Search results for: pressure coefficients
1194 Vitamin B9 Separation by Synergic Pertraction
Authors: Blaga Alexandra Cristina, Kloetzer Lenuta, Bompa Amalia Stela, Galaction Anca Irina, Cascaval Dan
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Vitamin B9 is an important member of vitamins B group, being a growth factor, important for making genetic material as DNA and RNA, red blood cells, for building muscle tissues, especially during periods of infancy, adolescence and pregnancy. Its production by biosynthesis is based on the high metabolic potential of mutant Bacillus subtilis, due to a superior biodisponibility compared to that obtained by chemical pathways. Pertraction, defined as the extraction and transport through liquid membranes consists in the transfer of a solute between two aqueous phases of different pH-values, phases that are separated by a solvent layer of various sizes. The pertraction efficiency and selectivity could be significantly enhanced by adding a carrier in the liquid membrane, such as organophosphoric compounds, long chain amines or crown-ethers etc., the separation process being called facilitated pertraction. The aim of the work is to determine the impact of the presence of two extractants/carriers in the bulk liquid membrane, i.e. di(2-ethylhexyl) phosphoric acid (D2EHPA) and lauryltrialkylmetilamine (Amberlite LA2) on the transport kinetics of vitamin B9. The experiments have been carried out using two pertraction equipments for a free liquid membrane or bulk liquid membrane. One pertraction cell consists on a U-shaped glass pipe (used for the dichloromethane membrane) and the second one is an H-shaped glass pipe (used for h-heptane), having 45 mm inner diameter of the total volume of 450 mL, the volume of each compartment being of 150 mL. The aqueous solutions are independently mixed by means of double blade stirrers with 6 mm diameter and 3 mm height, having the rotation speed of 500 rpm. In order to reach high diffusional rates through the solvent layer, the organic phase has been mixed with a similar stirrer, at a similar rotation speed (500 rpm). The area of mass transfer surface, both for extraction and for reextraction, was of 1.59x10-³ m2. The study on facilitated pertraction with the mixture of two carriers, namely D2EHPA and Amberlite LA-2, dissolved in two solvents with different polarities: n-heptane and dichloromethane, indicated the possibility to obtain the synergic effect. The synergism has been analyzed by considering the vitamin initial and final mass flows, as well as the permeability factors through liquid membrane. The synergic effect has been observed at low D2EHPA concentrations and high Amberlite LA-2 concentrations, being more important for the low-polar solvent (n-heptane). The results suggest that the mechanism of synergic pertraction consists on the reaction between the organophosphoric carrier and vitamin B9 at the interface between the feed and membrane phases, while the aminic carrier enhances the hydrophobicity of this compound by solvation. However, the formation of this complex reduced the reextraction rate and, consequently, affects the synergism related to the final mass flows and permeability factor. For describing the influences of carriers concentrations on the synergistic coefficients, some equations have been proposed by taking into account the vitamin mass flows or permeability factors, with an average deviations between 4.85% and 10.73%.Keywords: pertraction, synergism, vitamin B9, Amberlite LA-2, di(2-ethylhexyl) phosphoric acid
Procedia PDF Downloads 2741193 Thermophysical Properties of Glycine/L-Alanine in 1-Butyl-3-Methylimidazolium Bromide and in 1-Butyl-3-Methylimidazolium Chloride
Authors: Tarnveer Kaur
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Amino acids, as fundamental structural units of peptides and proteins, have an important role in biological systems by affecting solubility, denaturation, and activity of biomolecules. A study of these effects on thermophysical properties of model compounds in the presence of electrolytes solutions provides information about solute-solvent and solute-solute interactions on biomolecules. Ionic liquids (ILs) as organic electrolytes and green solvents are composed of an organic cation and an inorganic anion, which are liquid at ambient conditions. In the past decade, extensive investigations showed that the use of ILs as reaction media for processes involving biologically relevant compounds is promising in view of their successful application in kinetic resolution, biocatalysis, biosynthesis, separation, and purification processes. The scope of this information is valuable to explore the interactions of amino acids in ILs. To reach this purpose, apparent molar volumes of glycine/L-alanine in aqueous solutions of 1-butyl-3-methylimidazolium bromide/chloride were determined from precise density measurements at temperatures T = (288.15-318.15) K and at atmospheric pressure. Positive values for all the studied amino acids indicate the dominance of hydrophilic-ionic interactions between amino acids and Ionic liquids. The effect of temperature on volumetric properties of glycine/L-alanine in solutions has been determined from the partial molar expansibility and second-order partial molar expansibility. Further, volumetric interaction parameters and hydration number have been calculated, which have been interpreted in terms of possible solute-solvent interactions.Keywords: ILs, amino acids, volumetric properties, hydration numbers
Procedia PDF Downloads 1651192 Visual Outcome After 360-Degree Retinectomy in Total Rhegmatogenous Retinal Detachment with Advanced Proliferative Vitreoretinopathy: A Case Series
Authors: Andriati Nadhilah Widyarini, Ezra Margareth
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Introduction: Rhegmatogenous retinal detachment is a condition where there’s a break in the retina, which allows the vitreous to directly enter the subretinal space. Proliferative vitreoretinopathy (PVR) may develop due to this condition and can result in a new break, which could cause traction on the previously detached retina. Various methods of therapy can be done to treat this complication. Case: This case series involved 2 eyes of 2 patients who had total retinal detachment with advanced PVR. Pars plana vitrectomy was performed, and a 360-degree retinectomy procedure with perfluorocarbon liquid usage was done. This was followed by endo laser retinopexy to surround the border of retinectomy. 5000 cs silicone oil was used in 1 eye, whereas 12% of perfluoropropane gas was used in the other eye as a tamponade. These procedures were performed with meticulous attention to prevent any fluid from entering the subretinal space. Postoperative examination showed attachment of the retina and improvement of the patient’s visual acuity. Both eyes’ intraocular pressure was in the normal range. One eye developed retinal displacement, but no other complications occurred. Discussion: Rhegmatogenous retinal detachment with advanced PVR is a complex situation for vitreoretinal surgeons. PVR is characterized by the growth and migration of preretinal or subretinal membranes. PVR is the most common cause of retinal reattachment failure. A 360-degree retinectomy is an alternative surgical method to overcome this condition. Objectives of this procedure are releasing retinal traction caused by PVR, reducing the recurrence rate of PVR, and reattaching the retina to the pigment epithelial surface. Conclusion: 360-degree retinectomy provides satisfactory retinal reattachment and visual outcome improvement in rhegmatogenous retinal detachment with advanced PVR.Keywords: RRD, retinectomy, pars plana, advanced PVR
