with diversified options is increasing for meeting the new generation buyers trend. This paper is aimed to augment the current speed of the hatchback cars through the aerodynamic drag reduction technique. The inverted airfoils are facilitated at the bottom of the car for generating the downward force for negating the lift while increasing the current speed range for achieving a better road performance. The numerical simulations have been carried out using a 2D steady pressure-based    k-ɛ realizable model with enhanced wall treatment. In our numerical studies, Reynolds-averaged Navier-Stokes model and its code of solution are used. The code is calibrated and validated using the exact solution of the 2D boundary layer displacement thickness at the Sanal flow choking condition for adiabatic flows. We observed through the parametric analytical studies that the inverted airfoil integrated with the bottom surface at various predesigned locations of Hatchback cars can improve its overall aerodynamic efficiency through drag reduction, which obviously decreases the fuel consumption significantly and ensure an optimum road performance lucratively with maximum permissible speed within the framework of the manufactures constraints.

Keywords: aerodynamics of commercial cars, downward force, hatchback car, inverted airfoil

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Authors: Jannika Dombrowski, Sabine Ambros, Ulrich Kulozik

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Due to the increasing popularity of healthy products, probiotics are still of rising importance in food manufacturing. With the aim to amplify the field of probiotic application to non-chilled products, the cultures have to be preserved by drying. Microwave drying has proved to be a suitable technique to achieve relatively high survival rates, resulting from drying at gentle temperatures, among others. However, diffusion limitation due to compaction of cell suspension during drying can prolong drying times as well as deteriorate product properties (grindability, rehydration performance). Therefore, we aimed to embed probiotics in an aerated matrix of whey proteins (surfactants) and di-/polysaccharides (foam stabilization, probiotic protection) during drying. As a result of the manifold increased inner surface of the cell suspension, drying performance was enhanced significantly as compared to non-foamed suspensions. This work comprises investigations on suitable foam matrices, being stable under vacuum (variation of protein concentration, type and concentration of di-/polysaccharide) as well as development of an applicable microwave drying process in terms of microwave power, chamber pressure and maximum product temperatures. Performed analyses included foam characteristics (overrun, drainage, firmness, bubble sizes), and properties of the dried cultures (survival, activity). In addition, efficiency of the drying process was evaluated.

Keywords: foam structure, microwave drying, polysaccharides, probiotics

Procedia PDF Downloads 262

Authors: Daniel Ter Goon, Aanuoluwa O. Adedokun, Eyitayo Omolara Owolabi, Oladele Vincent Adeniyi, Anthony Idowu Ajayi

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Background: The unhealthy food choices and sedentary lifestyle of commercial drivers predisposes them to obesity and obesity related diseases. Yet, no attention has been paid to obesity burden among this high risk group in South Africa. This study examines the prevalence of obesity and its risk factors among commercial drivers in East London, South Africa. Methods: This cross-sectional study utilized the WHO STEP wise approach to screen for obesity among 403 drivers in Buffalo City Metropolitan Municipality (BCMM), South Africa. Anthropometric, blood pressure and blood glucose measurements were taken following a standard procedure. Overweight and obesity was defined as a body mass index (BMI) of 25.0 kgm⁻²–29.9 kg/m² and≥ 30 kg/ m², respectively. Bivariate and multivariate analysis were used to determine the prevalence and determinants of obesity. Result: The mean age of the participants was 43.3 (SD12.5) years, mean height (cm) and weight (kg) were 170.1(6.2cm) and 83(SD18.7), respectively. The prevalence of overweight and obesity was 34.0% and 38.0%, respectively. After adjusting for confounding factors, only age (OR 1.6, CI 1.0-2.7), hypertension (OR 3.6, CI 2.3-5.7) and non-smoking (OR 2.0, CI 1.3-3.1) were independent predictors of obesity. Conclusion: The prevalence of overweight and obesity is high among commercial drivers. Age, hypertension, and non-smoking were independent predictors of obesity among the sample. Measures aimed at promoting health and reducing obesity should be prioritized among this group.

