Search results for: exposure rate
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9619

Search results for: exposure rate

6289 Multicenter Evaluation of the ACCESS HBsAg and ACCESS HBsAg Confirmatory Assays on the DxI 9000 ACCESS Immunoassay Analyzer, for the Detection of Hepatitis B Surface Antigen

Authors: Vanessa Roulet, Marc Turini, Juliane Hey, Stéphanie Bord-Romeu, Emilie Bonzom, Mahmoud Badawi, Mohammed-Amine Chakir, Valérie Simon, Vanessa Viotti, Jérémie Gautier, Françoise Le Boulaire, Catherine Coignard, Claire Vincent, Sandrine Greaume, Isabelle Voisin

Abstract:

Background: Beckman Coulter, Inc. has recently developed fully automated assays for the detection of HBsAg on a new immunoassay platform. The objective of this European multicenter study was to evaluate the performance of the ACCESS HBsAg and ACCESS HBsAg Confirmatory assays† on the recently CE-marked DxI 9000 ACCESS Immunoassay Analyzer. Methods: The clinical specificity of the ACCESS HBsAg and HBsAg Confirmatory assays was determined using HBsAg-negative samples from blood donors and hospitalized patients. The clinical sensitivity was determined using presumed HBsAg-positive samples. Sample HBsAg status was determined using a CE-marked HBsAg assay (Abbott ARCHITECT HBsAg Qualitative II, Roche Elecsys HBsAg II, or Abbott PRISM HBsAg assay) and a CE-marked HBsAg confirmatory assay (Abbott ARCHITECT HBsAg Qualitative II Confirmatory or Abbott PRISM HBsAg Confirmatory assay) according to manufacturer package inserts and pre-determined testing algorithms. False initial reactive rate was determined on fresh hospitalized patient samples. The sensitivity for the early detection of HBV infection was assessed internally on thirty (30) seroconversion panels. Results: Clinical specificity was 99.95% (95% CI, 99.86 – 99.99%) on 6047 blood donors and 99.71% (95%CI, 99.15 – 99.94%) on 1023 hospitalized patient samples. A total of six (6) samples were found false positive with the ACCESS HBsAg assay. None were confirmed for the presence of HBsAg with the ACCESS HBsAg Confirmatory assay. Clinical sensitivity on 455 HBsAg-positive samples was 100.00% (95% CI, 99.19 – 100.00%) for the ACCESS HBsAg assay alone and for the ACCESS HBsAg Confirmatory assay. The false initial reactive rate on 821 fresh hospitalized patient samples was 0.24% (95% CI, 0.03 – 0.87%). Results obtained on 30 seroconversion panels demonstrated that the ACCESS HBsAg assay had equivalent sensitivity performances compared to the Abbott ARCHITECT HBsAg Qualitative II assay with an average bleed difference since first reactive bleed of 0.13. All bleeds found reactive in ACCESS HBsAg assay were confirmed in ACCESS HBsAg Confirmatory assay. Conclusion: The newly developed ACCESS HBsAg and ACCESS HBsAg Confirmatory assays from Beckman Coulter have demonstrated high clinical sensitivity and specificity, equivalent to currently marketed HBsAg assays, as well as a low false initial reactive rate. †Pending achievement of CE compliance; not yet available for in vitro diagnostic use. 2023-11317 Beckman Coulter and the Beckman Coulter product and service marks mentioned herein are trademarks or registered trademarks of Beckman Coulter, Inc. in the United States and other countries. All other trademarks are the property of their respective owners.

Keywords: dxi 9000 access immunoassay analyzer, hbsag, hbv, hepatitis b surface antigen, hepatitis b virus, immunoassay

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6288 Civic Engagement and Political Participation in Bangladesh

Authors: Syeda Salina Aziz, Tanvir Ahmed Mozumder

Abstract:

Citizenship is an important concept of democracy which broadly defines the relationship between the state and its citizens; at the same time, it analyzes the rights and duties of a citizen. The universal citizenship principle demands that citizens should be aware of the political system, possess democratic attitudes, and join the political activity. Bangladesh presents an interesting case for democracy; the democratic practices in the country have been long introduced, have been interrupted several times, and the democratic values and practices have yet to be established in the country. These transitions have influenced citizens’ ideologies and participation in decision-making and also shaped their expectations differently. In this backdrop, this paper aims to understand and explain the citizenship behavior of Bangladeshi nationals. Based on nationally representative household survey data of 4000 respondents, this paper creates a composite citizenship index which is a combination of three separate indices, including participation index, knowledge and awareness index, and ideology index. The paper then tries to explain the factors that affect the citizenship index. Using fixed effect regression analysis, the paper intends to explore the association between citizenship and socio-demographic variables, including education, location, gender, and exposure to the media of respondents. Additionally, using national election polls, the paper creates a variable to measure long-term support towards the current ruling party and tests whether and how this affects the citizenship variables.

Keywords: citizenship, political participation, Bangladesh, stronghold

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6287 Mobile Schooling for the Most Vulnerable Children on the Street: An Innovation

Authors: Md. Shakhawat Ullah Chowdhury

Abstract:

Mobile school is an innovative methodology in non-formal education to increase access to education for children during conflict through theatre for education for appropriate basic education to children during conflict. The continuous exposure to harsh environments and the nature of the lifestyles of children in conflict make them vulnerable. However, the mobile school initiative takes into consideration the mobile lifestyle of children in conflict. Schools are provided considering the pocket area of the street children with portable chalkboards, tin of books and materials as communities move. Teaching is multi-grade to ensure all children in the community benefit. The established mobile schools, while focused on basic literacy and numeracy skills according to traditions of the communities. The school teachers are selected by the community and trained by a theatre activist. These teachers continue to live and move with the community and provide continuous education for children in conflict. The model proposed a holistic team work to deliver education focused services to the street children’s pocket area where the team is mobile. The team consists of three members –an educator (theatre worker), a psychological counsellor and paramedics. The mobile team is responsible to educate street children and also play dramas which specially produce on the basis of national curriculum and awareness issues for street children. Children enjoy play and learn about life skills and basic literacy and numeracy skills which may be a pillar of humanitarian aid during conflict.