Procedia PDF Downloads 461191 Serum Potassium Before, During and After Exercise at 70% Maximal Heart Rate: The Safe Exercise Dosage Across Different Parameters of Health and Fitness Level
Authors: Omar bin Mihat
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The number of sudden deaths is increasing over the past years. These deaths occur not during physical activities but upon cessation. Post-mortem confirms these deaths as cardiac arrest non-specifically. Congenital heart disease is a condition undiagnosed whereby only surface upon physical exertion leading to sudden death is unavoidable. Channelopathy, a condition that refers to any disease from the defect in iron-channel function, particularly the sodium-potassium pump, during the cessation of the exercise can be controlled. The derivation of heart rate return (HRrtn) is a procedure of a control cooling down process according to the heart rate (HR). Empirically, potassium rises linearly with intensity and falls sharply upon abrupt cessation of exertion, resulting in fatal arrhythmia due to hypokalaemia. It is vital that the flux of potassium should be maintained within the normal range during physical activities. To achieve this, the dosage of physical exertion (exercise) should be identified. Various percentages of the intensity of maximum heart rate (MHR) will precipitate different adaptations and remodeling of various organs. 70% of MHR will surface physiological adaptations, including enhancement of endurance, fitness level, and general health, and there was no significant rise of serum potassium (K+) during the entire phase of the treadmill brisk walk at a different rate of perceived exertion (RPE) from the subject of various fitness background. There was also no significant rise in blood pressure (BP) during the entire phase of the treadmill brisk walk, substantiating 70% MHR is the safe dosage across different parameters of health and fitness level.Keywords: potassium, maximal heart rate, exercise dosage, fitness level
Procedia PDF Downloads 641190 Effects of Reclamation on Seasonal Dynamic of Carbon, Nitrogen and Phosphorus Stoichiometry in Suaeda salsa
Authors: Yajun Qiao, Yaner Yan, Ning Li, Shuqing An
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In order to relieve the pressure on a land resource from a huge population, reclamation has occurred in many coastal wetlands. Plants can maintain their elemental composition within normal limits despite the variations of external conditions. Reclamation may affect carbon (C), nitrogen (N) and phosphorus (P) stoichiometry in the plant to some extent by altering physical and chemical properties of soil in a coastal wetland. We reported the seasonal dynamic of C, N and P stoichiometry in root, stem and leaf of Suaeda salsa (L.) Pall. and in soil between reclamation plots and natural plots. Our results of three-way ANOVA indicated that sampling season always had significant effect on C, N, P concentrations and their ratios; organ had no significant effect on N, P concentration and N:P; plot type had no significant effect on N concentration and C:N. Sampling season explained the most variability of tissue N and P contents, C:N, C:P and N:P, while it’s organ for C using the restricted maximum likelihood (REML) method. By independent sample T-test, we found that reclamation affect more on C, N and P stoichiometry of stem than that of root or leaf on the whole. While there was no difference between reclamation plots and natural plots for soil in four seasons. For three organs, C concentration had peak values in autumn and minimum values in spring while N concentration had peak values in spring and minimum values in autumn. For P concentration, three organs all had peak values in spring; however, the root had minimum value in winter, the stem had that in autumn, and leaf had that in summer. The seasonal dynamic of C, N and P stoichiometry in a leaf of Suaeda salsa were much steadier than that in root or stem under the drive of reclamation.Keywords: nitrogen, phosphorus, reclamation, seasonal dynamic, Suaeda salsa
Procedia PDF Downloads 3521189 Metaphors of Love and Passion in Lithuanian Comics
Authors: Saulutė Juzelėnienė, Skirmantė Šarkauskienė
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In this paper, it is aimed to analyse the multimodal representations of the concepts of LOVE and PASSION in Lithuanian graphic novel “Gertrūda”, by Gerda Jord. The research is based on the earlier findings by Forceville (2005), Eerden (2009) as well as insights made by Shihara and Matsunaka (2009) and Kövecses (2000). The domains of target and source of LOVE and PASSION metaphors in comics are expressed by verbal and non-verbal cues. The analysis of non-verbal cues adopts the concepts of rune and indexes. A pictorial rune is a graphic representation of an object that does not exist in reality in comics, such as lines, dashes, text "balloons", and pictorial index – a graphically represented object of reality, a real symptom expressing a certain emotion, such as a wide smile, furrowed eyebrows, etc. Indexes are often hyperbolized in comics. The research revealed that most frequent source domains are CLOSINESS/UNITY, NATURAL/ PHYSICAL FORCE, VALUABLE OBJECT, PRESSURE. The target is the emotion of LOVE/PASSION which belongs to a more abstract domain of psychological experience. In this kind of metaphor, the picture can be interpreted as representing the emotion of happiness. Data are taken from Lithuanian comic books and Internet sites, where comics have been presented. The data and the analysis we are providing in this article aims to reveal that there are pictorial metaphors that manifest conceptual metaphors that are also expressed verbally and that methodological framework constructed for the analysis in the papers by Forceville at all is applicable to other emotions and culture specific pictorial manifestations.Keywords: multimodal metaphor, conceptual metaphor, comics, graphic novel, concept of love/passion
Procedia PDF Downloads 631188 Influence of Some Chemical Drinking Water Parameters on Germ Count in Nalout Region, Libya
Authors: Dukali Abujnah, Mokhtar Blgacem Halbuda
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Water is one of the world's natural resources. It is an essential source for the maintenance of human, animal, and plant life. It has a significant impact on the country's economy and all human activities. Over the past twenty years, pressure on water resources has increased due to population and industrial growth and increasing demand for agricultural and household products, which has become a major concern of the international community. The aim of this study is the physical and bacteriological analysis of drinking water in the city of Value. The study covered different locations in the city. Thirty-six groundwater samples were taken from wells and various tanks owned by the State and private wells, and the Ain Thalia spring and other samples were taken from underground water tanks. It fills up with rainwater during the rainy season. These samples were analyzed for their physical, chemical, and biological status and the results were compared to Libyan and World Health Organization drinking water specifications to assess the quality of drinking water in the city of Value. Physical and chemical analysis of water samples showed acceptable values for acidity and electrical conductivity, and turbidity was found in water samples collected from underground reservoirs compared to Libyan and World Health Organization standards. The highest levels of electrical conductivity and alkalinity, TDS, and water hardness in the samples collected were below the maximum acceptable levels for drinking water as recommended by Libyan and World Health Organization specifications. The biological test results also showed that the water samples were free of intestinal bacteria.Keywords: quality, agriculture, region, reservoir, evaluation
