Search results for: infant mortality rate
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9094

Search results for: infant mortality rate

5404 Using HABIT to Estimate the Concentration of CO2 and H2SO4 for Kuosheng Nuclear Power Plant

Authors: Y. Chiang, W. Y. Li, J. R. Wang, S. W. Chen, W. S. Hsu, J. H. Yang, Y. S. Tseng, C. Shih

Abstract:

In this research, the HABIT code was used to estimate the concentration under the CO2 and H2SO4 storage burst conditions for Kuosheng nuclear power plant (NPP). The Final Safety Analysis Report (FSAR) and reports were used in this research. In addition, to evaluate the control room habitability for these cases, the HABIT analysis results were compared with the R.G. 1.78 failure criteria. The comparison results show that the HABIT results are below the criteria. Additionally, some sensitivity studies (stability classification, wind speed and control room intake rate) were performed in this study.

Keywords: BWR, HABIT, habitability, Kuosheng

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5403 Maternal and Neonatal Outcome Analysis in Preterm Abdominal Delivery Underwent Umbilical Cord Milking Compared to Early Cord Clamping

Authors: Herlangga Pramaditya, Agus Sulistyono, Risa Etika, Budiono Budiono, Alvin Saputra

Abstract:

Preterm birth and anemia of prematurity are the most common cause of morbidity and mortality in neonates, and anemia of the preterm neonates has become a major issue. The timing of umbilical cord clamping after a baby is born determines the amount of blood transferred from the placenta to fetus, Delayed Cord Clamping (DCC) has proven to prevent anemia in the neonates but it is constrained concern regarding the delayed in neonatal resuscitation. Umbilical Cord Milking (UCM) could be an alternative method for clamping the umbilical cord due to the active blood transfer from the placenta to the fetus. The aim of this study was to analyze the difference between maternal and neonatal outcome in preterm abdominal delivery who underwent UCM compared to ECC. This was an experimental study with randomized post-test only control design. Analyzed maternal and neonatal outcomes, significant P values (P <0.05). Statistical comparison was carried out using Paired Samples t-test (α two tailed 0,05). The result was the mean of preoperative mother’s hemoglobin in UCM group compared to ECC (10,9 + 0,9 g/dL vs 10,4 + 0,9 g/dL) and postoperative (11,1 + 1,1 g/dL vs 10,5 + 0,7 g/dL), the delta was (0,2 + 0,7 vs 0,1 + 0,6.). It showed no significant difference (P=0,395 vs 0,627). The mean of 3rd phase labor duration in UCM group vs ECC was (20,5 + 3,5 second vs 21,1 + 3,3 second), showed insignificant difference (P=0,634). The amount of bleeding after delivery in UCM group compared to ECC has the median of 190 cc (100-280cc) vs 210 cc (150-330 cc) showed insignificant difference (P=0,083) so the incidence of post-partum bleeding was not found. The mean of the neonates hemoglobin, hematocrit and erythrocytes of UCM group compared to ECC was (19,3 + 0,7 vs 15,9 + 0,8 g/dl), (57,1 + 3,6 % vs 47,2 + 2,8 %), and (5,4 + 0,4 g/dl vs 4,5 + 0,3 g/dl) showed significant difference (P<0,0001). There was no baby in UCM group received blood transfusion and one baby in the control ECC group received blood transfusion was found. Umbilical Cord Milking has shown to increase the baby’s blood component such as hemoglobin, hematocrit, and erythrocytes 6 hours after birth as well as lowering the incidence of blood transfusions. Maternal and neonatal morbidity were not found. Umbilical Cord Milking was the act of clamping the umbilical cord that was more beneficial to the baby and no adverse or negative effects on the mother.