Keywords: vulnerable, children in conflict, mobile schooling, child-friendly

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6286 Enhancing Wheat Productivity for Small-Scale Farmers in the Northern State of Sudan through Developing a Local Made Seed Cleaner and Different Seeding Methods

Authors: Yasir Hassan Satti Mohammed

Abstract:

The wheat cleaner was designed, manufactured, and tested in the workshop of the department of agricultural engineering, faculty of agricultural sciences, university of Dongola, the northern state of Sudan, for the purpose of enhancing productivity for small-scale-farmers who used to plant their saved wheat seeds every season with all risk of weed infestation and low viability. A one-season field experiment was then conducted according to the Randomized Complete Block Design (RCBD) experimental design in the demonstration farm of Dongola research station using clean seeds and unclean seeds of a local wheat variety (Imam); two different planting methods were also adopted in the experiment. One is the traditional seed drilling within the recommended seed rate (50 kg.feddan⁻¹), whereas the other was the precision seeding method using half of the recommended seed rate (25 kg.feddan⁻¹). The effect of seed type and planting method on field parameters were investigated, and the data was then analyzed using a computer application SAS system version 9.3. The results revealed significant (P ≥ 0.05) and highly significant (P ≥ 0.01) differences between treatments. The precision seeding method with clean seeds increased the number of kernels per spike (KS), tillers per plant (TPP), one thousand kernels mass (TKM), the biomass of wheat (BWT), and total yield (TOY), whereas weeds per area (WSM), the biomass of weeds (BWD) and weight of weed seeds were apparently decreased compared to seed drilling with unclean seed. Wheat seed cleaner could be of great benefit for small-scale wheat farmers in Sudan who cannot afford the cleaned seeds commercially provided by the local government.

Keywords: wheat cleaner, precision seeding, seed drilling method, small-scale farmers

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6285 Equilibrium, Kinetics, and Thermodynamic Studies on Heavy Metal Biosorption by Trichoderma Species

Authors: Sobia Mushtaq, Firdaus E. Bareen, Asma Tayyeb

Abstract:

This study conducted to investigate the metal biosorption potential of indigenous Trichoderma species (T. harzianum KS05T01, T. longibrachiatum KS09T03, Trichoderma sp KS17T09., T. viridi KS17T011, T. atrobruneo KS21T014, and T. citrinoviride) that have been isolated from contaminated soil of Kasur Tannery Waste Management Agency. The effect of different biosorption parameters as initial metal ion concentration, pH, contact time , and temperature of incubation was investigated on the biosorption potential of these species. The metal removal efficiency and (E%) and metal uptake capacity (mg/g) increased along with the increase of initial metal concentration in media. The Trichoderma species can tolerate and survive under heavy metal stress up to 800mg/L. Among the two isotherm models were applied on the biosorption data, Langmuir isotherm model and Freundlich isotherm model, maximum correlation coefficients values (R 2 ) of 1was found for Langmuir model, which showed the better fitted model for the Trichoderma biosorption. The metal biosorption was increased with the increase of temperature and pH of the media. The maximum biosorption was observed between 25-30 o C and at pH 6.-7.5, while the biosorption rate was increased from 3-6 days of incubation, and then the rate of biosorption was slowed down. The biosorption data was better fitted for Pseudo kinetic first order during the initial days of biosorption. Thermodynamic parameters as standard Gibbs free energy (G), standard enthalpy change (H), and standard entropy (S) were calculated. The results confirmed the heavy metal biosorption by Trichoderma species was endothermic and spontaneous reaction in nature. The FTIR spectral analysis and SEM-EDX analysis of the treated and controlled mycelium revealed the changes in the active functional sites and morphological variations of the outer surface. The data analysis envisaged that high metal tolerance exhibited by Trichoderma species indicates its potential as efficacious and successful mediator for bioremediation of the heavy metal polluted environments.

Keywords: heavy metal, fungal biomass, biosorption, kinetics

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6284 Association between Hypertensive Disorders of Pregnancy and the Development of Offspring Mental and Behavioural Problems: Systematic Review and Meta-Analysis

Authors: Berihun Dachew, Abdullah Mamun, Joemer Maravilla, Rosa Alati

Abstract:

Background: Hypertensive disorders of pregnancy are a major cause of maternal and childhood morbidity and mortality worldwide. However, its effect on offspring mental and behavioural disorders is unclear. Aims:The aim of this study was to provide the best scientific evidence regarding the association between hypertensive disorders of pregnancy and offspring mental and behavioural problems. Methods: We systematically searched Scopus, PubMed, Cochrane, EMBASE, CINAH and PsycINFO databases. A total of 23 studies (11 included in meta-analysis) were identified. A qualitative analysis was conducted by summarizing, comparing, and contrasting the abstracted data for all included studies. For quantitative analysis, relative risk (RR) with 95% confidence interval (95% CI) was used as pooled effect size. Heterogeneity was assessed by measuring Cochran’s Q and I2 test statistics. Results: Of the 23 studies included in this review, 15 studies found that hypertensive disorders of pregnancy had a negative impact for at least one mental or behavioural problem. The pooled effect of 11 studies included in the meta-analysis showed that preeclampsia was associated with increased risk of offspring schizophrenia (RR=1.37; 95% CI, 1.08-1.72). Conclusions: Intrauterine exposure to pre-eclampsia increased the risk of schizophrenia among offspring. However, we found inconclusive finding on the effect of hypertensive disorders of pregnancy and other mental and behavioural problems. Further high quality, large sample, mother child cohort studies are needed to further progress this area of research.

Keywords: behavioural disorders, hypertensive disorders of pregnancy, mental disorders, offspring

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6283 Development of Scenarios for Sustainable Next Generation Nuclear System

Authors: Muhammad Minhaj Khan, Jaemin Lee, Suhong Lee, Jinyoung Chung, Johoo Whang

Abstract:

The Republic of Korea has been facing strong storage crisis from nuclear waste generation as At Reactor (AR) temporary storage sites are about to reach saturation. Since the country is densely populated with a rate of 491.78 persons per square kilometer, Construction of High-level waste repository will not be a feasible option. In order to tackle the storage waste generation problem which is increasing at a rate of 350 tHM/Yr. and 380 tHM/Yr. in case of 20 PWRs and 4 PHWRs respectively, the study strongly focuses on the advancement of current nuclear power plants to GEN-IV sustainable and ecological nuclear systems by burning TRUs (Pu, MAs). First, Calculations has made to estimate the generation of SNF including Pu and MA from PWR and PHWR NPPS by using the IAEA code Nuclear Fuel Cycle Simulation System (NFCSS) for the period of 2016, 2030 (including the saturation period of each site from 2024~2028), 2089 and 2109 as the number of NPPS will increase due to high import cost of non-nuclear energy sources. 2ndly, in order to produce environmentally sustainable nuclear energy systems, 4 scenarios to burnout the Plutonium and MAs are analyzed with the concentration on burning of MA only, MA and Pu together by utilizing SFR, LFR and KALIMER-600 burner reactor after recycling the spent oxide fuel from PWR through pyro processing technology developed by Korea Atomic Energy Research Institute (KAERI) which shows promising and sustainable future benefits by minimizing the HLW generation with regard to waste amount, decay heat, and activity. Finally, With the concentration on front and back end fuel cycles for open and closed fuel cycles of PWR and Pyro-SFR respectively, an overall assessment has been made which evaluates the quantitative as well as economical combativeness of SFR metallic fuel against PWR once through nuclear fuel cycle.

Keywords: GEN IV nuclear fuel cycle, nuclear waste, waste sustainability, transmutation

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6282 Multi-Walled Carbon Nanotubes as Nucleating Agents

Authors: Rabindranath Jana, Plabani Basu, Keka Rana

Abstract:

Nucleating agents are widely used to modify the properties of various polymers. The rate of crystallization and the size of the crystals have a strong impact on mechanical and optical properties of a polymer. The addition of nucleating agents to the semi-crystalline polymers provides a surface on which the crystal growth can start easily. As a consequence, fast crystal formation will result in many small crystal domains so that the cycle times for injection molding may be reduced. Moreover, the mechanical properties e.g., modulus, tensile strength, heat distortion temperature and hardness may increase. In the present work, multi-walled carbon nanotubes (MWNTs) as nucleating agents for the crystallization of poly (e-caprolactone)diol (PCL). Thus nanocomposites of PCL filled with MWNTs were prepared by solution blending. Differential scanning calorimetry (DSC) tests were carried out to study the effect of CNTs on on-isothermal crystallization of PCL. The polarizing optical microscopy (POM), and wide-angle X-ray diffraction (WAXD) were used to study the morphology and crystal structure of PCL and its nanocomposites. It is found that MWNTs act as effective nucleating agents that significantly shorten the induction period of crystallization and however, decrease the crystallization rate of PCL, exhibiting a remarkable decrease in the Avrami exponent n, surface folding energy σe and crystallization activation energy ΔE. The carbon-based fillers act as templates for hard block chains of PCL to form an ordered structure on the surface of nanoparticles during the induction period, bringing about some increase in equilibrium temperature. The melting process of PCL and its nanocomposites are also studied; the nanocomposites exhibit two melting peaks at higher crystallization temperature which mainly refer to the melting of the crystals with different crystal sizes however, PCL shows only one melting temperature.

Keywords: poly(e-caprolactone)diol, multiwalled carbon nanotubes, composite materials, nonisothermal crystallization, crystal structure, nucleation

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6281 Evaluation of a Potential Metabolism-Mediated Drug-Drug Interaction between Carvedilol and Fluvoxamine in Rats

Authors: Ana-Maria Gheldiu, Bianca M. Abrudan, Maria A. Neag, Laurian Vlase, Dana M. Muntean

Abstract:

Background information: The objective of this study was to investigate the effect of multiple-dose fluvoxamine on the pharmacokinetic profile of single-dose carvedilol in rats, in order to evaluate this possible drug-drug pharmacokinetic interaction. Methods: A preclinical study, in 28 white male Wistar rats, was conducted. Each rat was cannulated on the femoral vein, prior to being connected to BASi Culex ABC®. Carvedilol was orally administrated in rats (3.57 mg/kg body mass (b.m.)) in the absence of fluvoxamine or after a pre-treatment with multiple oral doses of fluvoxamine (14.28 mg/kg b.m.). The plasma concentrations of carvedilol were estimated by high performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters of carvedilol were analyzed by non-compartmental method. Results: After carvediol co-administration with fluvoxamine, an approximately 2-fold increase in the exposure of carvedilol was observed, considering the significantly elevated value of the total area under the concentration versus time curve (AUC₀₋∞). Moreover, an increase by approximately 145% of the peak plasma concentration was found, as well as an augmentation by approximately 230% of the half life time of carvedilol was observed. Conclusion: Fluvoxamine co-administration led to a significant alteration of carvedilol’s pharmacokinetic profile in rats, these effects could be explained by the existence of a drug-drug interaction mediated by CYP2D6 inhibition. Acknowledgement: This work was supported by CNCS Romania – project PNII-RU-TE-2014-4-0242.

Keywords: carvedilol, fluvoxamine, drug-drug pharmacokinetic interaction, rats

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6280 Psychosocial Effect of Body-Contouring Surgery on Patients after Weight Loss

Authors: Abdullah Kattan, Khalid Alzahrani, Saud Alsaleh, Loui Ezzat, Khalid Murad, Bader Alghamdi

Abstract:

Background and Significance: Patients are often bothered by the excess skin laxity and redundancy that they are left with after losing weight. Body-contouring surgery offers a solution to this problem; however, there is scarce literature on the psychological and social effects of these surgeries. This study was conducted to assess the psychosocial impact of body-contouring surgery on patients after weight loss. Methodology: In this cross-sectional study, a specifically designed questionnaire was administered to forty three patients whom have undergone body-contouring surgery. All included patients had lost no less than 20 Kg before body-contouring surgery, and were interviewed at least 6 months after surgery. The twenty-question interviewer based questionnaire was used to assess the psychosocial status of the patients before and after undergoing body-contouring surgery. The questionnaire assessed the quality of life (social life, job performance and sexual activity), presence of symptoms of depression and overall satisfaction. Data was analyzed as paired variables in SPSS using McNemar’s test. Results: Among the 43 participants, 19 (44.2%) have undergone mammoplasty, 12 (27.9%) have undergone abdominoplasty and the remainder of the patients have undergone other various procedures including brachioplasty, thigh lifts and nick liposuction. The mean age of patients was 34 +/- 10, the sample included 24 (55.8%) females and 19 (44.2%) males. The patients’ quality of life significantly improved in the following areas; social life (P<0.001), job performance (P<0.002) and sexual activity (P<0.001). Moreover, 17 (39.5%) patients suffered symptoms of depression before body-contouring surgery; however, only 1 (2.3%) patient suffered symptoms of depression after surgery. Overall satisfaction rate was found to be 62.8%; with mammoplasty being the highest satisfaction rate procedure (66.6 %). Conclusion: Body-contouring surgery after weight loss has shown to improve the psychological and social aspects in patients. These findings have been found to be consistent with the majority of relevant published studies, further increasing reliability of our study.