Procedia PDF Downloads 891187 Authentic Engagement for Institutional Leadership: Implications for Educational Policy and Planning
Authors: Simeon Adebayo Oladipo
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Institutional administrators are currently facing pressure and challenges in their daily operations. Reasons for this may include the increasing multiplicity, uncertainty and tension that permeate institutional leadership. Authentic engagement for institutional leadership is premised on the ethical foundation that the leaders in the schools are engaged. The institutional effectiveness is dependent on the relationship that exists between the leaders and employees in the workplace. Leader’s self-awareness, relational transparency, emotional control, strong moral code and accountability have a positive influence on authentic engagement which variably determines leadership effectiveness. This study therefore examined the role of authentic engagement in effective school leadership; explored the interrelationship of authentic engagement indices in school leadership. The study adopted the descriptive research of the survey type using a quantitative method to gather data through a questionnaire among school leaders in Lagos State Tertiary Institutions. The population for the study consisted of all Heads of Departments, Deans and Principal Officers in Lagos State Tertiary Institutions. A sample size of 255 Heads of Departments, Deans and Principal Officers participated in the study. The data gathered were analyzed using descriptive and inferential statistical tools. The findings indicated that authentic engagement plays a crucial role in increasing leadership effectiveness amongst Heads of Departments, Deans and Principal Officers. The study recommended among others that there is a need for effective measures to enhance authentic engagement of institutional leadership practices through relevant educational support systems and effective quality control.Keywords: authentic engagement, self-awareness, relational transparency, emotional control
Procedia PDF Downloads 681186 Study of Fork Marks on Sapphire Wafers in Plasma Enhanced Chemical Vapor Deposition Tool
Authors: Qiao Pei Wen, Ng Seng Lee, Sae Tae Veera, Chiu Ah Fong, Loke Weng Onn
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Thin film thickness uniformity is crucial to get consistent film etch rate and device yield across the wafer. In the capacitive-coupled parallel plate PECVD system; the film thickness uniformity can be affected by many factors such as the heater temperature uniformity, the spacing between top and bottom electrode, RF power, pressure, gas flows and etc. In this paper, we studied how the PECVD SiN film thickness uniformity is affected by the substrate electrical conductivity and the RF power coupling efficiency. PECVD SiN film was deposited on 150-mm sapphire wafers in 200-mm Lam Sequel tool, fork marks were observed on the wafers. On the fork marks area SiN film thickness is thinner than that on the non-fork area. The forks are the wafer handler inside the process chamber to move the wafers from one station to another. The sapphire wafers and the ceramic forks both are insulator. The high resistivity of the sapphire wafers and the forks inhibits the RF power coupling efficiency during PECVD deposition, thereby reducing the deposition rate. Comparing between the high frequency and low frequency RF power (HFRF and LFRF respectively), the LFRF power coupling effect on the sapphire wafers is more dominant than the HFRF power on the film thickness. This paper demonstrated that the SiN thickness uniformity on sapphire wafers can be improved by depositing a thin TiW layer on the wafer before the SiN deposition. The TiW layer can be on the wafer surface, bottom or any layer before SiN deposition.Keywords: PECVD SiN deposition, sapphire wafer, substrate electrical conductivity, RF power coupling, high frequency RF power, low frequency RF power, film deposition rate, thickness uniformity
Procedia PDF Downloads 3741185 The Emergence of Smart Growth in Developed and Developing Countries and Its Possible Application in Kabul City, Afghanistan
Authors: Bashir Ahmad Amiri, Nsenda Lukumwena
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The global trend indicates that more and more people live and will continue to live in urban areas. Today cities are expanding both in physical size and number due to the rapid population growth along with sprawl development, which caused the cities to expand beyond the growth boundary and exerting intense pressure on environmental resources specially farmlands to accommodate new housing and urban facilities. Also noticeable is the increase in urban decay along with the increase of slum dwellers present another challenge that most cities in developed and developing countries have to deal with. Today urban practitioners, researchers, planners, and decision-makers are seeking for alternative development and growth management policies to house the rising urban population and also cure the urban decay and slum issues turn to Smart Growth to achieve their goals. Many cities across the globe have adopted smart growth as an alternative growth management tool to deal with patterns and forms of development and to cure the rising urban and environmental problems. The method used in this study is a literature analysis method through reviewing various resources to highlight the potential benefits of Smart Growth in both developed and developing countries and analyze, to what extent it can be a strategic alternative for Afghanistan’s cities, especially the capital city. Hence a comparative analysis is carried on three countries, namely the USA, China, and India to identify the potential benefits of smart growth likely to serve as an achievable broad base for recommendations in different urban contexts.Keywords: growth management, housing, Kabul city, smart growth, urban-expansion
Procedia PDF Downloads 2291184 Estimating Poverty Levels from Satellite Imagery: A Comparison of Human Readers and an Artificial Intelligence Model
Authors: Ola Hall, Ibrahim Wahab, Thorsteinn Rognvaldsson, Mattias Ohlsson