Keywords: obesity and overweight, commercial taxi drivers, risk factors, South Africa

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Authors: Mahmood Al Ramahi, G. Keszthelyi-Szabo, S. Beszedes

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Hydrothermal carbonization (HTC) is a thermochemical reaction that utilizes saturated water and vapor pressure to convert waste biomass to C-rich products This work evaluated the effect of HTC as a pre- and post-treatment technique to anaerobic digestion (AD) of dairy sludge, as information in this field is still in its infancy, with many research and methodological gaps. HTC effect was evaluated based on energy recovery, nutrients transformation, and sludge biodegradability. The first treatment approach was executed by applying hydrothermal carbonization (HTC) under a range of temperatures, prior to mesophilic anaerobic digestion (AD) of dairy sludge. Results suggested an optimal pretreatment temperature at 210 °C for 30 min. HTC pretreatment increased methane yield and chemical oxygen demand removal. The theoretical model based on Boyle’s equation had a very close match with the experimental results. On the other hand, applying HTC subsequent to AD increased total energy production, as additional energy yield was obtained by the solid fuel (hydrochar) beside the produced biogas. Furthermore, hydrothermal carbonization of AD digestate generated liquid products (HTC digestate) with improved chemical characteristics suggesting their use as liquid fertilizers.

Keywords: hydrothermal carbonization, anaerobic digestion, energy balance, sludge biodegradability, biogas

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Authors: Abeer Ahmed Abdelhameed

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The aim of this study was to investigate the effect of aerobic exercises on LV parameters, lipid profile, and anthropometric measurements in hypertensive middle aged male subjects. Thirty obese patients were recruited for the study from the outpatient clinic of National Heart Institute, Egypt. Their ages ranges from 40 to 60 years. All participants underwent an aerobic training program including regular aerobic sub-maximal exercises in the form of treadmill walking and abdominal exercises 3/week for four months, the exercise were individually tailored for each participant depending on the result of cardiopulmonary exercise test. The result showed no significant difference observed in both LVPWT and LVSWT data from pre-test values to post-test values in all subjects after 4 months, with a significant reduction in WHR, systolic blood pressure, TAG and LDL records. Result also revealed a significant increase in HDL, Eƒ, LVEDD and FS records for all participants. The significant improvement in ventricular functions in form of ejection fraction of electrical group more than exercise group after 4 months at the end of the study may be due to the beneficial effect of faradic stimulation in lipolysis of storage adipose tissues, stimulation of lean body mass and muscles and/or thermal effect that improves vascularization.

Keywords: left ventricular parameters, aerobic training, electrical stimulation, lipid profile

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

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

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

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Authors: John Gaber

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Objectives: Complementary and alternative medicine (CAM) is a medicine or health practice that is used alongside conventional practice. Nowadays, CAM is commonly used in North America and other countries, and there is a need for more scientific study to understand its efficacy in different clinical cases. This retrospective study explores the effectiveness and recovery time of CAMs such as cupping, acupuncture, and sotai to treat cases of non-specific low back pain (ANLBP). Methods: We assessed the effectiveness of acupuncture, cupping, and sotai methods on pain and for the treatment of ANLBP. We have compared the magnitude of pain relief using a pain scale assessment method to compare the efficacy of each treatment. The Face Pain Scale assessment was conducted before and 24 hours post-treatment. This retrospective study analyzed 40 patients and categorized them according to the treatment they received. The study included the control group, and the three intervention groups, each with ten patients. Each of the three intervention groups received one of the intervention methods. The first group received the cupping treatment, where cups were placed on the lower back of both sides on points: BL23, BL25, BL26, BL54, BL37, BL40, and BL57. After vacuuming, the cups will stay for 10-15 minutes under infrared light (IR) heating. IR heating is applied by an infrared heat lamp. The second group received the acupuncture treatment, placing needles on points: BL23, BL25, BL26, BL52BL54, GB30, BL37, BL40, BL57, BL59, BL60, and KI3. The needles will be simulated with IR light. The final group received the sotai treatment, a Japanese form of structural realignment that relieves pain, balance, and mobility -moving the body naturally and spontaneously towards a comfortable direction by focusing on the inner feeling and synchronizing with the patient’s breathing. The SPSS statistical software was used to analyze the data using repeated-measures ANOVA. The data collected demonstrates the change in the FPS assessment method value over the course of treatment. p<0.05 was considered statistically significant. Results: In the cupping, acupuncture, and sotai therapy groups, the mean of the FPS value reduced from 8.7±1.2, 8.8±1.2, 9.0±0.8 before the intervention to 3.5±1.4, 4.3±1.4, 3.3±1.3, 24 hours after the intervention, respectively. The data collected shows that the CAM methods included in this study all show improvements in pain relief 24 hours after treatment. Conclusion: Complementary and alternative medicine were developed to treat injuries and illnesses with the whole body in mind, designed to be used in addition to standard treatments. The data above shows that the use of these treatments can have a pain-relieving effect, but more research should be done on the matter, as finding CAM methods that are efficacious is crucial in the landscape of health sciences.