Keywords: abdominoplasty, body-contouring, mammoplasty, psychosocial

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6279 Protective Effect of Bexarotene, a Selective RXRα Agonist, against Hypotension Associated with Inflammation and Tissue Injury Linked to Decreased Circulating iNOS Levels in A Rat Model of Septic Shock

Authors: Bahar Tunctan, Sefika Pinar Kucukkavruk, Meryem Temiz-Resitoglu, Demet Sinem Guden, Ayse Nihal Sari, Seyhan Sahan-Firat

Abstract:

We hypothesized that rexinoids such as bexarotene, a selective retinoid X receptor α (RXRα) agonist, may be beneficial for preventing mortality due to inflammation associated with increased expression/activity of inducible nitric oxide synthase (iNOS) induced by lipopolysaccharide (LPS). Therefore, we investigated effects of bexarotene on the changes in circulating protein levels of iNOS (an index for systemic iNOS expression), myeloperoxidase (MPO) (an index for systemic inflammation), and lactate dehydrogenase (LDH) (an index for systemic tissue injury) in LPS-induced systemic inflammation model resulting in septic shock in rats. Rats were injected with saline (4 ml/kg; i.p.), LPS (10 mg/kg; i.p.), dimethylsulphoxide (4 ml/kg, 0.1%; s.c.) at time 0. Mean arterial blood pressure and heart rate were measured using a tail-cuff device. Bexarotene (0.03, 0.1, 0.3, and 1 mg/kg; s.c.) was administered to separate groups of rats 1 h after injection of saline or LPS. The rats were sacrificed 4 h after saline or LPS injection and blood was collected for measurement of serum iNOS, MPO, and LDH protein levels. Blood pressure decreased by 31 mmHg and heart rate increased by 63 bpm in the LPS-treated rats. Bexarotene at 0.3 and 1 mg/kg doses caused 20% mortality 4 h after LPS injection. In the LPS-treated rats, serum iNOS, MPO, and LDH protein levels were increased. Bexarotene only at 0.1 mg/kg dose prevented the LPS-induced hypotension and increased in iNOS, MPO, and LDH protein levels. These data are consistent with the view that a decrease in systemic iNOS levels contributes to the beneficial effect of bexarotene to prevent the hypotension associated with inflammation and tissue injury during rat endotoxemia. [This work was financially supported by The Scientific and Technological Research Council of Turkey (SBAG-109S121)].

Keywords: bexarotene, inflammation, iNOS, lipopolisaccharide, RXRa

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6278 Study on Hybridization between Clarias gariepinus (Burchell 1822) and Heterobranchus bidorsalis (Geoffroy Saint Hilaire, 1809)

Authors: Wasiu Olaniyi, Ofelia Omitogun

Abstract:

Hybridization has been of importance in both research and commercial aquaculture due to its benefits such as increased growth rate, sex ratio manipulation, production of sterile species and many other desirable economic traits. In this study, we successfully produced hybrids between crosses of Clariid catfish species of Clarias gariepinus and Heterobranchus bidorsalis for stock improvement. Milt and eggs from parent broodstock of C. gariepinus and H. bidorsalis were collected for both intrageneric and interspecific hybridization, viz: same parent species crosses (♀C. gariepinus ×♂C. gariepinus; ♀H. bidorsalis × ♂H. bidorsalis) and inter-specific crosses (♀H. bidorsalis × ♂C. gariepinus; ♀C. gariepinus × ♂H. bidorsalis). These crosses were made in triplicates whereby the data on latency period, fertility, hatchability, deformity, and survival were recorded. A phenotypic form of distinction was registered in the hybrid ♀C. gariepinus × ♂H. bidorsalis that was smooth-greyed while its reciprocal cross was marpatic. The parent species C. gariepinus had greyed-marpatic color while the H. bidorsalis was yellowish-brown. Fertility data revealed the significant difference (p < 0.05) between the hybrid cross ♀C. gariepinus × ♂H. bidorsalis (88.00 ± 1.00%) compared to its reciprocal ♀H. bidorsalis × ♂C. gariepinus (71.67 ± 10.41%) which further had carried over effects to hatchability. The reciprocal ♀H. bidorsalis × ♂C. gariepinus recorded the highest deformity (11.67 ± 3.06%) that was significantly different (p < 0.05) from the rest of the crosses. Also, an outcome of equal sex ratio in the hybrids compared with the two parent species was shown. Specific growth rate (SGR) data revealed highest significant difference (p < 0.05) in the hybrid ♀C. gariepinus × ♂H. bidorsalis (2.64 ± 0.09%), followed by the cross of ♀C. gariepinus × ♂ C. gariepinus (1.91 ± 0.02%) while there were no significant differences (p > 0.05) between the reciprocal hybrid ♀H. bidorsalis × ♂C. gariepinus (2.20 ± 0.57%) and ♀H. bidorsalis × ♂H. bidorsalis (2.19 ± 0.19%). The SGR analysis proved that the crosses ♀C. gariepinus × ♂C. gariepinus had slow growth performance compared to its hybrid ♀C. gariepinus × ♂H. bidorsalis. Critical evaluation based on survival and specific growth performance showed the superiority of the hybrid ♀C. gariepinus × ♂H. bidorsalis. The least survival in reciprocal hybrid ♀H. bidorsalis × ♂C. gariepinus (27.33%) can be explained by significant deformity (11.67%) recorded due to maternal effects. Hence, the survival of hybrid ♀C. gariepinus × ♂H. bidorsalis was better.