Keywords: umbilical cord milking, early cord clamping, maternal and neonatal outcome, preterm, abdominal delivery

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5402 Exercise and Geriatric Depression: a Scoping Review of the Research Evidence

Authors: Samira Mehrabi

Abstract:

Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

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5401 Effects of Supplementation of Nano-Particle Zinc Oxide and Mannan-Oligosaccharide (MOS) on Growth, Feed Utilization, Fatty Acid Profile, Intestinal Morphology, and Hematology in Nile tilapia, Oreochromis niloticus (L.) fry

Authors: Tewodros Abate Alemayehu, Abebe Getahun, Akewake Geremew, Dawit Solomon Demeke, John Recha, Dawit Solomon, Gebremedihin Ambaw, Fasil Dawit Moges

Abstract:

The purpose of this study was to examine the effects of supplementation of zinc oxide (ZnO) nanoparticles and Mannan-oligosaccharide (MOS) on growth performance, feed utilization, fatty acid profiles, hematology, and intestinal morphology of Chamo strain Nile tilapia Oreochromis niloticus (L.) fry reared at optimal temperature (28.62 ± 0.11 ⁰C). Nile tilapia fry (initial weight 1.45 ± 0.01g) were fed basal diet/control diet (Diet-T1), 6 g kg-¹ MOS supplemented diet (Diet-T2), 4 mg ZnO-NPs supplemented diet (Diet-T3), 4 mg ZnO-Bulk supplemented diet (Diet-T4), a combination of 6 g kg-¹ MOS and 4 mg ZnO-Bulk supplemented diet (Diet-T5) and combination of 6 g kg-¹ MOS and 4 mg ZnO-NPs supplemented diet (Diet-T6). Randomly, duplicate aquariums for each diet were assigned and hand-fed to apparent satiation three times daily (08:00, 12:00, and 16:00) for 12 weeks. Fish fed MOS, ZnO-NPs, and a combination of MOS and ZnO-Bulk supplemented diet had higher weight gain, Daily Growth Rate (DGR), and Specific Growth Rate (SGR) than fish fed the basal diet and other feeding groups, although the effect was not significant. According to the GC analysis, Nile tilapia was supplemented with 6 g kg-¹ MOS, 4 mg ZnO-NPs, or a combination of ZnO-NPs, and MOS showed the highest content of EPA, DHA, and higher ratios of PUFA/SFA than other feeding groups. Mean villi length in the proximal and middle portion of the Nile tilapia intestine was affected significantly (p<0.05) by diet. Fish fed Diet-T2 and Diet-T3 had significantly higher villi lengths in the proximal and middle portions of the intestine compared to other feeding groups. The inclusion of additives significantly improved goblet numbers at the proximal, middle, and distal portions of the intestine. Supplementation of additives had also improved some hematological parameters compared with control groups. In conclusion, dietary supplementation of additives MOS and ZnO-NPs could confer benefits on growth performance, fatty acid profiles, hematology, and intestinal morphology of Chamo strain Nile tilapia.

Keywords: chamo strain nile tilapia, fatty acid profile, hematology, intestinal morphology, MOS, ZnO-Bulk, ZnO-NPs

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5400 Quantifying Automation in the Architectural Design Process via a Framework Based on Task Breakdown Systems and Recursive Analysis: An Exploratory Study

Authors: D. M. Samartsev, A. G. Copping

Abstract:

As with all industries, architects are using increasing amounts of automation within practice, with approaches such as generative design and use of AI becoming more commonplace. However, the discourse on the rate at which the architectural design process is being automated is often personal and lacking in objective figures and measurements. This results in confusion between people and barriers to effective discourse on the subject, in turn limiting the ability of architects, policy makers, and members of the public in making informed decisions in the area of design automation. This paper proposes the use of a framework to quantify the progress of automation within the design process. The use of a reductionist analysis of the design process allows it to be quantified in a manner that enables direct comparison across different times, as well as locations and projects. The methodology is informed by the design of this framework – taking on the aspects of a systematic review but compressed in time to allow for an initial set of data to verify the validity of the framework. The use of such a framework of quantification enables various practical uses such as predicting the future of the architectural industry with regards to which tasks will be automated, as well as making more informed decisions on the subject of automation on multiple levels ranging from individual decisions to policy making from governing bodies such as the RIBA. This is achieved by analyzing the design process as a generic task that needs to be performed, then using principles of work breakdown systems to split the task of designing an entire building into smaller tasks, which can then be recursively split further as required. Each task is then assigned a series of milestones that allow for the objective analysis of its automation progress. By combining these two approaches it is possible to create a data structure that describes how much various parts of the architectural design process are automated. The data gathered in the paper serves the dual purposes of providing the framework with validation, as well as giving insights into the current situation of automation within the architectural design process. The framework can be interrogated in many ways and preliminary analysis shows that almost 40% of the architectural design process has been automated in some practical fashion at the time of writing, with the rate at which progress is made slowly increasing over the years, with the majority of tasks in the design process reaching a new milestone in automation in less than 6 years. Additionally, a further 15% of the design process is currently being automated in some way, with various products in development but not yet released to the industry. Lastly, various limitations of the framework are examined in this paper as well as further areas of study.

