Search results for: harmony search optimization (HSA)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4952

Search results for: harmony search optimization (HSA)

1262 Six Sigma-Based Optimization of Shrinkage Accuracy in Injection Molding Processes

Authors: Sky Chou, Joseph C. Chen

Abstract:

This paper focuses on using six sigma methodologies to reach the desired shrinkage of a manufactured high-density polyurethane (HDPE) part produced by the injection molding machine. It presents a case study where the correct shrinkage is required to reduce or eliminate defects and to improve the process capability index Cp and Cpk for an injection molding process. To improve this process and keep the product within specifications, the six sigma methodology, design, measure, analyze, improve, and control (DMAIC) approach, was implemented in this study. The six sigma approach was paired with the Taguchi methodology to identify the optimized processing parameters that keep the shrinkage rate within the specifications by our customer. An L9 orthogonal array was applied in the Taguchi experimental design, with four controllable factors and one non-controllable/noise factor. The four controllable factors identified consist of the cooling time, melt temperature, holding time, and metering stroke. The noise factor is the difference between material brand 1 and material brand 2. After the confirmation run was completed, measurements verify that the new parameter settings are optimal. With the new settings, the process capability index has improved dramatically. The purpose of this study is to show that the six sigma and Taguchi methodology can be efficiently used to determine important factors that will improve the process capability index of the injection molding process.

Keywords: injection molding, shrinkage, six sigma, Taguchi parameter design

Procedia PDF Downloads 168
1261 Optimization of Microencapsulation of β-Carotene by Complex Coacervation Technique Using Casein and Gum Tragacanth

Authors: Gargi Ghoshal, Ashay Jain

Abstract:

Microencapsulation of β-carotene was optimized by complex coacervation technique using casein/gum tragacanth (CAS/GT) coating as a function of pH, initial protein to polysaccharide mixing ratio (Pr:Ps), total biopolymer concentration, core material load, zeta potential, and ionic strength. This study was aimed to understand the influence of experimental parameters on the coacervation kinetics, the coacervate yield, and entrapment efficiency. At a Pr:Ps = 2:1, an optimum pH of complex coacervation was found 4.35, at which the intensity of electrostatic interaction was maximum. At these ratios of coating, the phase separation occurred the fastest and the final coacervate yield and entrapment efficiency was the highest. Varying the Pr: Ps shifted the value of optimum pH. This incident was due to the level of charge compensation of the CAS/GT complexes. Finally, electrostatic interaction and formation of coacervates between CAS and GT were confirmed by Fourier transform infra-red (FTIR) spectra. The size and surface properties of coacervates were studied using scanning electron microscopy (SEM). The resultant formulation (β-carotene loaded microcapsules) was evaluated for in vitro release study and antioxidant activity. Stability of encapsulated β-carotene was also evaluated under three levels of temperature (5, 25 and 40 °C) for 3 months. Encapsulation strongly increased the stability of micronutrients. Our results advocate potential of microcapsules as a novel carrier for the safeguard and sustained release of micronutrient.

Keywords: β-carotene, casein, complex coacervation, controlled release, gum tragacanth, microcapsules

Procedia PDF Downloads 255
1260 The Predictability of Three Implants to Support a Fixed Prosthesis in the Edentulous Mandible

Authors: M. Hirani, M. Devine, O. Obisesan, C. Bryant

Abstract:

Introduction: The use of four or more implants to support a fixed prosthesis in the edentulous mandible is well documented, with high levels of clinical outcomes recorded. Despite this, the use of three implant-supported fixed prostheses offers the potential to deliver a more cost-effective method of oral rehabilitation in the lower arch, an important consideration given that edentulism is most prevalent in low-income subpopulations. The purpose of this study aimed to evaluate the implant and prosthetic survival rate, changes in marginal bone level, and patient satisfaction associated with a three-implant-supported fixed prosthesis for rehabilitation of the edentulous mandible over a follow-up period of at least one year. Methods: A comprehensive literature search was performed to evaluate studies that met the selection criteria. The information extracted included the study design and population, participant demographics, observation period, loading protocol, and the number of implants placed together with the required outcome measures. Mean values and standard deviations (SD) were calculated using SPSS® (IBM Corporation, New York, USA), and the level of statistical significance across all comparative studies described was set at P < 0.05. Results: The eligible studies included a total of 1968 implants that were placed in 652 patients. The subjects ranged in age from 33-89 years, with a mean of 63.2 years. The mean cumulative implant and prosthetic survival rates were 95.5% and 96.2%, respectively, over a mean follow-up period of 3.25 years. The mean marginal bone loss recorded was 1.04 mm, and high patient satisfaction rates were reported across the studies. Conclusion: Current evidence suggests that a three implant-supported fixed prosthesis for the edentulous mandible is a successful treatment strategy presenting high implant and prosthetic survival rates over the short-to-medium term. Further well-designed controlled clinical trials are required to evaluate longer-term outcomes, with supplemental data correlating implant dimensions and prosthetic design.