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The subfield of poverty and welfare estimation that applies machine learning tools and methods on satellite imagery is a nascent but rapidly growing one. This is in part driven by the sustainable development goal, whose overarching principle is that no region is left behind. Among other things, this requires that welfare levels can be accurately and rapidly estimated at different spatial scales and resolutions. Conventional tools of household surveys and interviews do not suffice in this regard. While they are useful for gaining a longitudinal understanding of the welfare levels of populations, they do not offer adequate spatial coverage for the accuracy that is needed, nor are their implementation sufficiently swift to gain an accurate insight into people and places. It is this void that satellite imagery fills. Previously, this was near-impossible to implement due to the sheer volume of data that needed processing. Recent advances in machine learning, especially the deep learning subtype, such as deep neural networks, have made this a rapidly growing area of scholarship. Despite their unprecedented levels of performance, such models lack transparency and explainability and thus have seen limited downstream applications as humans generally are apprehensive of techniques that are not inherently interpretable and trustworthy. While several studies have demonstrated the superhuman performance of AI models, none has directly compared the performance of such models and human readers in the domain of poverty studies. In the present study, we directly compare the performance of human readers and a DL model using different resolutions of satellite imagery to estimate the welfare levels of demographic and health survey clusters in Tanzania, using the wealth quintile ratings from the same survey as the ground truth data. The cluster-level imagery covers all 608 cluster locations, of which 428 were classified as rural. The imagery for the human readers was sourced from the Google Maps Platform at an ultra-high resolution of 0.6m per pixel at zoom level 18, while that of the machine learning model was sourced from the comparatively lower resolution Sentinel-2 10m per pixel data for the same cluster locations. Rank correlation coefficients of between 0.31 and 0.32 achieved by the human readers were much lower when compared to those attained by the machine learning model – 0.69-0.79. This superhuman performance by the model is even more significant given that it was trained on the relatively lower 10-meter resolution satellite data while the human readers estimated welfare levels from the higher 0.6m spatial resolution data from which key markers of poverty and slums – roofing and road quality – are discernible. It is important to note, however, that the human readers did not receive any training before ratings, and had this been done, their performance might have improved. The stellar performance of the model also comes with the inevitable shortfall relating to limited transparency and explainability. The findings have significant implications for attaining the objective of the current frontier of deep learning models in this domain of scholarship – eXplainable Artificial Intelligence through a collaborative rather than a comparative framework.Keywords: poverty prediction, satellite imagery, human readers, machine learning, Tanzania
Procedia PDF Downloads 1021183 Obesity, Metabolic Syndrome and Related Risk Behaviors Among Thai Medical Students of Thammasat University
Authors: Patcharapa Thaweekul, Paskorn Sritipsukho
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Background: During the training period of the 6-year medical curriculum, medical students seem to have many risk behaviors of developing obesity. This study aims to demonstrate the prevalence and risk behavior of obesity and related metabolic disorders among the final-year medical students of Thammasat University as well as the change in nutritional status during studying program. Methods: 123 participants were asked to complete the self-report questionnaires. Weight, height, waist circumference and blood pressure were obtained. Blood samples were drawn for total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides and plasma glucose. Body weight and height of the medical students in the first year were obtained from the medical report at the entry. Results: The prevalence of overweight and obesity at the entry to medical school was 22.0% and increased to 30.1% in the final year. Two obese students (5.4%) was diagnosed as metabolic syndrome. During 6-year curriculum, the BMI gained in male medical students were more significant as compared to female students (1.76±1.74 and 0.43±1.82 kg/m2, respectively; p <.001). The current BMI is significantly correlated with the BMI at entry. Serum LDL-C in the overweight/obese students was significantly higher as compared to the normal weight and underweight group. Sleep deprivation was a significantly frequent behavior in the overweight/obese students. Conclusion: Medical students, as having high-risk behaviors, should be assessed for the nutritional status and metabolic parameters. Medical schools should promote the healthy behaviors to increase the healthy eating and exercise habits and reduced the risk behaviors among them.Keywords: medical students, metabolic syndrome, obesity, risk behaviors
Procedia PDF Downloads 2591182 Numerical Simulation of Footing on Reinforced Loose Sand
Authors: M. L. Burnwal, P. Raychowdhury
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Earthquake leads to adverse effects on buildings resting on soft soils. Mitigating the response of shallow foundations on soft soil with different methods reduces settlement and provides foundation stability. Few methods such as the rocking foundation (used in Performance-based design), deep foundation, prefabricated drain, grouting, and Vibro-compaction are used to control the pore pressure and enhance the strength of the loose soils. One of the problems with these methods is that the settlement is uncontrollable, leading to differential settlement of the footings, further leading to the collapse of buildings. The present study investigates the utility of geosynthetics as a potential improvement of the subsoil to reduce the earthquake-induced settlement of structures. A steel moment-resisting frame building resting on loose liquefiable dry soil, subjected to Uttarkashi 1991 and Chamba 1995 earthquakes, is used for the soil-structure interaction (SSI) analysis. The continuum model can simultaneously simulate structure, soil, interfaces, and geogrids in the OpenSees framework. Soil is modeled with PressureDependentMultiYield (PDMY) material models with Quad element that provides stress-strain at gauss points and is calibrated to predict the behavior of Ganga sand. The model analyzed with a tied degree of freedom contact reveals that the system responses align with the shake table experimental results. An attempt is made to study the responses of footing structure and geosynthetics with unreinforced and reinforced bases with varying parameters. The result shows that geogrid reinforces shallow foundation effectively reduces the settlement by 60%.Keywords: settlement, shallow foundation, SSI, continuum FEM
Procedia PDF Downloads 1931181 Efficacy of Collagen Matrix Implants in Phacotrabeculectomy with Mitomycin C at One Year
Authors: Lalit Tejwani, Reetika Sharma, Arun Singhvi, Himanshu Shekhar