Keywords: acupuncture, cupping, alternative medicine, rehabilitation, acute injury

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Authors: Luai Z. Hasoun, Steven W. Bailey, Kitti K. Outlaw, June E. Ayling

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Human skin color is thought to have evolved to balance sufficient photochemical synthesis of vitamin D versus the need to protect not only DNA but also folate from degradation by ultraviolet light (UV). Although the risk of DNA damage and subsequent skin cancer is related to light skin color, the effect of UV on skin folate of any species is unknown. Here we show that UVA irradiation at 13 mW/cm2 for a total exposure of 187 J/cm2 (similar to a maximal daily equatorial dose) induced a significant loss of total folate in epidermis of ex vivo white skin. No loss was observed in black skin samples, or in the dermis of either color. Interestingly, while the concentration of 5 methyltetrahydrofolate (5-MTHF) fell in white epidermis, a concomitant increase of tetrahydrofolic acid was found, though not enough to maintain the total pool. These results demonstrate that UVA indeed not only decreases folate in skin, but also rearranges the pool components. This could be due in part to the reported increase of NADPH oxidase activity upon UV irradiation, which in turn depletes the NADPH needed for 5-MTHF biosynthesis by 5,10-methylenetetrahydrofolate reductase. The increased tetrahydrofolic acid might further support production of the nucleotide bases needed for DNA repair. However, total folate was lost at a rate that could, with strong or continuous enough exposure to ultraviolet radiation, substantially deplete light colored skin locally, and also put pressure on total body stores for individuals with low intake of folate.

Keywords: depletion, folate, human skin, ultraviolet

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Nazanin Naderi, Milton Smith

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Since worldwide demand for renewable energy is increasing rapidly because of the climate problem and the limitation of fossil fuels, technologies of alternative energy sources have been developed and the electric power network now includes renewable energy resources such as wind energy. Because of the huge advantages that wind energy has, like reduction in natural gas use, price pressure, emissions of greenhouse gases and other atmospheric pollutants, electric sector water consumption and many other contributions to the nation’s economy like job creation it has got too much attention these days from different parts of the world especially in the United States which is trying to provide 20% of the nation’s energy from wind by 2030. This study is trying to evaluate the effect of splitting wind farms on power output. We are trying to find if we can get more output by installing wind turbines in different sites rather than installing all wind turbines in one site. Five potential sites in Texas have been selected as a case study and two years wind data has been gathered for these sites. Wind data are analyzed and effect of correlation between sites on power output has been evaluated. Standard deviation and autocorrelation effect has also been considered for this study. The paper has been organized as follows: After the introduction the second section gives a brief overview of wind analysis. The third section addresses the case study and evaluates correlation between sites, auto correlation of sites and standard deviation of power output. In section four we describe the results.

Keywords: auto correlation, correlation between sites, splitting wind farms, power output, standard deviation

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Authors: Majid Samiee Zonoozian

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For such important constructions as jacket type platforms, scrupulous attention in analysis, design and calculation processes is needed. The reliability assessment method has been established into an extensively used method to behavior safety calculation of jacket platforms. In the present study, a methodology for the reliability calculation of an offshore jacket platform in contradiction of the extreme wave loading state is available. Therefore, sensitivity analyses are applied to acquire the nonlinear response of jacket-type platforms against extreme waves. The jacket structure is modeled by applying a nonlinear finite-element model with regards to the tubular members' behave. The probability of a member’s failure under extreme wave loading is figured by a finite-element reliability code. The FORM and SORM approaches are applied for the calculation of safety directories and reliability indexes have been detected. A case study for a fixed jacket-type structure positioned in the Persian Gulf is studied by means of the planned method. Furthermore, to define the failure standards, equations suggested by the 21st version of the API RP 2A-WSD for The jacket-type structures’ tubular members designing by applying the mixed axial bending and axial pressure. Consequently, the effect of wave Loades in the reliability index was considered.