Keywords: aquaculture, hybridization, Clarias gariepinus, Heterobranchus bidorsalis

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6277 Recurrent Torsades de Pointes Post Direct Current Cardioversion for Atrial Fibrillation with Rapid Ventricular Response

Authors: Taikchan Lildar, Ayesha Samad, Suraj Sookhu

Abstract:

Atrial fibrillation with rapid ventricular response results in the loss of atrial kick and shortened ventricular filling time, which often leads to decompensated heart failure. Pharmacologic rhythm control is the treatment of choice, and patients frequently benefit from the restoration of sinus rhythm. When pharmacologic treatment is unsuccessful or a patient declines hemodynamically, direct cardioversion is the treatment of choice. Torsades de pointes or “twisting of the points'' in French, is a rare but under-appreciated risk of cardioversion therapy and accounts for a significant number of sudden cardiac death each year. A 61-year-old female with no significant past medical history presented to the Emergency Department with worsening dyspnea. An electrocardiogram showed atrial fibrillation with rapid ventricular response, and a chest X-ray was significant for bilateral pulmonary vascular congestion. Full-dose anticoagulation and diuresis were initiated with moderate improvement in symptoms. A transthoracic echocardiogram revealed biventricular systolic dysfunction with a left ventricular ejection fraction of 30%. After consultation with an electrophysiologist, the consensus was to proceed with the restoration of sinus rhythm, which would likely improve the patient’s heart failure symptoms and possibly the ejection fraction. A transesophageal echocardiogram was negative for left atrial appendage thrombus; the patient was treated with a loading dose of amiodarone and underwent successful direct current cardioversion with 200 Joules. The patient was placed on telemetry monitoring for 24 hours and was noted to have frequent premature ventricular contractions with subsequent degeneration to torsades de pointes. The patient was found unresponsive and pulseless; cardiopulmonary resuscitation was initiated with cardioversion, and return of spontaneous circulation was achieved after four minutes to normal sinus rhythm. Post-cardiac arrest electrocardiogram showed sinus bradycardia with heart-rate corrected QT interval of 592 milliseconds. The patient continued to have frequent premature ventricular contractions and required two additional cardioversions to achieve a return of spontaneous circulation with intravenous magnesium and lidocaine. An automatic implantable cardioverter-defibrillator was subsequently implanted for secondary prevention of sudden cardiac death. The backup pacing rate of the automatic implantable cardioverter-defibrillator was set higher than usual in an attempt to prevent premature ventricular contractions-induced torsades de pointes. The patient did not have any further ventricular arrhythmias after implantation of the automatic implantable cardioverter-defibrillator. Overdrive pacing is a method utilized to treat premature ventricular contractions-induced torsades de pointes by preventing a patient’s susceptibility to R on T-wave-induced ventricular arrhythmias. Pacing at a rate of 90 beats per minute succeeded in controlling the arrhythmia without the need for traumatic cardiac defibrillation. In our patient, conversion of atrial fibrillation with rapid ventricular response to normal sinus rhythm resulted in a slower heart rate and an increased probability of premature ventricular contraction occurring on the T-wave and ensuing ventricular arrhythmia. This case highlights direct current cardioversion for atrial fibrillation with rapid ventricular response resulting in persistent ventricular arrhythmia requiring an automatic implantable cardioverter-defibrillator placement with overdrive pacing to prevent a recurrence.

Keywords: refractory atrial fibrillation, atrial fibrillation, overdrive pacing, torsades de pointes

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6276 Improvement of Healthcare Quality and Psychological Stress Relieve for Transition Program in Intensive Care Units

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

Abstract:

Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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6275 Hazardous Effects of Metal Ions on the Thermal Stability of Hydroxylammonium Nitrate

Authors: Shweta Hoyani, Charlie Oommen

Abstract:

HAN-based liquid propellants are perceived as potential substitute for hydrazine in space propulsion. Storage stability for long service life in orbit is one of the key concerns for HAN-based monopropellants because of its reactivity with metallic and non-metallic impurities which could entrain from the surface of fuel tanks and the tubes. The end result of this reactivity directly affects the handling, performance and storability of the liquid propellant. Gaseous products resulting from the decomposition of the propellant can lead to deleterious pressure build up in storage vessels. The partial loss of an energetic component can change the ignition and the combustion behavior and alter the performance of the thruster. The effect of largely plausible metals- iron, copper, chromium, nickel, manganese, molybdenum, zinc, titanium and cadmium on the thermal decomposition mechanism of HAN has been investigated in this context. Studies involving different concentrations of metal ions and HAN at different preheat temperatures have been carried out. Effect of metal ions on the decomposition behavior of HAN has been studied earlier in the context of use of HAN as gun propellant. However the current investigation pertains to the decomposition mechanism of HAN in the context of use of HAN as monopropellant for space propulsion. Decomposition onset temperature, rate of weight loss, heat of reaction were studied using DTA- TGA and total pressure rise and rate of pressure rise during decomposition were evaluated using an in-house built constant volume batch reactor. Besides, reaction mechanism and product profile were studied using TGA-FTIR setup. Iron and copper displayed the maximum reaction. Initial results indicate that iron and copper shows sensitizing effect at concentrations as low as 50 ppm with 60% HAN solution at 80°C. On the other hand 50 ppm zinc does not display any effect on the thermal decomposition of even 90% HAN solution at 80°C.

Keywords: hydroxylammonium nitrate, monopropellant, reaction mechanism, thermal stability

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6274 Effect of Cement Amount on California Bearing Ratio Values of Different Soil

Authors: Ayse Pekrioglu Balkis, Sawash Mecid

Abstract:

Due to continued growth and rapid development of road construction in worldwide, road sub-layers consist of soil layers, therefore, identification and recognition of type of soil and soil behavior in different condition help to us to select soil according to specification and engineering characteristic, also if necessary sometimes stabilize the soil and treat undesirable properties of soils by adding materials such as bitumen, lime, cement, etc. If the soil beneath the road is not done according to the standards and construction will need more construction time. In this case, a large part of soil should be removed, transported and sometimes deposited. Then purchased sand and gravel is transported to the site and full depth filled and compacted. Stabilization by cement or other treats gives an opportunity to use the existing soil as a base material instead of removing it and purchasing and transporting better fill materials. Classification of soil according to AASHTOO system and USCS help engineers to anticipate soil behavior and select best treatment method. In this study soil classification and the relation between soil classification and stabilization method is discussed, cement stabilization with different percentages have been selected for soil treatment based on NCHRP. There are different parameters to define the strength of soil. In this study, CBR will be used to define the strength of soil. Cement by percentages, 0%, 3%, 7% and 10% added to soil for evaluation effect of added cement to CBR of treated soil. Implementation of stabilization process by different cement content help engineers to select an economic cement amount for the stabilization process according to project specification and characteristics. Stabilization process in optimum moisture content (OMC) and mixing rate effect on the strength of soil in the laboratory and field construction operation have been performed to see the improvement rate in strength and plasticity. Cement stabilization is quicker than a universal method such as removing and changing field soils. Cement addition increases CBR values of different soil types by the range of 22-69%.