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Purpose: To assess the efficacy of collagen matrix implant (Ologen) in phacotrabeculectomy augmented with mitomycin C (MMC). Methods: A biodegradable collagen matrix (Ologen) was placed in the subconjunctival and subscleral space in twenty-two eyes of 22 patients with glaucoma and cataract who underwent combined phacoemulsification and trabeculectomy augmented with MMC. All of them were examined preoperatively and on the first postoperative day. They were followed for twelve months after surgery. Any intervention needed in follow-up period was noted. Any complication was recorded. The primary outcome measure was postoperative intraocular pressure at one year follow-up. Any additional postoperative treatments needed and adverse events were noted. Results: The mean age of patients included in the study was 57.77 ± 9.68 years (range=36 to 70 years). All the patients were followed for at least one year. Three patients had history of failed trabeculectomy. Fifteen patients had chronic angle closure glaucoma with cataract, five had primary open angle glaucoma with cataract, one had uveitic glaucoma with cataract, and one had juvenile open angle glaucoma with cataract. Mean preoperative IOP was 32.63 ± 8.29 mm Hg, eighteen patients were on oral antiglaucoma medicines. The mean postoperative IOP was 10.09 ± 2.65 mm Hg at three months, 10.36 ± 2.19 mm Hg at six months and 11.36 ± 2.72 mm Hg at one year follow up. No adverse effect related to Ologen was seen. Anterior chamber reformation was done in five patients, and three needed needling of bleb. Four patients needed additional antiglaucoma medications in the follow-up period. Conclusions: Combined phacotrabeculectomy with MMC with Ologen implantation appears to be a safe and effective option in glaucoma patients needing trabeculectomy with significant cataract. Comparative studies with longer duration of follow-up in larger number of patients are needed.Keywords: combined surgery, ologen, phacotrabeculectomy, success
Procedia PDF Downloads 2121180 The Impact of Work Stress on Professionals' Life and Health: The Usage of Instant Messaging Applications
Authors: Pui-Lai To, Chechen Liao, Ming-Chi Sung
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Work and family life are the most important areas for men and women today. Every professional is required to meet and fulfill the responsibilities of work and family roles. Although the development and popularity of communication technology bring a lot of benefits, including effective and efficient communication, may also generate conflicts between work and family life. Since mobile devices and the applications of mobile devices, such as instant messages, are ubiquitous, the boundaries of work and family roles are increasingly blurred. Professionals may be in the risk of work over-loading and work-family conflict. This study examines the impact of work stress on professionals’ life and health in the context of instant messaging application of smart phone. This study uses a web-based questionnaire to collect samples. The questionnaires are sent via virtual community sites, instant messaging applications, and e-mail. The study develops and empirically validates a work-family conflict model by integrating the pressure theory and technostress factors. The causal relationship between variables in the research model is tested. In terms of data analysis, Partial Least Square (PLS) in Structural Equation Modeling (SEM) is used for sample analysis and research model testing. The results of this study are as follows. First, both the variables of work-related stress and technological violations positively affect the work-family conflict. Second, both the variables of work-loading and technology-overloading have no effect on work-family conflict. Third, work-family conflict has negative effect on job satisfaction, family satisfaction, physical health, and mental health.Keywords: mental health, physical health, technostress, work-family conflict, work-related stress
Procedia PDF Downloads 2991179 Computed Tomography Differential Diagnose of Intraventicular Masses in the Emergency Departemen
Authors: Angelis P. Barlampas
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Purpose: A 29 years old woman presented in the emergency department with psychiatric symptoms. The psychiatrist ordered a computed tomography scan as part of a general examination. Material and methods: The CT showed bilateral enlarged choroid plexus structures mimicking papillomata and situated in the trigones of the lateral ventricles. The left choroid plexus was heavily calcified, but the right one has no any obvious calcifications. Results: It is well kown that any brain mass can present with behavioral changes and even psychiatric symptomatology. Papillomata of the ventricular system have been described to cause psychotic episodes. According to literature, choroid plexus papillomas are seldom neuroepithelial intraventricular tumors, which are benign and categorized as WHO grade 1 tumors. They are more common in the pediatric population, but they can occur in the adults, too1. In addition, the distinction between choroid plexus papilloma and carcinoma is very difficult and impossible by imagine alone. It can only be implied with more advanced imaging, such as arterial spin labeling and MRI. The final diagnosis is, of course, after surgical excision. The usual location in adults is the fourth ventricle, but in children, it is the lateral ventricles. Their imaging appearance is that of a solid vascular tumor, which enhances intensely after the intravenous administration of contrast material. One out of fourth tumors presents speckled calcifications1. In our case, there are symmetrically sized masses at the trigones, and there are no calcifications in one of them, whereas the other one is grossly calcified. Also, there is no obvious hydrocephalus or any other evidence of increased intracranial pressure. General conclusions: When there is a new psychiatric patient, someone must undergo any possible examination, and of course, a brain CT study should be done to exclude any rare organic causes that may be responsible for the disease.Keywords: phycosis, intraventricular masses, CT, brain calcifications
Procedia PDF Downloads 561178 A Dual Spark Ignition Timing Influence for the High Power Aircraft Radial Engine Using a CFD Transient Modeling
Authors: Tytus Tulwin, Ksenia Siadkowska, Rafał Sochaczewski
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A high power radial reciprocating engine is characterized by a large displacement volume of a combustion chamber. Choosing the right moment for ignition is important for a high performance or high reliability and ignition certainty. This work shows methods of simulating ignition process and its impact on engine parameters. For given conditions a flame speed is limited when a deflagration combustion takes place. Therefore, a larger length scale of the combustion chamber compared to a standard size automotive engine makes combustion take longer time to propagate. In order to speed up the mixture burn-up time the second spark is introduced. The transient Computational Fluid Dynamics model capable of simulating multicycle engine processes was developed. The CFD model consists of ECFM-3Z combustion and species transport models. A relative ignition timing difference for the both spark sources is constant. The temperature distribution on engine walls was calculated in the separate conjugate heat transfer simulation. The in-cylinder pressure validation was performed for take-off power flight conditions. The influence of ignition timing on parameters like in-cylinder temperature or rate of heat release was analyzed. The most advantageous spark timing for the highest power output was chosen. The conditions around the spark plug locations for the pre-ignition period were analyzed. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.Keywords: CFD, combustion, ignition, simulation, timing