Keywords: implants, mandible, fixed, prosthesis

Procedia PDF Downloads 125
1259 The Employees' Classification Method in the Space of Their Job Satisfaction, Loyalty and Involvement

Authors: Svetlana Ignatjeva, Jelena Slesareva

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The aim of the study is development and adaptation of the method to analyze and quantify the indicators characterizing the relationship between a company and its employees. Diagnostics of such indicators is one of the most complex and actual issues in psychology of labour. The offered method is based on the questionnaire; its indicators reflect cognitive, affective and connotative components of socio-psychological attitude of employees to be as efficient as possible in their professional activities. This approach allows measure not only the selected factors but also such parameters as cognitive and behavioural dissonances. Adaptation of the questionnaire includes factor structure analysis and suitability analysis of phenomena indicators measured in terms of internal consistency of individual factors. Structural validity of the questionnaire was tested by exploratory factor analysis. Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. Factor analysis allows reduce dimension of the phenomena moving from the indicators to aggregative indexes and latent variables. Aggregative indexes are obtained as the sum of relevant indicators followed by standardization. The coefficient Cronbach's Alpha was used to assess the reliability-consistency of the questionnaire items. The two-step cluster analysis in the space of allocated factors allows classify employees according to their attitude to work in the company. The results of psychometric testing indicate possibility of using the developed technique for the analysis of employees’ attitude towards their work in companies and development of recommendations on their optimization.

Keywords: involved in the organization, loyalty, organizations, method

Procedia PDF Downloads 349
1258 Study Skills Empowering Strategies to Enhance Second Year Diploma Accountancy Students’ Academic Performance

Authors: Mohamed Karodia

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Accountancy as a subject is one of the sciences that for many years has been perceived as a difficult subject to study and teach. Yet, it continuously attracts scholars graduating from school and entering Higher Education Institutions as a subject of choice and career. The teaching and learning of this subject have not been easy and has evolved and progressed over the past few decades however students still find it difficult to study and this has resulted in poor student achievement. In search of solutions, this study has considered the effect and efficacy that study skills have on the performance of Accountancy students and in particular students studying Second Year Diploma in Accountancy at the University of Johannesburg. These students appear to have a lack of appropriate study skills and as a result of these impacts on their performance in the courses, they are studying. This study also focuses on strategies to enhance Second Year Diploma Accountancy students’ academic performance. A literature review was conducted to investigate what scholarly literature suggests about study skills, in general, and in particular for Accountancy to be successful. In order to determine what study skills Second Year Accountancy students are applying when they learn and why they are failing the Accountancy examinations and formal class tests, the study adopted the quantitative research method. A questionnaire addressing various aspects of study skills, studying accountancy and studying, in general, was provided to 800 students studying Second Year Diploma in Accountancy at the University of Johannesburg’s Soweto Campus. The quantitative data collected were analyzed using descriptive statistics in the form of proportions, frequencies, means, and standard deviations, t-tests to compare differences between two groups as well as correlations between variables. Based on the findings of this study, it is recommended that students are provided with courses in time management, procrastination, reading, note taking and writing, test preparation techniques as well as study attitude. Lecturers spend more time teaching students how to study in general as well as accountancy specifically preferably at the first-year level before proceeding to the second year. It is also recommended that the University implements a study skills course to assist the students with studying.

Keywords: accountancy, skills, strategies, study

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1257 Enhancing Industrial Wastewater Treatment through Fe3o4 Nanoparticles-loaded Activated Charcoal: Design and Optimization for Sustainable Development

Authors: Komal Verma, V. S. Moholkar

Abstract:

This paper reports investigations in the mineralization of industrial wastewater (COD = 3246 mg/L, TOC = 2500 mg/L) using a ternary (ultrasound + Fenton + adsorption) hybrid advanced oxidation process. Fe3O4 decorated activated charcoal (Fe3O4@AC) nanocomposites (surface area = 538.88 m2/g; adsorption capacity = 294.31 mg/g) were synthesized using co-precipitation. The wastewater treatment process was optimized using central composite statistical design. At optimum conditions, viz. pH = 4.2, H2O2 loading = 0.71 M, adsorbent dose = 0.34 g/L, reduction in COD and TOC of wastewater were 94.75% and 89%, respectively. This result is essentially a consequence of synergistic interactions among the adsorption of pollutants onto activated charcoal and surface Fenton reactions induced due to the leaching of Fe2+/Fe3+ ions from the Fe3O4 nanoparticles. Microconvection generated due to sonication assisted faster mass transport (adsorption/desorption) of pollutants between Fe₃O₄@AC nanocomposite and the solution. The net result of this synergism was high interactions and reactions among and radicals and pollutants that resulted in the effective mineralization of wastewater The Fe₃O₄@AC showed excellent recovery (> 90 wt%) and reusability (> 90% COD removal) in 5 successive cycles of treatment. LC-MS analysis revealed effective (> 50%) degradation of more than 25 significant contaminants (in the form of herbicides and pesticides) after the treatment with ternary hybrid AOP. Similarly, the toxicity analysis test using the seed germination technique revealed ~ 60% reduction in the toxicity of the wastewater after treatment.

Keywords: Fe₃O₄@AC nanocomposite, RSM, COD;, LC-MS, Toxicity

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1256 Response Surface Methodology for the Optimization of Sugar Extraction from Phoenix dactylifera L.

Authors: Lila Boulekbache-Makhlouf, Kahina Djaoud, Myriam Tazarourte, Samir Hadjal, Khodir Madani

Abstract:

In Algeria, important quantities of secondary date variety (Phoenix dactylifera L.) are generated in each campaign; their chemical composition is similar to that of commercial dates. The present work aims to valorize this common date variety (Degla-Beida) which is often poorly exploited. In this context, we tried to prepare syrup from the secondary date variety and to evaluate the effect of conventional extraction (CE) or water bath extraction (WBE) and alternative extraction (microwaves assisted extraction (MAE), and ultrasounds assisted extraction (UAE)) on its total sugar content (TSC), using response surface methodology (RSM). Then, the analysis of individual sugars was performed by high-performance liquid chromatography (HPLC). Maximum predicted TSC recoveries under the optimized conditions for MAE, UAE and CE were 233.248 ± 3.594 g/l, 202.889 ± 5.797 g/l, and 233.535 ± 5.412 g/l, respectively, which were close to the experimental values: 233.796 ± 1.898 g/l; 202.037 ± 3.401 g/l and 234.380 ± 2.425 g/l. HPLC analysis revealed high similarity in the sugar composition of date juices obtained by MAE (60.11% sucrose, 16.64% glucose and 23.25% fructose) and CE (50.78% sucrose, 20.67% glucose and 28.55% fructose), although a large difference was detected for that obtained by UAE (0.00% sucrose, 46.94% glucose and 53.06% fructose). Microwave-assisted extraction was the best method for the preparation of date syrup with an optimal recovery of total sugar content. However, ultrasound-assisted extraction was the best one for the preparation of date syrup with high content of reducing sugars.