Keywords: California Bearing Ratio, cement stabilization, clayey soil, mechanical properties

Procedia PDF Downloads 383
6273 Common Orthodontic Indices and Classification in the United Kingdom

Authors: Ashwini Mohan, Haris Batley

Abstract:

An orthodontic index is used to rate or categorise an individual’s occlusion using a numeric or alphanumeric score. Indexing of malocclusions and their correction is important in epidemiology, diagnosis, communication between clinicians as well as their patients and assessing treatment outcomes. Many useful indices have been put forward, but to the author’s best knowledge, no one method to this day appears to be equally suitable for the use of epidemiologists, public health program planners and clinicians. This article describes the common clinical orthodontic indices and classifications used in United Kingdom.

Keywords: classification, indices, orthodontics, validity

Procedia PDF Downloads 138
6272 Reintroduction and in vitro Propagation of Declapeis arayalpathra: A Critically Endangered Plant of Western Ghats, India

Authors: Zishan Ahmad, Anwar Shahzad

Abstract:

The present studies describe a protocol for high frequency in vitro propagation through nodal segments and shoot tips in D. arayalpathra, a critically endangered medicinal liana of the Western Ghats, India. Nodal segments were more responsive than shoot tips in terms of shoot multiplication. Murashige and Skoog’s (MS) basal medium supplemented with 2.5 µM 6-benzyladenine (BA) was optimum for shoot induction through both the explants. Among different combinations of plant growth regulator (PGRs) and growth additive screened, MS medium supplemented with BA (2.5 µM) + indole-3-acetic acid (IAA) (0.25 µM) + adenine sulphate (ADS) (10.0 µM) induced a maximum of 9.0 shoots per nodal segment and 3.9 shoots per shoot tip with mean shoot length of 8.5 and 3.9 cm respectively. Half-strength MS medium supplemented with Naphthaleneacetic acid (NAA) (2.5 µM) was the best for in vitro root induction. After successful acclimatization in SoilriteTM, 92 % plantlets were survived in field conditions. Acclimatized plantlets were studied for chlorophyll and carotenoid content, net photosynthetic rate (PN) and related attributes such as stomatal conductance (Gs) and transpiration rate during subsequent days of acclimatization. The rise and fall of different biochemical enzymes (SOD, CAT, APX and GR) were also studies during successful days of acclimatization. Moreover, the effect of acclimatization on the synthesis of 2-hydroxy-4-methoxy benzaldehyde (2H4MB) was also studied in relation to the biomass production. Maximum fresh weight (2.8 gm/plant), dry weight (0.35 gm/plant) of roots and 2H4MB content (8.5 µg/ ml of root extract) were recorded after 8 weeks of acclimatization. The screening of in vitro raised plantlet root was also carried out by using GC-MS analysis which witnessed more than 25 compounds. The regenerated plantlets were also screened for homogeneity by using RAPD and ISSR. The proposed protocol surely can be used for the conservation and commercial production of the plant.

Keywords: 6-benzyladenine, PGRs, RAPD, 2H4MB

Procedia PDF Downloads 183
6271 Generic Early Warning Signals for Program Student Withdrawals: A Complexity Perspective Based on Critical Transitions and Fractals

Authors: Sami Houry

Abstract:

Complex systems exhibit universal characteristics as they near a tipping point. Among them are common generic early warning signals which precede critical transitions. These signals include: critical slowing down in which the rate of recovery from perturbations decreases over time; an increase in the variance of the state variable; an increase in the skewness of the state variable; an increase in the autocorrelations of the state variable; flickering between different states; and an increase in spatial correlations over time. The presence of the signals has management implications, as the identification of the signals near the tipping point could allow management to identify intervention points. Despite the applications of the generic early warning signals in various scientific fields, such as fisheries, ecology and finance, a review of literature did not identify any applications that address the program student withdrawal problem at the undergraduate distance universities. This area could benefit from the application of generic early warning signals as the program withdrawal rate amongst distance students is higher than the program withdrawal rate at face-to-face conventional universities. This research specifically assessed the generic early warning signals through an intensive case study of undergraduate program student withdrawal at a Canadian distance university. The university is non-cohort based due to its system of continuous course enrollment where students can enroll in a course at the beginning of every month. The assessment of the signals was achieved through the comparison of the incidences of generic early warning signals among students who withdrew or simply became inactive in their undergraduate program of study, the true positives, to the incidences of the generic early warning signals among graduates, the false positives. This was achieved through significance testing. Research findings showed support for the signal pertaining to the rise in flickering which is represented in the increase in the student’s non-pass rates prior to withdrawing from a program; moderate support for the signals of critical slowing down as reflected in the increase in the time a student spends in a course; and moderate support for the signals on increase in autocorrelation and increase in variance in the grade variable. The findings did not support the signal on the increase in skewness of the grade variable. The research also proposes a new signal based on the fractal-like characteristic of student behavior. The research also sought to extend knowledge by investigating whether the emergence of a program withdrawal status is self-similar or fractal-like at multiple levels of observation, specifically the program level and the course level. In other words, whether the act of withdrawal at the program level is also present at the course level. The findings moderately supported self-similarity as a potential signal. Overall, the assessment of the signals suggests that the signals, with the exception with the increase of skewness, could be utilized as a predictive management tool and potentially add one more tool, the fractal-like characteristic of withdrawal, as an additional signal in addressing the student program withdrawal problem.