Keywords: analysis, architecture, automation, design process, technology

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5399 Numerical Study of a 6080HP Open Drip Proof (ODP) Motor

Authors: Feng-Hisang Lai

Abstract:

CFD(Computational Fluid Dynamics) is conducted to numerically study the flow and heat transfer features of a two-pole, 6,080HP, 60Hz, 3,150V open drip-proof (ODP) motor. The stator and rotor cores in this high voltage induction motor are segmented with the use of spacers for cooling purposes, which leads to difficulties in meshing when the entire system is to be simulated. The system is divided into 4 parts, meshed separately and then combined using interfaces. The deviation between the CFD and experimental results in temperature and flow rate is less than 10%. The internal flow is further examined and a final design is proposed to reduce the winding temperature by 10 degrees.

Keywords: CFD, open drip proof, induction motor, cooling

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5398 Effects of Using a Recurrent Adverse Drug Reaction Prevention Program on Safe Use of Medicine among Patients Receiving Services at the Accident and Emergency Department of Songkhla Hospital Thailand

Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn

Abstract:

Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.

Keywords: recurrent drug, adverse reaction, safety, use of medicine

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5397 In silico Model of Transamination Reaction Mechanism

Authors: Sang-Woo Han, Jong-Shik Shin

Abstract:

w-Transaminase (w-TA) is broadly used for synthesizing chiral amines with a high enantiopurity. However, the reaction mechanism of w-TA has been not well studied, contrary to a-transaminase (a-TA) such as AspTA. Here, we propose in silico model on the reaction mechanism of w-TA. Based on the modeling results which showed large free energy gaps between external aldimine and quinonoid on deamination (or ketimine and quinonoid on amination), withdrawal of Ca-H seemed as a critical step which determines the reaction rate on both amination and deamination reactions, which is consistent with previous researches. Hyperconjugation was also observed in both external aldimine and ketimine which weakens Ca-H bond to elevate Ca-H abstraction.

Keywords: computational modeling, reaction intermediates, w-transaminase, in silico model

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5396 The Routine Use of a Negative Pressure Incision Management System in Vascular Surgery: A Case Series

Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

Abstract:

Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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5395 Efficient Use of Energy through Incorporation of a Gas Turbine in Methanol Plant

Authors: M. Azadi, N. Tahouni, M. H. Panjeshahi

Abstract:

A techno-economic evaluation for efficient use of energy in a large scale industrial plant of methanol is carried out. This assessment is based on integration of a gas turbine with an existing plant of methanol in which the outlet gas products of exothermic reactor is expanded to power generation. Also, it is decided that methanol production rate is constant through addition of power generation system to the existing methanol plant. Having incorporated a gas turbine with the existing plant, the economic results showed total investment of MUSD 16.9, energy saving of 3.6 MUSD/yr with payback period of approximately 4.7 years.

Keywords: energy saving, methanol, gas turbine, power generation

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5394 Forecasting Regional Data Using Spatial Vars

Authors: Taisiia Gorshkova

Abstract:

Since the 1980s, spatial correlation models have been used more often to model regional indicators. An increasingly popular method for studying regional indicators is modeling taking into account spatial relationships between objects that are part of the same economic zone. In 2000s the new class of model – spatial vector autoregressions was developed. The main difference between standard and spatial vector autoregressions is that in the spatial VAR (SpVAR), the values of indicators at time t may depend on the values of explanatory variables at the same time t in neighboring regions and on the values of explanatory variables at time t-k in neighboring regions. Thus, VAR is a special case of SpVAR in the absence of spatial lags, and the spatial panel data model is a special case of spatial VAR in the absence of time lags. Two specifications of SpVAR were applied to Russian regional data for 2000-2017. The values of GRP and regional CPI are used as endogenous variables. The lags of GRP, CPI and the unemployment rate were used as explanatory variables. For comparison purposes, the standard VAR without spatial correlation was used as “naïve” model. In the first specification of SpVAR the unemployment rate and the values of depending variables, GRP and CPI, in neighboring regions at the same moment of time t were included in equations for GRP and CPI respectively. To account for the values of indicators in neighboring regions, the adjacency weight matrix is used, in which regions with a common sea or land border are assigned a value of 1, and the rest - 0. In the second specification the values of depending variables in neighboring regions at the moment of time t were replaced by these values in the previous time moment t-1. According to the results obtained, when inflation and GRP of neighbors are added into the model both inflation and GRP are significantly affected by their previous values, and inflation is also positively affected by an increase in unemployment in the previous period and negatively affected by an increase in GRP in the previous period, which corresponds to economic theory. GRP is not affected by either the inflation lag or the unemployment lag. When the model takes into account lagged values of GRP and inflation in neighboring regions, the results of inflation modeling are practically unchanged: all indicators except the unemployment lag are significant at a 5% significance level. For GRP, in turn, GRP lags in neighboring regions also become significant at a 5% significance level. For both spatial and “naïve” VARs the RMSE were calculated. The minimum RMSE are obtained via SpVAR with lagged explanatory variables. Thus, according to the results of the study, it can be concluded that SpVARs can accurately model both the actual values of macro indicators (particularly CPI and GRP) and the general situation in the regions

Keywords: forecasting, regional data, spatial econometrics, vector autoregression

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5393 CFD Simulation of Forced Convection Nanofluid Heat Transfer in the Automotive Radiator

Authors: Sina Movafagh, Younes Bakhshan

Abstract:

Heat transfer of coolant flow through the automobile radiators is of great importance for the optimization of fuel consumption. In this study, the heat transfer performance of the automobile radiator is evaluated numerically. Different concentrations of nanofluids have been investigated by the addition of Al2O3 nano-particles into the water. Also, the effect of the inlet temperature of nanofluid on the performance of radiator is studied. Results show that with an increase of inlet temperature the outlet temperature and pressure drop along the radiator increase. Also, it has been observed that increase of nono-particle concentration will result in an increase in heat transfer rate within the radiator.

Keywords: heat transfer, nanofluid, car radiator, CFD simulation

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5392 Influence of Smoking on Fine And Ultrafine Air Pollution Pm in Their Pulmonary Genetic and Epigenetic Toxicity

Authors: Y. Landkocz, C. Lepers, P.J. Martin, B. Fougère, F. Roy Saint-Georges. A. Verdin, F. Cazier, F. Ledoux, D. Courcot, F. Sichel, P. Gosset, P. Shirali, S. Billet

Abstract:

In 2013, the International Agency for Research on Cancer (IARC) classified air pollution and fine particles as carcinogenic to humans. Causal relationships exist between elevated ambient levels of airborne particles and increase of mortality and morbidity including pulmonary diseases, like lung cancer. However, due to a double complexity of both physicochemical Particulate Matter (PM) properties and tumor mechanistic processes, mechanisms of action remain not fully elucidated. Furthermore, because of several common properties between air pollution PM and tobacco smoke, like the same route of exposure and chemical composition, potential mechanisms of synergy could exist. Therefore, smoking could be an aggravating factor of the particles toxicity. In order to identify some mechanisms of action of particles according to their size, two samples of PM were collected: PM0.03 2.5 and PM0.33 2.5 in the urban-industrial area of Dunkerque. The overall cytotoxicity of the fine particles was determined on human bronchial cells (BEAS-2B). Toxicological study focused then on the metabolic activation of the organic compounds coated onto PM and some genetic and epigenetic changes induced on a co-culture model of BEAS-2B and alveolar macrophages isolated from bronchoalveolar lavages performed in smokers and non-smokers. The results showed (i) the contribution of the ultrafine fraction of atmospheric particles to genotoxic (eg. DNA double-strand breaks) and epigenetic mechanisms (eg. promoter methylation) involved in tumor processes, and (ii) the influence of smoking on the cellular response. Three main conclusions can be discussed. First, our results showed the ability of the particles to induce deleterious effects potentially involved in the stages of initiation and promotion of carcinogenesis. The second conclusion is that smoking affects the nature of the induced genotoxic effects. Finally, the in vitro developed cell model, using bronchial epithelial cells and alveolar macrophages can take into account quite realistically, some of the existing cell interactions existing in the lung.