Keywords: dates, extraction, RSM, sugars, syrup

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1255 Mycophenolate Versus Methotrexate in Non-Infectious Ocular Inflammatory Disease: A Systematic Review and Meta-Analysis

Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

Abstract:

Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

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1254 Antimicrobial, Antioxidant and Cytotoxic Activities of Cleoma viscosa Linn. Crude Extracts

Authors: Suttijit Sriwatcharakul

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The bioactivity studies from the weed ethanolic crude extracts from leaf, stem, pod and root of wild spider flower; Cleoma viscosa Linn. were analyzed for the growth inhibition of 6 bacterial species; Salmonella typhimurium TISTR 5562, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus TISTR 1466, Streptococcus epidermidis ATCC 1228, Escherichia coli DMST 4212 and Bacillus subtilis ATCC 6633 with initial concentration crude extract of 50 mg/ml. The agar well diffusion results found that the extracts inhibit only gram positive bacteria species; S. aureus, S. epidermidis and B. subtilis. The minimum inhibition concentration study with gram positive strains revealed that leaf crude extract give the best result of the lowest concentration compared with other plant parts to inhibit the growth of S. aureus, S. epidermidis and B. subtilis at 0.78, 0.39 and lower than 0.39 mg/ml, respectively. The determination of total phenolic compounds in the crude extracts exhibited the highest phenolic content was 10.41 mg GAE/g dry weight in leaf crude extract. Analyzed the efficacy of free radical scavenging by using DPPH radical scavenging assay with all crude extracts showed value of IC50 of leaf, stem, pod and root crude extracts were 8.32, 12.26, 21.62 and 35.99 mg/ml, respectively. Studied cytotoxicity of crude extracts on human breast adenocarcinoma cell line by MTT assay found that pod extract had the most cytotoxicity CC50 value, 32.41 µg/ml. Antioxidant activity and cytotoxicity of crude extracts exhibited that the more increase of extract concentration, the more activities indicated. According to the bioactivities results, the leaf crude extract of Cleoma viscosa Linn. is the most interesting plant part for further work to search the beneficial of this weed.

Keywords: antimicrobial, antioxidant activity, Cleoma viscosa Linn., cytotoxicity test, total phenolic compound

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1253 Screening and Optimization of Pretreatments for Rice Straw and Their Utilization for Bioethanol Production Using Developed Yeast Strain

Authors: Ganesh Dattatraya Saratale, Min Kyu Oh

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Rice straw is one of the most abundant lignocellulosic waste materials and its annual production is about 731 Mt in the world. This study treats the subject of effective utilization of this waste biomass for biofuels production. We have showed a comparative assessment of numerous pretreatment strategies for rice straw, comprising of major physical, chemical and physicochemical methods. Among the different methods employed for pretreatment alkaline pretreatment in combination with sodium chlorite/acetic acid delignification found efficient pretreatment with significant improvement in the enzymatic digestibility of rice straw. A cellulase dose of 20 filter paper units (FPU) released a maximum 63.21 g/L of reducing sugar with 94.45% hydrolysis yield and 64.64% glucose yield from rice straw, respectively. The effects of different pretreatment methods on biomass structure and complexity were investigated by FTIR, XRD and SEM analytical techniques. Finally the enzymatic hydrolysate of rice straw was used for ethanol production using developed Saccharomyces cerevisiae SR8. The developed yeast strain enabled efficient fermentation of xylose and glucose and produced higher ethanol production. Thus development of bioethanol production from lignocellulosic waste biomass is generic, applicable methodology and have great implication for using ‘green raw materials’ and producing ‘green products’ much needed today.

Keywords: rice straw, pretreatment, enzymatic hydrolysis, FPU, Saccharomyces cerevisiae SR8, ethanol fermentation

Procedia PDF Downloads 528
1252 Optimization of Highly Oriented Pyrolytic Graphite Crystals for Neutron Optics

Authors: Hao Qu, Xiang Liu, Michael Crosby, Brian Kozak, Andreas K. Freund

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The outstanding performance of highly oriented pyrolytic graphite (HOPG) as an optical element for neutron beam conditioning is unequaled by any other crystalline material in the applications of monochromator, analyzer, and filter. This superiority stems from the favorable nuclear properties of carbon (small absorption and incoherent scattering cross-sections, big coherent scattering length) and the specific crystalline structure (small thermal diffuse scattering cross-section, layered crystal structure). The real crystal defect structure revealed by imaging techniques is correlated with the parameters used in the mosaic model (mosaic spread, mosaic block size, uniformity). The diffraction properties (rocking curve width as determined by both the intrinsic mosaic spread and the diffraction process, peak and integrated reflectivity, filter transmission) as a function of neutron wavelength or energy can be predicted with high accuracy and reliability by diffraction theory using empirical primary extinction coefficients extracted from a great amount of existing experimental data. The results of these calculations are given as graphs and tables permitting to optimize HOPG characteristics (mosaic spread, thickness, curvature) for any given experimental situation.