Keywords: critical transitions, fractals, generic early warning signals, program student withdrawal

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6270 Expanding the World: Public and Global Health Experiences for Undergraduate Nursing Students

Authors: Kristen Erekson, Sarah Spendlove Caswell

Abstract:

Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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6269 Developmental Differences of Elementary School Children in Knowledge Acquisition Following a Sexual Abuse Prevention Program

Authors: Chrysanthi Nega, Fotini-Sonia Apergi

Abstract:

Child sexual abuse (CSA) in Greece is a highly prevalent phenomenon and yet remains largely underreported. CSA can negatively impact cognitive, emotional and psychosocial development, as well as personality formation and capacity for initiation and maintenance of healthy interpersonal relationships. It is particularly important for school-based prevention programs to be implemented early in elementary school, as they are reportedly effective in lowering abuse incidences and providing knowledge for coping in threatening environments. The purpose of the current study was to test the effectiveness of a school-based CSA prevention program (Safe-Touches) on Greek elementary school students (grades 1-3, N=272) and explore the effect of age and time of testing (academic term). There was a significant effect of age in the knowledge of Inappropriate Touch, when comparing pre and post-intervention assessments, with third graders showing greatest gains in knowledge, followed by second and first graders. Time of testing during the academic year also had a significant effect, as first graders tested later in the school year, scored higher on knowledge of Inappropriate Touch. The findings of the current study provide insight into the optimal timing to implement CSA prevention programs. Exposure to such programs and incorporation in the school curricula could largely benefit children of the Greek community in terms of safety and awareness.

Keywords: child sexual abuse, Safe-Touches, school-based prevention, schooling

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6268 Green Crypto Mining: A Quantitative Analysis of the Profitability of Bitcoin Mining Using Excess Wind Energy

Authors: John Dorrell, Matthew Ambrosia, Abilash

Abstract:

This paper employs econometric analysis to quantify the potential profit wind farms can receive by allocating excess wind energy to power bitcoin mining machines. Cryptocurrency mining consumes a substantial amount of electricity worldwide, and wind energy produces a significant amount of energy that is lost because of the intermittent nature of the resource. Supply does not always match consumer demand. By combining the weaknesses of these two technologies, we can improve efficiency and a sustainable path to mine cryptocurrencies. This paper uses historical wind energy from the ERCOT network in Texas and cryptocurrency data from 2000-2021, to create 4-year return on investment projections. Our research model incorporates the price of bitcoin, the price of the miner, the hash rate of the miner relative to the network hash rate, the block reward, the bitcoin transaction fees awarded to the miners, the mining pool fees, the cost of the electricity and the percentage of time the miner will be running to demonstrate that wind farms generate enough excess energy to mine bitcoin profitably. Excess wind energy can be used as a financial battery, which can utilize wasted electricity by changing it into economic energy. The findings of our research determine that wind energy producers can earn profit while not taking away much if any, electricity from the grid. According to our results, Bitcoin mining could give as much as 1347% and 805% return on investment with the starting dates of November 1, 2021, and November 1, 2022, respectively, using wind farm curtailment. This paper is helpful to policymakers and investors in determining efficient and sustainable ways to power our economic future. This paper proposes a practical solution for the problem of crypto mining energy consumption and creates a more sustainable energy future for Bitcoin.

Keywords: bitcoin, mining, economics, energy

Procedia PDF Downloads 20
6267 Molecular Dynamic Simulation of CO2 Absorption into Mixed Aqueous Solutions MDEA/PZ

Authors: N. Harun, E. E. Masiren, W. H. W. Ibrahim, F. Adam

Abstract:

Amine absorption process is an approach for mitigation of CO2 from flue gas that produces from power plant. This process is the most common system used in chemical and oil industries for gas purification to remove acid gases. On the challenges of this process is high energy requirement for solvent regeneration to release CO2. In the past few years, mixed alkanolamines have received increasing attention. In most cases, the mixtures contain N-methyldiethanolamine (MDEA) as the base amine with the addition of one or two more reactive amines such as PZ. The reason for the application of such blend amine is to take advantage of high reaction rate of CO2 with the activator combined with the advantages of the low heat of regeneration of MDEA. Several experimental and simulation studies have been undertaken to understand this process using blend MDEA/PZ solvent. Despite those studies, the mechanism of CO2 absorption into the aqueous MDEA is not well understood and available knowledge within the open literature is limited. The aim of this study is to investigate the intermolecular interaction of the blend MDEA/PZ using Molecular Dynamics (MD) simulation. MD simulation was run under condition 313K and 1 atm using NVE ensemble at 200ps and NVT ensemble at 1ns. The results were interpreted in term of Radial Distribution Function (RDF) analysis through two system of interest i.e binary and tertiary. The binary system will explain the interaction between amine and water molecule while tertiary system used to determine the interaction between the amine and CO2 molecule. For the binary system, it was observed that the –OH group of MDEA is more attracted to water molecule compared to –NH group of MDEA. The –OH group of MDEA can form the hydrogen bond with water that will assist the solubility of MDEA in water. The intermolecular interaction probability of –OH and –NH group of MDEA with CO2 in blended MDEA/PZ is higher than using single MDEA. This findings show that PZ molecule act as an activator to promote the intermolecular interaction between MDEA and CO2.Thus, blend of MDEA with PZ is expecting to increase the absorption rate of CO2 and reduce the heat regeneration requirement.

Keywords: amine absorption process, blend MDEA/PZ, CO2 capture, molecular dynamic simulation, radial distribution function

Procedia PDF Downloads 284
6266 A Questionnaire-Based Survey: Therapists Response towards Upper Limb Disorder Learning Tool

Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah

Abstract:

Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).

Keywords: upper limb disorder, clinical education tool, inter/intra-raters variability, spasticity, modified Ashworth scale

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6265 PM10 Chemical Characteristics in a Background Site at the Universidad Libre Bogotá

Authors: Laura X. Martinez, Andrés F. Rodríguez, Ruth A. Catacoli

Abstract:

One of the most important factors for air pollution is that the concentrations of PM10 maintain a constant trend, with the exception of some places where that frequently surpasses the allowed ranges established by Colombian legislation. The community that surrounds the Universidad Libre Bogotá is inhabited by a considerable number of students and workers, all of whom are possibly being exposed to PM10 for long periods of time while on campus. Thus, the chemical characterization of PM10 found in the ambient air at the Universidad Libre Bogotá was identified as a problem. A Hi-Vol sampler and EPA Test Method 5 were used to determine if the quality of air is adequate for the human respiratory system. Additionally, quartz fiber filters were utilized during sampling. Samples were taken three days a week during a dry period throughout the months of November and December 2015. The gravimetric analysis method was used to determine PM10 concentrations. The chemical characterization includes non-conventional carcinogenic pollutants. Atomic absorption spectrophotometry (AAS) was used for the determination of metals and VOCs were analyzed using the FTIR (Fourier transform infrared spectroscopy) method. In this way, concentrations of PM10, ranging from values of 13 µg/m3 to 66 µg/m3, were obtained; these values were below standard conditions. This evidence concludes that the PM10 concentrations during an exposure period of 24 hours are lower than the values established by Colombian law, Resolution 610 of 2010; however, when comparing these with the limits set by the World Health Organization (WHO), these concentrations could possibly exceed permissible levels.