Procedia PDF Downloads 2941177 The Influence of Aerobic Physical Exercise with Different Frequency to Concentration of Vascular Endothelial Growth Factor in Brain Tissue of Wistar Rat
Authors: Rostika Flora, Muhammad Zulkarnain, Syokumawena
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Background: Aerobic physical exercises are recommended to keep body fit and healthy although physical exercises themselves can increase body metabolism and oxygen and can lead into tissue hypoxia. Oxygen pressure can serve as Vascular Endhothelial Growth Factor (VEGF) regulator. Hypoxia increases gene expression of VEGF through ascendant regulation of HIF-1. VEGF is involved in regulating angiogenesis process. Aerobic physical exercises can increase the concentration of VEGF in brain and enables angiogenesis process. We have investigated the influence of aerobic physical exercise to the VGEF concentration of wistar rat’s brain. Methods: This was experimental study using post test only control group design. Independent t-test was used as statistical test. The samples were twenty four wistar rat (Rattus Norvegicus) which were divided into four groups: group P1 (control group), group P2 (treatment group with once-a-week exercise), group P3 (treatment group with three time-a-week exercise), and group P4 (treatment group with seven time-a-week exercise). Group P2, P3, and P4 were treated with treadmil with speed of 20 m/minute for 30 minutes. The concentration of VEGF was determined by ELISA. Results: There was a significant increase of VEGF in treatment group compared with control one (<0.05). The maximum increase was found in group P2 (129.02±64.49) and the minimum increase was in group P4 (96.98±11.20). Conclusion: The frequency of aerobic physical exercises influenced the concentration of Vascular Endhothelial Growth Factor (VEGF) of brain tissue of Rattus Norvegicus.Keywords: brain tissue, hypoxia, physical exercises, vascular endhothelial growth factor
Procedia PDF Downloads 4901176 Optimal Approach for Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Metanalysis
Authors: Maatouk Mohamed, Nouira Mariem
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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review
Procedia PDF Downloads 811175 Modelling of Pipe Jacked Twin Tunnels in a Very Soft Clay
Authors: Hojjat Mohammadi, Randall Divito, Gary J. E. Kramer
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Tunnelling and pipe jacking in very soft soils (fat clays), even with an Earth Pressure Balance tunnel boring machine (EPBM), can cause large ground displacements. In this study, the short-term and long-term ground and tunnel response is predicted for twin, pipe-jacked EPBM 3 meter diameter tunnels with a narrow pillar width. Initial modelling indicated complete closure of the annulus gap at the tail shield onto the centrifugally cast, glass-fiber-reinforced, polymer mortar jacking pipe (FRP). Numerical modelling was employed to simulate the excavation and support installation sequence, examine the ground response during excavation, confirm the adequacy of the pillar width and check the structural adequacy of the installed pipe. In the numerical models, Mohr-Coulomb constitutive model with the effect of unloading was adopted for the fat clays, while for the bedrock layer, the generalized Hoek-Brown was employed. The numerical models considered explicit excavation sequences and different levels of ground convergence prior to support installation. The well-studied excavation sequences made the analysis possible for this study on a very soft clay, otherwise, obtaining the convergency in the numerical analysis would be impossible. The predicted results indicate that the ground displacements around the tunnel and its effect on the pipe would be acceptable despite predictions of large zones of plastic behaviour around the tunnels and within the entire pillar between them due to excavation-induced ground movements.Keywords: finite element modeling (FEM), pipe-jacked tunneling, very soft clay, EPBM
Procedia PDF Downloads 801174 Strategies for a Sustainable Future of Forest and Tribal Peoples on This Planet
Authors: Dharmpal Singh
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The objective of this proposed project is to relocation and resettlement of carnivores tribal communities who are currently residing in the protected forest land in all over the world just like resettlement project of the carnivores tribal families of Mongia who at past were residing in Ranthambhore Tiger Reserve (RTR) and had caused excess damage of endangered species of wildlife including Tigers. At present several tribal communities are residing in the another national parks and they not only consuming the wild animals but also involved in illegal trading of vital organs, skin and bones with National and international traders. Tribal are ideally suited for the job because they are highly skilled game trackers and due to having had a definite source of income over the years, they easily drawn in to the illegal wildlife trade and slaughter of wild animals. Their income is increasing but wild animals are on the brink of extinction. For the conservation of flora and fauna the rehabilitation process should be thought out according to the RTR project (which not only totally change the quality of life of mongia tribal community but also increased the conopy cover of forest and grass due to reduced the biotic pressure on protected land of forest in Rajasthan state) with appropriate understanding of the sociology of the people involved, their culture, education standard and the need of different skills to be acquired by them for sustenance such as agriculture, dairy, poultry, social forestry, job as forest guard and others eco-development programmes. Perhaps, the dimensions presented by me may generate discussion among the international wild life lovers and conservationists and remedies may be result oriented in the field of management of forest and conservation of wildlife on this planet.Keywords: strategies, rehablety of tribals, conservation of forest, eco-development Programmes, wildlife
Procedia PDF Downloads 4351173 Green Design Study of Prefabricated Community Control Measures in Response to Public Health Emergencies
Authors: Enjia Zhang