Keywords: neutron optics, pyrolytic graphite, mosaic spread, neutron scattering, monochromator, analyzer

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1251 Nutritional Characteristics, Phytochemical and Antimicrobial Potential of Leaf Protein Concentrates from Huckleberry

Authors: Sodamade Abiodun, Adeboye Olubunmi Omolara

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Problems associated with protein malnutrition are still prevalent in third-world countries, leading to the constant search for plants that can serve as nutrients and medicinal purposes. Huckleberry is one of the plants that has been proven useful locally in the treatment of numerous ailments and diseases. A fresh sample of Huckleberry was collected from a vegetable garden situated near the Erelu dam of the Emmanuel Alayande College of Education campus, Oyo. The sample was authenticated at the forestry research institute of Nigeria (FRIN) Ibadan. The leaves of the plant were plucked and processed for leaf protein concentrates before proximate composition; mineral analysis phytochemical and antimicrobial properties of the leaf protein concentrates were determined using a standard method of analysis. The results of proximate constituents showed; moisture content; 9.89±0.051g/100g, Ash; 3.23±0.12g/100g, crude fat; 3.96±0.11g/100g and 61.27±0.56g/100g of Nitrogen free extractive results of the mineral analysis showed that the sample contains Mg; 0.081±0.00mg/100g, Ca; 42.30±0.05mg/100g, Na; 27.57±0.09mg/100g, K; 6.81±0.01mg/100g, P; 8.90±0.03mg/100g Fe; 0.51±0.00mg/100g, Zn; 0.021±0.00mg/100g, Cd; 0.04±0.04mg/100g, Pb; 0.002±0.00mg/100g, Cr; 0.041±0.00mg/100g while cadmium was not detected in the sample. The result of phytochemical analysis of leaf protein concentrates of the Huckleberry showed the presence of Alkaloid, Saponin, Flavonoid, Tanin, Coumarin, steroid, Terpenoid, cordial glycosides, Glycosides, Quinones, Anthocyanin, phytosterols, and phenols. Ethanolic extracts of the Huckleberry leaf protein concentrates showed that it contains bioactive compounds that are capable of eradicating some tested microorganisms; Staphylococcus aureus, Streptococcus pyogenes, Streptococcus faecalis, Pseudomonas aeruginosa, Klebisidlae pneumonia and Proteus merabilis. The results of the analysis of leaf protein concentrates of Huckleberry showed that the sample contains high nutrient and mineral constituents and phytochemical compounds that could make the sample useful for medicinal activities.

Keywords: huckleberry, mentha piperita, phytochemical, leaf protein concentrates, nutritional characteristics

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1250 The Effects of Virtual Reality Technology in Maternity Delivery: A Systematic Review and Meta-Analysis

Authors: Nuo Xu, Sijing Chen

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Background: Childbirth is considered a critical traumatic event throughout our lives, positively or negatively impacting the mother's physiology, psychology, and even the whole family. Adverse birth experiences, such as labor pain, anxiety, and fear can negatively impact the mother. Studies had shown that the immersive nature of VR can distract attention from pain and increase focus on interventions for pain relief. However, the existing studies that applied VR to maternal delivery were still in their infancy and showed disparate results, and the small sample size is not representative, so this review analyzed the effects of VR in labor, such as on maternal pain and anxiety, with a view to providing a basis for future applications. Search strategy: We searched Pubmed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wan-Fang database from the building to November 17, 2021. Selection Criteria: Randomized controlled trials (RCTs) that intervened the pregnant women aged 18-35 years with gestational >34 weeks and without complications with VR technology were contained within this review. Data Collection and Analysis: Two researchers completed the study selection, data extraction, and assessment of study quality. For quantitative data we used MD or SMD, and RR (risk ratio) for qualitative data. Random-effects model and 95% confidence interval (95% CI) were used. Main Results: 12 studies were included. Using VR could relieve pain during labor (MD=-1.81, 95% CI (-2.04, -1.57), P< 0.00001) and active period (SMD=-0.41, 95% CI (-0.68, -0.14), P= 0.003), reduce anxiety (SMD=-1.39, 95% CI (-1.99, -0.78), P< 0.00001) and improve satisfaction (RR = 1.32; 95% CI (1.10, 1.59); P = 0.003), but the effect on the duration of first (SMD=-1.12, 95% CI (-2.38, 0.13), P=0.08) and second (SMD=-0.22, 95% CI (-0.67, 0.24), P=0.35) stage of labor was not statistically significant. Conclusions: Compared with conventional care, VR technology can relieve labor pain and anxiety and improve satisfaction. However, extensive experimental validation is still needed.

Keywords: virtual reality, delivery, labor pain, anxiety, meta-analysis, systematic review

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1249 Spatio-Temporal Pest Risk Analysis with ‘BioClass’

Authors: Vladimir A. Todiras

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Spatio-temporal models provide new possibilities for real-time action in pest risk analysis. It should be noted that estimation of the possibility and probability of introduction of a pest and of its economic consequences involves many uncertainties. We present a new mapping technique that assesses pest invasion risk using online BioClass software. BioClass is a GIS tool designed to solve multiple-criteria classification and optimization problems based on fuzzy logic and level set methods. This research describes a method for predicting the potential establishment and spread of a plant pest into new areas using a case study: corn rootworm (Diabrotica spp.), tomato leaf miner (Tuta absoluta) and plum fruit moth (Grapholita funebrana). Our study demonstrated that in BioClass we can combine fuzzy logic and geographic information systems with knowledge of pest biology and environmental data to derive new information for decision making. Pests are sensitive to a warming climate, as temperature greatly affects their survival and reproductive rate and capacity. Changes have been observed in the distribution, frequency and severity of outbreaks of Helicoverpa armigera on tomato. BioClass has demonstrated to be a powerful tool for applying dynamic models and map the potential future distribution of a species, enable resource to make decisions about dangerous and invasive species management and control.