Keywords: Jacket-Type structure, reliability, failure probability, tubular members

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Authors: Clement Leroy, Guillaume Boitel

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This paper presents a comparative benchmarking review of a steady and transient three-dimensional (3D) flow computations in centrifugal pump using commercial (AnsysCFX) and open source (OpenFOAM) computational fluid dynamics (CFD) software. In centrifugal rotor-dynamic pump, the fluid enters in the impeller along to the rotating axis to be accelerated in order to increase the pressure, flowing radially outward into another stage, vaned diffuser or volute casing, from where it finally exits into a downstream pipe. Simulations are carried out at the best efficiency point (BEP) and part load, for single-phase flow with several turbulence models. The results are compared with overall performance report from experimental data. The use of CFD technology in industry is still limited by the high computational costs, and even more by the high cost of commercial CFD software and high-performance computing (HPC) licenses. The main objectives of the present study are to define OpenFOAM methodology for high-quality 3D steady and transient turbomachinery CFD simulation to conduct a thorough time-accurate performance analysis. On the other hand a detailed comparisons between computational methods, features on latest Ansys release 18 and OpenFOAM is investigated to assess the accuracy and industrial applications of those solvers. Finally an automated connected workflow (IoT) for turbine blade applications is presented.

Keywords: benchmarking, CFX, internet of things, openFOAM, time-accurate, turbomachinery

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Authors: Pavel E. Mikriukov

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The demand for natural gas (NG) is increasing every year around the world, so it is necessary to produce and transport NG in large quantities. To solve this problem, liquefied natural gas (LNG) plants are used, using different equipment and different technologies to achieve the required LNG quality. To determine the best efficiency of the LNG liquefaction plant, it is necessary to analyze the equipment used in this process and identify other technological solutions for LNG production using more productive and energy-efficient equipment. Based on this, mathematical models of the technological process of the LNG plant were created, which are based on a two-circuit system of heat exchange equipment and a nitrogen isolated cycle for NG cooling. The final liquefaction of natural gas is performed on the construction of the basic principle of the Joule-Thompson effect. The pressure and temperature drop are considered on different types of equipment such as throttle valve, which was used in the basic scheme; turbo expander and supersonic separator, which act as new equipment, to be compared with the efficiency of the basic scheme of the unit. New configurations of LNG plants are suggested, which can be used in almost all LNG facilities. As a result of the analysis, it turned out that the turbo expander and the supersonic separator have comparatively equal potential in comparison with the baseline scheme execution on the throttle valve. A more rational method of selecting the technology and the equipment used for natural gas liquefaction can improve the efficiency of low-tonnage plants and reduce the cost of gas for own needs.

Keywords: gas liquefaction, gas, Joule-Thompson effect, LNG, low-tonnage LNG, supersonic separator, Throttle valve, turbo expander

Procedia PDF Downloads 111

Authors: Carolina Pereira Lobato Costa, Cristina Pascual-González, Monica Echeverry, Javier LLorca, Carlos Gonzáléz, Juan Pedro Fernández-Bláquez

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Although the potential of PLA self-reinforced composites for bone applications, not much literature addresses optimal manufacturing conditions. In this regard, this paper describes the woven self-reinforced PLA composites manufacturing processes: the commingling of yarns, weaving, and hot pressing and characterizes the manufactured laminates. Different structures and properties can be achieved by varying the hot compaction process parameters (pressure, holding time, and temperature). The specimens manufactured were characterized in terms of thermal properties (DSC), microstructure (C-scan optical microscope and SEM), strength (tensile test), and biocompatibility (MTT assays). Considering the final device, 155 ℃ for 10 min at 2 MPa act as the more appropriate hot pressing parameters. The laminate produced with these conditions has few voids/porosity, a tensile strength of 30.39 ± 1.21 MPa, and a modulus of 4.09 ± 0.24 GPa. Subsequently to the tensile testing was possible to observe fiber pullout from the fracture surfaces, confirming that this material behaves as a composite. From the results, no single laminate can fulfill all the requirements, being necessary to compromise in function of the priority property. Further investigation is required to improve materials' mechanical performance. Subsequently, process parameters and materials configuration can be adjusted depending on the place and type of implant to suit its function.