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During the prevention and control of the COVID-19 pandemic, all communities in China were gated and under strict management, which was highly effective in preventing the spread of the epidemic from spreading. Based on the TRIZ theory, this paper intends to propose green design strategies of community control in response to public health emergencies and to optimize community control facilities according to the principle of minimum transformation. Through the questionnaire method, this paper investigates and summarizes the situation and problems of community control during the COVID-19 pandemic. Based on these problems, the TRIZ theory is introduced to figure out the problems and associates them with prefabricated facilities. Afterward, the innovation points and solutions of prefabricated community control measures are proposed by using the contradiction matrix. This paper summarizes the current situation of community control under public health emergencies and concludes the problems such as simple forms of temporary roadblocks, sudden increase of community traffic pressure, and difficulties to access public spaces. The importance of entrance and exit control in community control is emphasized. Therefore, the community control measures are supposed to focus on traffic control, and the external access control measures, including motor vehicles, non-motor vehicles, residents and non-residents access control, and internal public space access control measures, including public space control shared with the society or adjacent communities, are proposed in order to make the community keep the open characteristics and have the flexibility to deal with sudden public health emergencies in the future.Keywords: green design, community control, prefabricated structure, public health emergency
Procedia PDF Downloads 1281172 Finite Element Model to Evaluate Gas Conning Phenomenon in Naturally Fractured Oil Reservoirs
Authors: Reda Abdel Azim
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Gas conning phenomenon considered one of the prevalent matter in oil field applications as it significantly affects the amount of produced oil, increase cost of production operation and it has a direct effect on oil reservoirs recovery efficiency as well. Therefore, evaluation of such phenomenon and study the reservoir mechanisms that may strongly affect invading gas to the producing formation is crucial. Gas conning is a result of an imbalance between two major forces controlling the oil production: gravitational and viscous forces especially in naturally fractured reservoirs where the capillary pressure forces are negligible. Once the gas invading the producing formation near the wellbore due to large producing oil rate, the oil gas contact will change and such reservoirs are prone to gas conning. Moreover, the oil volume expected to be produced requires the use of long horizontal perforated well. This work presents a numerical simulation study to predict and propose solutions to gas coning in naturally fractured oil reservoirs. The simulation work is based on discrete fractures and permeability tensors approaches. The governing equations are discretized using finite element approach and Galerkin’s least square technique (GLS) is employed to stabilize the equation solutions. The developed simulator is validated against Eclipse-100 using horizontal fractures. The matrix and fracture properties are modelled. Critical rate, breakthrough time and GOR are determined to be used in investigation of the effect of matrix and fracture properties on gas coning. Results show that fracture distribution in terms of diverse dip and azimuth has a great effect on conning occurring. In addition, fracture porosity, anisotropy ratio, and fracture aperture.Keywords: gas conning, finite element, fractured reservoirs, multiphase
Procedia PDF Downloads 1941171 Hydrothermal Liquefaction for Astaxanthin Extraction from Wet Algae
Authors: Spandana Ramisetty, Mandan Chidambaram, Ramesh Bhujade
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Algal biomass is not only a potential source for biocrude but also for high value chemicals like carotenoids, fatty acids, proteins, polysaccharides, vitamins etc. Astaxanthin is one such high value vital carotenoid which has extensive applications in pharmaceutical, aquaculture, poultry and cosmetic industries and expanding as dietary supplement to humans. Green microalgae Haematococcus pluvialis is identified as the richest natural source of astaxanthin and is the key source of commercial astaxanthin. Several extraction processes from wet and dry Haematococcus pluvialis biomass have been explored by researchers. Extraction with supercritical CO₂ and various physical disruption techniques like mortar and pestle, homogenization, ultrasonication and ball mill from dried algae are widely used extraction methods. However, these processes require energy intensive drying of biomass that escalates overall costs notably. From the process economics perspective, it is vital to utilize wet processing technology in order to eliminate drying costs. Hydrothermal liquefaction (HTL) is a thermo-chemical conversion process that converts wet biomass containing over 80% water to bio-products under high temperature and high pressure conditions. Astaxanthin is a lipid soluble pigment and is usually extracted along with lipid component. Mild HTL at 200°C and 60 bar has been demonstrated by researchers in a microfluidic platform achieving near complete extraction of astaxanthin from wet biomass. There is very limited work done in this field. An integrated approach of sequential HTL offers cost-effective option to extract astaxanthin/lipid from wet algal biomass without drying algae and also recovering water, minerals and nutrients. This paper reviews past work and evaluates the astaxanthin extraction processes with focus on hydrothermal extraction.Keywords: astaxanthin, extraction, high value chemicals, hydrothermal liquefaction
Procedia PDF Downloads 3051170 Effectiveness of a Malaysian Workplace Intervention Study on Physical Activity Levels
Authors: M. Z. Bin Mohd Ghazali, N. C. Wilson, A. F. Bin Ahmad Fuad, M. A. H. B. Musa, M. U. Mohamad Sani, F. Zulkifli, M. S. Zainal Abidin
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Physical activity levels are low in Malaysia and this study was undertaken to determine if a four week work-based intervention program would be effective in changing physical activity levels. The study was conducted in a Malaysian Government Department and had three stages: baseline data collection, four-week intervention and two-month post intervention data collection. During the intervention and two-month post intervention phases, physical activity levels (determined by a pedometer) and basic health profiles (BMI, abdominal obesity, blood pressure) were measured. Staff (58 males, 47 females) with an average age of 33 years completed baseline data collection. Pedometer steps averaged 7,102 steps/day at baseline, although male step counts were significantly higher than females (7,861 vs. 6114). Health profiles were poor: over 50% were overweight/obese (males 66%, females 40%); hypertension (males 23%, females 6%); excess waist circumference (males 52%, females 17%). While 86 staff participated in the intervention, only 49 regularly reported their steps. There was a significant increase (17%) in average daily steps from 8,965 (week 1) to 10,436 (week 4). Unfortunately, participation in the intervention program was avoided by the less healthy staff. Two months after the intervention there was no significant difference in average steps/day, despite the fact that 89% of staff reporting they planned to make long-term changes to their lifestyle. An unexpected average increase of 2kg in body weight occurred in participants, although this was less than the 5.6kg in non-participants. A number of recommendations are made for future interventions, including the conclusion that pedometers were a useful tool and popular with participants.Keywords: pedometers, walking, health, intervention
Procedia PDF Downloads 3021169 Injection of Bradykinin in Femoral Artery Elicits Cardiorespiratory Reflexes Involving Perivascular Afferents in Rat Models
Authors: Sanjeev K. Singh, Maloy B. Mandal, Revand R.