Keywords: classification, model, pest, risk

Procedia PDF Downloads 275
1248 Numerical Investigation and Optimization of the Effect of Number of Blade and Blade Type on the Suction Pressure and Outlet Mass Flow Rate of a Centrifugal Fan

Authors: Ogan Karabas, Suleyman Yigit

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Number of blade and blade type of centrifugal fans are the most decisive factor on the field of application, noise level, suction pressure and outlet mass flow rate. Nowadays, in order to determine these effects on centrifugal fans, numerical studies are carried out in addition to experimental studies. In this study, it is aimed to numerically investigate the changes of suction pressure and outlet mass flow rate values of a centrifugal fan according to the number of blade and blade type. Centrifugal fans of the same size with forward, backward and straight blade type were analyzed by using a simulation program and compared with each other. This analysis was carried out under steady state condition by selecting k-Ɛ turbulence model and air is assumed incompressible. Then, 16, 32 and 48 blade centrifugal fans were again analyzed by using same simulation program, and the optimum number of blades was determined for the suction pressure and the outlet mass flow rate. According to the results of the analysis, it was obtained that the suction pressure in the 32 blade fan was twice the value obtained in the 16 blade fan. In addition, the outlet mass flow rate increased by 45% with the increase in the number of blade from 16 to 32. There is no significant change observed on the suction pressure and outlet mass flow rate when the number of blades increased from 32 to 48. In the light of the analysis results, the optimum blade number was determined as 32.

Keywords: blade type, centrifugal fan, cfd, outlet mass flow rate, suction pressure

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1247 Workforce Optimization: Fair Workload Balance and Near-Optimal Task Execution Order

Authors: Alvaro Javier Ortega

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A large number of companies face the challenge of matching highly-skilled professionals to high-end positions by human resource deployment professionals. However, when the professional list and tasks to be matched are larger than a few dozens, this process result is far from optimal and takes a long time to be made. Therefore, an automated assignment algorithm for this workforce management problem is needed. The majority of companies are divided into several sectors or departments, where trained employees with different experience levels deal with a large number of tasks daily. Also, the execution order of all tasks is of mater consequence, due to some of these tasks just can be run it if the result of another task is provided. Thus, a wrong execution order leads to large waiting times between consecutive tasks. The desired goal is, therefore, creating accurate matches and a near-optimal execution order that maximizes the number of tasks performed and minimizes the idle time of the expensive skilled employees. The problem described before can be model as a mixed-integer non-linear programming (MINLP) as it will be shown in detail through this paper. A large number of MINLP algorithms have been proposed in the literature. Here, genetic algorithm solutions are considered and a comparison between two different mutation approaches is presented. The simulated results considering different complexity levels of assignment decisions show the appropriateness of the proposed model.

Keywords: employees, genetic algorithm, industry management, workforce

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1246 Optimization of Palm Oil Plantation Revitalization in North Sumatera

Authors: Juliza Hidayati, Sukardi, Ani Suryani, Sugiharto, Anas M. Fauzi

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The idea of making North Sumatera as a barometer of national oil palm industry requires efforts commodities and agro-industry development of oil palm. One effort that can be done is by successful execution plantation revitalization. The plantation Revitalization is an effort to accelerate the development of smallholder plantations, through expansion and replanting by help of palm Estate Company as business partner and bank financed plantation revitalization fund. Business partner agreement obliged and bound to make at least the same smallholder plantation productivity with business partners, so that the refund rate to banks become larger and prosperous people as a plantation owner. Generally low productivity of smallholder plantations under normal potential caused a lot of old and damaged plants with plant material at random. The purpose of revitalizing oil palm plantations is which are to increase their competitiveness through increased farm productivity. The research aims to identify potential criteria in influencing plantation productivity improvement priorities to be observed and followed up in order to improve the competitiveness of destinations and make North Sumatera barometer of national palm oil can be achieved. Research conducted with Analytical Network Process (ANP), to find the effect of dependency relationships between factors or criteria with the knowledge of the experts in order to produce an objective opinion and relevant depict the actual situation.

Keywords: palm barometer, acceleration of plantation development, productivity, revitalization

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1245 Performance Study of Experimental Ferritic Alloy with High Content of Molybdenum in Corrosive Environment of Soybean Methyl Biodiesel

Authors: Maurício N. Kleinberg, Ana P. R. N. Barroso, Frederico R. Silva, Natasha l. Gomes, Rodrigo F. Guimarães, Marcelo M. V. Parente, Jackson Q. Malveira

Abstract:

Increased production of biofuels, especially biodiesel, as an option to replace the diesel derived from oil is already a reality in countries seeking a renewable and environmentally friendly fuel, as is the case in Brazil. However, it is known that the use of fuels, renewable or not, implies that it is in contact with various metallic materials which may cause corrosion. In the search for more corrosion resistant materials has been experimentally observed that the addition of molybdenum in ferritic steels increases their protective character without significantly burdening the cost of production. In order to evaluate the effect of adding molybdenum, samples of commercial steel (austenitic, ferritic and carbon steel) and the experimental ferritic alloy with a high molybdenum content (5.3%) were immersed separately into biodiesel derived from transesterification of soy oil to monitor the corrosion process of these metal samples, and in parallel to analyze the oxidative degradation of biodiesel itself. During the immersion time of 258 days, biodiesel samples were taken for analysis of acidity, kinematic viscosity, density and refraction. Likewise, the metal samples were taken from the biodiesel to be weighed and microstructurally analyzed by light microscopy. The results obtained at the end of 258 days shown that biodiesel presented a considerable increase on the values of the studied parameters for all the samples. However, this increase was not able to produce significant mass loss in metallic samples. As regards the microstructural analysis, it showed the onset of surface oxidation on the carbon steel sample. As for the other samples, no significant surface changes were shown. These results are consistent with literature for short immersion times. It is concluded that the increase in the values of the studied parameters is not significant yet, probably due to the low time of immersion and exposure of the samples. Thus, it is necessary to continue the tests so that the objectives of this work are achieved.

Keywords: biodiesel, corrosion, immersion, experimental alloy

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1244 Deep Brain Stimulation and Motor Cortex Stimulation for Post-Stroke Pain: A Systematic Review and Meta-Analysis

Authors: Siddarth Kannan

Abstract:

Objectives: Deep Brain Stimulation (DBS) and Motor Cortex stimulation (MCS) are innovative interventions in order to treat various neuropathic pain disorders such as post-stroke pain. While each treatment has a varying degree of success in managing pain, comparative analysis has not yet been performed, and the success rates of these techniques using validated, objective pain scores have not been synthesised. The aim of this study was to compare the effect of pain relief offered by MCS and DBS on patients with post-stroke pain and to assess if either of these procedures offered better results. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPEROID CRD42021277542). Three databases were searched, and articles published from 2000 to June 2023 were included (last search date 25 June 2023). Meta-analysis was performed using random effects models. We evaluated the performance of DBS or MCS by assessing studies that reported pain relief using the Visual Analogue Scale (VAS). Data analysis of descriptive statistics was performed using SPSS (Version 27; IBM; Armonk; NY; USA). R statistics (Rstudio Version 4.0.1) was used to perform meta-analysis. Results: Of the 478 articles identified, 27 were included in the analysis (232 patients- 117 DBS & 115 MCS). The pooled number of patients who improved after DBS was 0.68 (95% CI, 0.57-0.77, I2=36%). The pooled number of patients who improved after MCS was 0.72 (95% CI, 0.62-0.80, I2=59%). Further sensitivity analysis was done to include only studies with a minimum of 5 patients in order to assess if there was any impact on the overall results. Nine studies each for DBS and MCS met these criteria. There seemed to be no significant difference in results. Conclusions: The use of surgical interventions such as DBS and MCS is an upcoming field for the treatment of post-stroke pain, with limited studies exploring and comparing these two techniques. While our study shows that MCS might be a slightly better treatment option, further research would need to be done in order to determine the appropriate surgical intervention for post-stroke pain.

Keywords: post-stroke pain, deep brain stimulation, motor cortex stimulation, pain relief

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1243 Coronary Artery Calcium Score and Statin Treatment Effect on Myocardial Infarction and Major Adverse Cardiovascular Event of Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis

Authors: Yusra Pintaningrum, Ilma Fahira Basyir, Sony Hilal Wicaksono, Vito A. Damay

Abstract:

Background: Coronary artery calcium (CAC) scores play an important role in improving prognostic accuracy and can be selectively used to guide the allocation of statin therapy for atherosclerotic cardiovascular disease outcomes and potentially associated with the occurrence of MACE (Major Adverse Cardiovascular Event) and MI (Myocardial Infarction). Objective: This systematic review and meta-analysis aim to analyze the findings of a study about CAC Score and statin treatment effect on MI and MACE risk. Methods: Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on PubMed, Cochrane Library, and Medline databases published in the last 20 years on “coronary artery calcium” AND “statin” AND “cardiovascular disease” Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results: Based on 11 studies included with a total of 1055 participants, we performed a meta-analysis and found that individuals with CAC score > 0 increased risk ratio of MI 8.48 (RR = 9.48: 95% CI: 6.22 – 14.45) times and MACE 2.48 (RR = 3.48: 95% CI: 2.98 – 4.05) times higher than CAC score 0 individual. Statin compared against non-statin treatment showed a statistically insignificant overall effect on the risk of MI (P = 0.81) and MACE (P = 0.89) in an individual with elevated CAC score 1 – 100 (P = 0.65) and > 100 (P = 0.11). Conclusions: This study found that an elevated CAC scores individual has a higher risk of MI and MACE than a non-elevated CAC score individual. There is no significant effect of statin compared against non-statin treatment to reduce MI and MACE in elevated CAC score individuals of 1 – 100 or > 100.

Keywords: coronary artery calcium, statin, cardiovascular disease, myocardial infarction, MACE

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1242 The Influence of Incorporating Coffee Grounds on Enhancing the Engineering Properties of Expansive Soils: Experimental Approach and Optimization

Authors: Bencheikh Messaouda, Aidoud Assia, Salima Boukour, Benamara Fatima Zohra, Boukhatem Ghania, Zegueur Chaouki Salah Eddine

Abstract:

The utilization of waste materials in civil engineering has gained widespread attention in recent years due to their adverse effects on the environment. One such waste material is coffee grounds, a black residue generated daily across the country after coffee brewing. Instead of disposing of it, there is a growing interest in repurposing it for various agricultural and industrial applications. Utilizing coffee grounds in geotechnical engineering, such as in road embankments, presents an opportunity for its valorization. The study aims to contribute to the valorization of coffee grounds by enhancing the physical and mechanical properties of clayey soils through their incorporation at varying weight percentages (3%, 6%, 9%, 12%) as partial replacements in these soils. This not only addresses the issue of coffee ground waste but also makes a tangible contribution to sustainable development. The findings demonstrate that incorporating coffee grounds generally has positive effects on the physical and mechanical properties of clayey soil. However, the extent of these effects depends on factors such as the quantity of coffee grounds added, the particle size of the grounds, and the characteristics of the soil. Additionally, coffee grounds can improve the compression and tensile strength of clayey soil, resulting in increased stability and reduced susceptibility to deformation under external forces.