Keywords: woven fabric, self-reinforced polymer composite, poly(lactic acid), biodegradable

Procedia PDF Downloads 196

Authors: Anas Rao, Hao Duan, Fanhua Ma

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The dependency on the fossil fuels can be minimized by using the hydrogen enriched compressed natural gas (HCNG) in the transportation vehicles. However, the NOx emissions of HCNG engines are significantly higher, and this turned to be its major drawback. Therefore, the study of NOx emission of HCNG engines is a very important area of research. In this context, the experiments have been performed at the different hydrogen percentage, ignition timing, air-fuel ratio, manifold-absolute pressure, load and engine speed. Afterwards, the simulation has been accomplished by the quasi-dimensional combustion model of HCNG engine. In order to investigate the NOx emission, the NO mechanism has been coupled to the quasi-dimensional combustion model of HCNG engine. The three NOx mechanism: the thermal NOx, prompt NOx and N2O mechanism have been used to predict NOx emission. For the validation purpose, NO curve has been transformed into NO packets based on the temperature difference of 100 K for the lean-burn and 60 K for stoichiometric condition. While, the width of the packet has been taken as the ratio of crank duration of the packet to the total burnt duration. The combustion chamber of the engine has been divided into three zones, with the zone equal to the product of summation of NO packets and space. In order to check the accuracy of the model, the percentage error of NOx emission has been evaluated, and it lies in the range of ±6% and ±10% for the lean-burn and stoichiometric conditions respectively. Finally, the percentage contribution of each NO formation has been evaluated.

Keywords: quasi-dimensional combustion , thermal NO, prompt NO, NO packet

Procedia PDF Downloads 251

Authors: Yogish Huchaiah, Chandrashekara Krishnappa

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This study considers the optimization and validation of experimental results using Multi-Functional Criteria Technique (MFCT). MFCT is concerned with structuring and solving decision and planning problems involving multiple variables. Production of biodiesel from Composite Oil Methyl Esters (COME) of Jatropha and Pongamia oils, mixed in various proportions and Biodiesel thus obtained from two step transesterification process were tested for various Physico-Chemical properties and it has been ascertained that they were within limits proposed by ASTME. They were blended with Petrodiesel in various proportions. These Methyl Esters were blended with Petrodiesel in various proportions and coded. These blends were used as fuels in a computerized CI DI engine to investigate Performance and Emission characteristics. From the analysis of results, it was found that 180MEM4B20 blend had the maximum Performance and minimum Emissions. To validate the experimental results, MFCT was used. Characteristics such as Fuel Consumption (FC), Brake Power (BP), Brake Specific Fuel Consumption (BSFC), Brake Thermal Efficiency (BTE), Carbon dioxide (CO2), Carbon Monoxide (CO), Hydro Carbon (HC) and Nitrogen oxide (NOx) were considered as dependent variables. It was found from the application of this method that the optimized combination of Injection Pressure (IP), Mix and Blend is 178MEM4.2B24. Overall corresponding variation between optimization and experimental results was found to be 7.45%.

Keywords: COME, IP, MFCT, optimization, PI, PN, PV

Procedia PDF Downloads 211

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

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

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

Procedia PDF Downloads 110

Authors: Reza Hosseinpourpia, Stergios Adamopoulos, Carsten Mai

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Medium density fiberboard (MDF) is a common category of wood-based panels that are widely used in the furniture industry. Fine lignocellulosic fibres are combined with a synthetic resin, mostly urea formaldehyde (UF), and joined together under heat and pressure to form panels. Like solid wood, MDF is a hygroscopic material; therefore, its moisture content depends on the surrounding relative humidity and temperature. In addition, UF is a hydrophilic resin and susceptible to hydrolysis under certain conditions of elevated temperatures and humidity, which cause dimensional instability of the panels. The latter directly affect the performance of final products such as furniture, when they are used in situations of high relative humidity. Existing water-repellent formulations, such as paraffin, present limitations related to their non-renewable nature, cost and highest allowed added amount. Therefore, the aim of the present study was to test the suitability of renewable water repellents as alternative chemicals for enhancing the dimensional stability of MDF panels. A small amount of tall oil based formulations were used as water-repellent agents in the manufacturing of laboratory scale MDF. The effects on dimensional stability, internal bond strength and formaldehyde release of MDF were tested. The results indicated a good potential of tall oil as a bio-based substance of water repellent formulations for improving the dimensional stability of MDF.

Keywords: dimensional stability, medium density fiberboard, tall oil, urea formaldehyde

Procedia PDF Downloads 240