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The physiology of baroreceptors and chemoreceptors present in large blood vessels of the heart is well known in regulation of cardiorespiratory functions. Since large blood vessels and peripheral blood vessels are of same mesodermal origin, therefore, involvement of the latter in regulation of cardiorespiratory system is expected. Role of perivascular nerves in mediating cardiorespiratory alterations produced after intra-arterial injection of a nociceptive agent (bradykinin) was examined in urethane anesthetized male rats. Respiratory frequency, blood pressure, and heart rate were recorded for 30 min after the retrograde injection of bradykinin/saline in the femoral artery. In addition, paw edema was determined and water content was expressed as percentage of wet weight. Injection of bradykinin produced immediate tachypnoeic, hypotensive and bradycardiac responses of shorter latency (5-8 s) favoring the neural mechanisms involved in it. Injection of equi-volume of saline did not produce any responses and served as time matched control. Paw edema was observed in the ipsilateral hind limb. Pretreatment with diclofenac sodium significantly attenuated the bradykinin-induced responses and also blocked the paw edema. Ipsilateral femoral and sciatic nerve sectioning attenuated bradykinin-induced responses significantly indicating the origin of responses from the local vascular bed. Administration of bradykinin in the segment of an artery produced reflex cardiorespiratory changes by stimulating the perivascular nociceptors involving prostaglandins. This is a novel study exhibiting the role of peripheral blood vessels in regulation of cardiorespiratory system.Keywords: vasosensory reflex, cardiorespiratory changes, nociceptive agent, bradykinin, VR1 receptors
Procedia PDF Downloads 1451168 Fatigue Behavior of Friction Stir Welded EN AW 5754 Aluminum Alloy Using Load Increase Procedure
Authors: A. B. Chehreh, M. Grätzel, M. Klein, J. P. Bergmann, F. Walther
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Friction stir welding (FSW) is an advantageous method in the thermal joining processes, featuring the welding of various dissimilar and similar material combinations, joining temperatures below the melting point which prevents irregularities such as pores and hot cracks as well as high strengths mechanical joints near the base material. The FSW process consists of a rotating tool which is made of a shoulder and a probe. The welding process is based on a rotating tool which plunges in the workpiece under axial pressure. As a result, the material is plasticized by frictional heat which leads to a decrease in the flow stress. During the welding procedure, the material is continuously displaced by the tool, creating a firmly bonded weld seam behind the tool. However, the mechanical properties of the weld seam are affected by the design and geometry of the tool. These include in particular microstructural and surface properties which can favor crack initiation. Following investigation compares the dynamic properties of FSW weld seams with conventional and stationary shoulder geometry based on load increase test (LIT). Compared to classical Woehler tests, it is possible to determine the fatigue strength of the specimens after a short amount of time. The investigations were carried out on a robotized welding setup on 2 mm thick EN AW 5754 aluminum alloy sheets. It was shown that an increased tensile and fatigue strength can be achieved by using the stationary shoulder concept. Furthermore, it could be demonstrated that the LIT is a valid method to describe the fatigue behavior of FSW weld seams.Keywords: aluminum alloy, fatigue performance, fracture, friction stir welding
Procedia PDF Downloads 1521167 Role of Ologen in Previously Failed Trabeculectomy in Advanced Glaucoma
Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi
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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma
Procedia PDF Downloads 3331166 Biofuel Production via Thermal Cracking of Castor Methyl Ester
Authors: Roghaieh Parvizsedghy, Seyed Mojtaba Sadrameli
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Diminishing oil reserves, deteriorating health standards because of greenhouse gas emissions and associated environmental impacts have emerged biofuel production. Vegetable oils are proved to be valuable feedstock in these growing industries as they are renewable and potentially inexhaustible sources. Thermal Cracking of vegetable oils (triglycerides) leads to production of biofuels which are similar to fossil fuels in terms of composition but their combustion and physical properties have limits. Acrolein (very poisonous gas) and water production during cracking of triglycerides occurs because of presence of glycerin in their molecular structure. Transesterification of vegetable oil is a method to extract glycerol from triglycerides structure and produce methyl ester. In this study, castor methyl ester was used for thermal cracking in order to survey the efficiency of this method to produce bio-gasoline and bio-diesel. Thus, several experiments were designed by means of central composite method. Statistical studies showed that two reaction parameters, namely cracking temperature and feed flowrate, affect products yield significantly. At the optimized conditions (480 °C and 29 g/h) for maximum bio-gasoline production, 88.6% bio-oil was achieved which was distilled and separated as bio-gasoline (28%) and bio-diesel (48.2%). Bio-gasoline exposed a high octane number and combustion heat. Distillation curve and Reid vapor pressure of bio-gasoline fell in the criteria of standard gasoline (class AA) by ASTM D4814. Bio-diesel was compatible with standard diesel by ASTM D975. Water production was negligible and no evidence of acrolein production was distinguished. Therefore, thermal cracking of castor methyl ester could be used as a method to produce valuable biofuels.Keywords: bio-diesel, bio-gasoline, castor methyl ester, thermal cracking, transesterification
Procedia PDF Downloads 2381165 External Vacuum Dressing: Optimising Non-Operative Management of Flail Sternum Post CPR
Authors: Nicholas Bayfield, Mark Newman
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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing
Procedia PDF Downloads 153