Keywords: clay soil, coffee grounds, optimizing, improvement, valorization, waste

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1241 Optimization of the Dental Direct Digital Imaging by Applying the Self-Recognition Technology

Authors: Mina Dabirinezhad, Mohsen Bayat Pour, Amin Dabirinejad

Abstract:

This paper is intended to introduce the technology to solve some of the deficiencies of the direct digital radiology. Nowadays, digital radiology is the latest progression in dental imaging, which has become an essential part of dentistry. There are two main parts of the direct digital radiology comprised of an intraoral X-ray machine and a sensor (digital image receptor). The dentists and the dental nurses experience afflictions during the taking image process by the direct digital X-ray machine. For instance, sometimes they need to readjust the sensor in the mouth of the patient to take the X-ray image again due to the low quality of that. Another problem is, the position of the sensor may move in the mouth of the patient and it triggers off an inappropriate image for the dentists. It means that it is a time-consuming process for dentists or dental nurses. On the other hand, taking several the X-ray images brings some problems for the patient such as being harmful to their health and feeling pain in their mouth due to the pressure of the sensor to the jaw. The author provides a technology to solve the above-mentioned issues that is called “Self-Recognition Direct Digital Radiology” (SDDR). This technology is based on the principle that the intraoral X-ray machine is capable to diagnose the location of the sensor in the mouth of the patient automatically. In addition, to solve the aforementioned problems, SDDR technology brings out fewer environmental impacts in comparison to the previous version.

Keywords: Dental direct digital imaging, digital image receptor, digital x-ray machine, and environmental impacts

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1240 Collaborative Stylistic Group Project: A Drama Practical Analysis Application

Authors: Omnia F. Elkommos

Abstract:

In the course of teaching stylistics to undergraduate students of the Department of English Language and Literature, Faculty of Arts and Humanities, the linguistic tool kit of theories comes in handy and useful for the better understanding of the different literary genres: Poetry, drama, and short stories. In the present paper, a model of teaching of stylistics is compiled and suggested. It is a collaborative group project technique for use in the undergraduate diverse specialisms (Literature, Linguistics and Translation tracks) class. Students initially are introduced to the different linguistic tools and theories suitable for each literary genre. The second step is to apply these linguistic tools to texts. Students are required to watch videos performing the poems or play, for example, and search the net for interpretations of the texts by other authorities. They should be using a template (prepared by the researcher) that has guided questions leading students along in their analysis. Finally, a practical analysis would be written up using the practical analysis essay template (also prepared by the researcher). As per collaborative learning, all the steps include activities that are student-centered addressing differentiation and considering their three different specialisms. In the process of selecting the proper tools, the actual application and analysis discussion, students are given tasks that request their collaboration. They also work in small groups and the groups collaborate in seminars and group discussions. At the end of the course/module, students present their work also collaboratively and reflect and comment on their learning experience. The module/course uses a drama play that lends itself to the task: ‘The Bond’ by Amy Lowell and Robert Frost. The project results in an interpretation of its theme, characterization and plot. The linguistic tools are drawn from pragmatics, and discourse analysis among others.

Keywords: applied linguistic theories, collaborative learning, cooperative principle, discourse analysis, drama analysis, group project, online acting performance, pragmatics, speech act theory, stylistics, technology enhanced learning

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1239 The Estimation Method of Inter-Story Drift for Buildings Based on Evolutionary Learning

Authors: Kyu Jin Kim, Byung Kwan Oh, Hyo Seon Park

Abstract:

The seismic responses-based structural health monitoring system has been performed to reduce seismic damage. The inter-story drift ratio which is the major index of the seismic capacity assessment is employed for estimating the seismic damage of buildings. Meanwhile, seismic response analysis to estimate the structural responses of building demands significantly high computational cost due to increasing number of high-rise and large buildings. To estimate the inter-story drift ratio of buildings from the earthquake efficiently, this paper suggests the estimation method of inter-story drift for buildings using an artificial neural network (ANN). In the method, the radial basis function neural network (RBFNN) is integrated with optimization algorithm to optimize the variable through evolutionary learning that refers to evolutionary radial basis function neural network (ERBFNN). The estimation method estimates the inter-story drift without seismic response analysis when the new earthquakes are subjected to buildings. The effectiveness of the estimation method is verified through a simulation using multi-degree of freedom system.