Keywords: air quality, atomic absorption spectrophotometry, gas chromatography, particulate matter

Procedia PDF Downloads 245
6264 Statistical Characteristics of Distribution of Radiation-Induced Defects under Random Generation

Authors: P. Selyshchev

Abstract:

We consider fluctuations of defects density taking into account their interaction. Stochastic field of displacement generation rate gives random defect distribution. We determinate statistical characteristics (mean and dispersion) of random field of point defect distribution as function of defect generation parameters, temperature and properties of irradiated crystal.

Keywords: irradiation, primary defects, interaction, fluctuations

Procedia PDF Downloads 331
6263 Xerostomia and Caries Incidence in Relation to Metabolic Control in Children and Adolescents with Type 1 Diabetes

Authors: Eftychia Pappa, Heleni Vastardis, Christos Rahiotis, Andriani Vazaiou

Abstract:

The aim of this study was to evaluate the prevalence of dry-mouth symptoms (xerostomia) and compare it with alterations in salivary characteristics of children and adolescents with type 1 diabetes (DM1), as measured with the use of chair-side saliva tests. This study also investigated the possible association between salivary dysfunction and incidence of caries, in relation to the level of metabolic control. A cross-sectional study was performed on young patients (6-18 years old) allocated among 3 groups: 40 patients poorly-controlled (DM1-A, HbA1c>8%), 40 well-controlled (DM1-B, HbA1c≤8%) and 40 age- and sex-matched healthy controls. The study was approved by the Research Ethics Committee of University of Athens and the parents signed written informed consent. All subjects were examined for dental caries, oral hygiene and salivary factors. Assessments of salivary function included self-reported xerostomia, quantification of resting and stimulated whole saliva flow rates, pH values, buffering capacity and saliva’s viscosity. Salivary characteristics were evaluated with the use of GC Saliva Check Buffer (3Μ ESPE). Data were analysed by chi-square and Kruskal-Wallis tests. Subjects with diabetes reported xerostomia more frequently than healthy controls (p<0.05). Unstimulated salivary flow rate and pH values remained significantly lower in DM1-A compared to DM1-B and controls. Low values of resting salivary flow rate were associated with a higher prevalence of dental caries in children and adolescents with poorly-controlled DM1 (p<0.05). The results suggested that diabetes-induced alterations in salivary characteristics are indicative of higher caries susceptibility of diabetics and chair-side saliva tests are a useful tool for the evaluation of caries risk assessment.

Keywords: caries risk assessment, saliva diagnostic tests, type 1 diabetes, xerostomia

Procedia PDF Downloads 275
6262 Reallocation of Bed Capacity in a Hospital Combining Discrete Event Simulation and Integer Linear Programming

Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

Abstract:

The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

Procedia PDF Downloads 131
6261 Assessment of Alternative Water Resources and Growing Media in Green Roofs

Authors: Hamideh Nouri, Sattar Chavoshi Borujeni

Abstract:

Grey infrastructure is an unavoidable part of urbanisation that is threatening the local microclimates. Sustainable urbanisation requires more green infrastructure in cities such as green roofs to minimise urbanisation impacts. The environmental, social and economic benefits of green roofs are widely deliberated. However, there is still a lack of assessment of the water management for green roofs. This paper aimed to assess the irrigation management of green roofs in a semi-arid region where blue water scarcity is one of the primary challenges in urban water management. To determine the appropriate water source and growing media for green roofs, an experiment was established at the University of South Australia, Australia. This study compared the performance of two growing media and three water sources on the drainage quality, medium weight and survival rate of potted Tussock grass (Poa labillardieral), an endemic plant to Australia and recommended for green roofs. Three irrigation sources were tap water, mixed of wastewater-stormwater, and rainwater. The growing media were natural sandy loam soil and Scoria - one of the most used commercial growing media for green roofs. The drainage quality of these media was tested by analysing leachate samples. Medium weight was measured before and after watering, and all pots were monitored for their survival rates. Results showed that although plant growing development was significantly higher in Scoria, the survival rate was lower. For all three water sources, EC and pH of the leachate were significantly lower from Scoria than the sandy loam soil. However, the mixed of wastewater-stormwater had the highest EC, and rainwater had the lowest EC. Results did not present a significant difference between pH of different water resources in the same media. Our experimental results found the scoria and rainwater as the best sources of medium and water for green roofs.

Keywords: green smart cities, urban water, green roofs, green walls, wastewater, stormwater

Procedia PDF Downloads 151
6260 Role of Collaborative Cultural Model to Step on Cleaner Energy: A Case of Kathmandu City Core

Authors: Bindu Shrestha, Sudarshan R. Tiwari, Sushil B. Bajracharya

Abstract:

Urban household cooking fuel choice is highly influenced by human behavior and energy culture parameters such as cognitive norms, material culture and practices. Although these parameters have a leading role in Kathmandu for cleaner households, they are not incorporated in the city’s energy policy. This paper aims to identify trade-offs to transform resident behavior in cooking pattern towards cleaner technology from the questionnaire survey, observation, mapping, interview, and quantitative analysis. The analysis recommends implementing a Collaborative Cultural Model (CCM) for changing impact on the neighborhood from the policy level. The results showed that each household produces 439.56 kg of carbon emission each year and 20 percent used unclean technology due to low-income level. Residents who used liquefied petroleum gas (LPG) as their cooking fuel suffered from an energy crisis every year that has created fuel hoarding, which ultimately creates more energy demand and carbon exposure. In conclusion, the carbon emission can be reduced by improving the residents’ energy consumption culture. It recommended the city to use holistic action of changing habits as soft power of collaboration in two-way participation approach within residents, private sectors, and government to change their energy culture and behavior in policy level.

Keywords: energy consumption pattern, collaborative cultural model, energy culture, fuel stacking

Procedia PDF Downloads 126