Keywords: structural health monitoring, inter-story drift ratio, artificial neural network, radial basis function neural network, genetic algorithm

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1238 The Effect of Psychosomatic Aspects of Endometriosis on Marital Relationships and Quality of Life: A Review Study

Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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1237 The Role of Immunologic Diamonds in Dealing with Mycobacterium Tuberculosis; Responses of Immune Cells in Affliction to the Respiratory Tuberculosis

Authors: Seyyed Mohammad Amin Mousavi Sagharchi, Elham Javanroudi

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Introduction: Tuberculosis (TB) is a known disease with hidden features caused by Mycobacterium tuberculosis (MTB). This disease, which is one of the 10 deadliest in the world, has caused millions of deaths in recent decades. Furthermore, TB is responsible for infecting about 30% population of world. Like any infection, TB can activate the immune system by locating and colonization in the human body, especially in the alveoli. TB is granulomatosis, so MTB can absorb the host’s immune cells and other cells to form granuloma. Method: Different databases (e.g., PubMed) were recruited to prepare this paper and fulfill our goals to search and find effective papers and investigations. Results: Immune response to MTB is related to T cell killers and contains CD1, CD4, and CD8 T lymphocytes. CD1 lymphocytes can recognize glycolipids, which highly exist in the Mycobacterial fatty cell wall. CD4 lymphocytes and macrophages form granuloma, and it is the main line of immune response to Mycobacteria. On the other hand, CD8 cells have cytolytic function for directly killing MTB by secretion of granulysin. Other functions and secretion to the deal are interleukin-12 (IL-12) by induction of expression interferon-γ (INF-γ) for macrophages activation and creating a granuloma, and tumor necrosis factor (TNF) by promoting macrophage phagolysosomal fusion. Conclusion: Immune cells in battle with MTB are macrophages, dendritic cells (DCs), neutrophils, and natural killer (NK) cells. These immune cells can recognize the Mycobacterium by various receptors, including Toll-like receptors (TLRs), Nod-like receptors (NLRs), and C-type lectin receptors (CLRs) located in the cell surface. In human alveoli exist about 50 dendritic macrophages, which have close communication with other immune cells in the circulating system and epithelial cells to deal with Mycobacteria. Against immune cells, MTB handles some factors (e.g., cordfactor, O-Ag, lipoarabinomannan, sulfatides, and adenylate cyclase) and practical functions (e.g., inhibition of macrophages).

Keywords: mycobacterium tuberculosis, immune responses, immunological mechanisms, respiratory tuberculosis

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1236 The Importance and Feasibility of Hospital Interventions for Patient Aggression and Violence Against Physicians in China: A Delphi Study

Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic

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Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.

Keywords: patient aggression and violence, hospital interventions, feasibility, importance

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1235 Investigations of the Crude Oil Distillation Preheat Section in Unit 100 of Abadan Refinery and Its Recommendation

Authors: Mahdi GoharRokhi, Mohammad H. Ruhipour, Mohammad R. ZamaniZadeh, Mohsen Maleki, Yusef Shamsayi, Mahdi FarhaniNejad, Farzad FarrokhZadeh

Abstract:

Possessing massive resources of natural gas and petroleum, Iran has a special place among all other oil producing countries, according to international institutions of energy. In order to use these resources, development and functioning optimization of refineries and industrial units is mandatory. Heat exchanger is one of the most important and strategic equipment which its key role in the process of production is clear to everyone. For instance, if the temperature of a processing fluid is not set as needed by heat exchangers, the specifications of desired product can change profoundly. Crude oil enters a network of heat exchangers in atmospheric distillation section before getting into the distillation tower; in this case, well-functioning of heat exchangers can significantly affect the operation of distillation tower. In this paper, different scenarios for pre-heating of oil are studied using oil and gas simulation software, and the results are discussed. As we reviewed various scenarios, adding a heat exchanger to pre-heating network is proposed as the most efficient factor in improving all governing parameters of the tower i.e. temperature, pressure, and reflux rate. This exchanger is embedded in crude oil’s path. Crude oil enters the exchanger after E-101 and exchanges heat with discharging kerosene pump around from E-136. As depicted in the results, it will efficiently assist the improvement of process operation and side expenses.

Keywords: atmospheric distillation unit, heat exchanger, preheat, simulation

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1234 Attitudes of the Indigenous People from Providencia, Amazon towards the Bora Language

Authors: Angela Maria Sarmiento

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Since the end of the 19th century, the Bora people struggled to survive two stages of colonial domination, which resulted in situations of forced contact with the Western world. Their inclusion in global designs altered the configuration of their local spaces and social practices; thus the Bora language was affected and prone to transformation. This descriptive, interpretive study, within the indigenous and minoritized groups’ research field, aimed at analysing the linguistic attitudes as well as the contextual situation of the Bora language in Providencia, an ancestral territory and a speech community contained in the midst of the Colombian Amazon rainforest. Through the inquiry of their sociolinguistic practices, this study also considered the effects of the course of events derived from the rubber exploitation in the late 19th century, and the arrival of the Capuchin’s mission in the early 20th century. The methodology used in this study had an ethnographic approach, which allowed the researcher to study the social phenomena from the perspective of the participants. Fieldwork, diary, field notes, and semi-structured interviews were conducted and then triangulated with participant observations. The findings of this study suggest that there is a transition from current individual bilingualism towards Spanish monolingualism; this is enhanced by the absence of a functional distribution of the three varieties (Bora, Huitoto, and Spanish). Also, the positive attitudes towards the Spanish language are based on its functionality while positive attitudes towards the Bora language mostly refer to pride and identity. Negative attitudes are only directed towards the Bora language. In the search for the roots of these negative attitudes, appeared the traumatic experiences of the rubber exploitation and the indigenous experiences at the capuchin’s boarding school. Finally, the situation of the Bora language can be configured as a social fact strongly connected to previous years of colonial dominations and to the current and continuous incursion of new global-colonial designs.

Keywords: Bora language, language contact, linguistic attitudes, speech communities

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1233 The Publication Impact of London’s Air Ambulance on the Field of Pre-Hospital Medicine and Its Application to Air Ambulances Internationally: A Bibliometric Analysis

Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

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Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

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