Keywords: air pollution, fine and ultrafine particles, genotoxic and epigenetic alterations, smoking

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5391 Micro-Milling Process Development of Advanced Materials

Authors: M. A. Hafiz, P. T. Matevenga

Abstract:

Micro-level machining of metals is a developing field which has shown to be a prospective approach to produce features on the parts in the range of a few to a few hundred microns with acceptable machining quality. It is known that the mechanics (i.e. the material removal mechanism) of micro-machining and conventional machining have significant differences due to the scaling effects associated with tool-geometry, tool material and work piece material characteristics. Shape memory alloys (SMAs) are those metal alloys which display two exceptional properties, pseudoelasticity and the shape memory effect (SME). Nickel-titanium (NiTi) alloys are one of those unique metal alloys. NiTi alloys are known to be difficult-to-cut materials specifically by using conventional machining techniques due to their explicit properties. Their high ductility, high amount of strain hardening, and unusual stress–strain behaviour are the main properties accountable for their poor machinability in terms of tool wear and work piece quality. The motivation of this research work was to address the challenges and issues of micro-machining combining with those of machining of NiTi alloy which can affect the desired performance level of machining outputs. To explore the significance of range of cutting conditions on surface roughness and tool wear, machining tests were conducted on NiTi. Influence of different cutting conditions and cutting tools on surface and sub-surface deformation in work piece was investigated. Design of experiments strategy (L9 Array) was applied to determine the key process variables. The dominant cutting parameters were determined by analysis of variance. These findings showed that feed rate was the dominant factor on surface roughness whereas depth of cut found to be dominant factor as far as tool wear was concerned. The lowest surface roughness was achieved at the feed rate of equal to the cutting edge radius where as the lowest flank wear was observed at lowest depth of cut. Repeated machining trials have yet to be carried out in order to observe the tool life, sub-surface deformation and strain induced hardening which are also expecting to be amongst the critical issues in micro machining of NiTi. The machining performance using different cutting fluids and strategies have yet to be studied.

Keywords: nickel titanium, micro-machining, surface roughness, machinability

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5390 Discrimination during a Resume Audit: The Impact of Job Context in Hiring

Authors: Alexandra Roy

Abstract:

Building on literature on cognitive matching and social categorization and using the correspondence testing method, we test the interaction effect of person characteristics (Gender with physical attractiveness) and job context (client contact, industry status, coworker contact). As expected, while findings show a strong impact of gender with beauty on hiring chances, job context characteristics have also a significant overall effect of this hiring outcome. Moreover, the rate of positive responses varies according some of the recruiter’s characteristics. Results are robust to various sensitivity checks. Implications of the results, limitations of the study, and directions for future research are discussed.

Keywords: correspondence testing, discrimination, hiring, physical attractiveness

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5389 Algorithm Development of Individual Lumped Parameter Modelling for Blood Circulatory System: An Optimization Study

Authors: Bao Li, Aike Qiao, Gaoyang Li, Youjun Liu

Abstract:

Background: Lumped parameter model (LPM) is a common numerical model for hemodynamic calculation. LPM uses circuit elements to simulate the human blood circulatory system. Physiological indicators and characteristics can be acquired through the model. However, due to the different physiological indicators of each individual, parameters in LPM should be personalized in order for convincing calculated results, which can reflect the individual physiological information. This study aimed to develop an automatic and effective optimization method to personalize the parameters in LPM of the blood circulatory system, which is of great significance to the numerical simulation of individual hemodynamics. Methods: A closed-loop LPM of the human blood circulatory system that is applicable for most persons were established based on the anatomical structures and physiological parameters. The patient-specific physiological data of 5 volunteers were non-invasively collected as personalized objectives of individual LPM. In this study, the blood pressure and flow rate of heart, brain, and limbs were the main concerns. The collected systolic blood pressure, diastolic blood pressure, cardiac output, and heart rate were set as objective data, and the waveforms of carotid artery flow and ankle pressure were set as objective waveforms. Aiming at the collected data and waveforms, sensitivity analysis of each parameter in LPM was conducted to determine the sensitive parameters that have an obvious influence on the objectives. Simulated annealing was adopted to iteratively optimize the sensitive parameters, and the objective function during optimization was the root mean square error between the collected waveforms and data and simulated waveforms and data. Each parameter in LPM was optimized 500 times. Results: In this study, the sensitive parameters in LPM were optimized according to the collected data of 5 individuals. Results show a slight error between collected and simulated data. The average relative root mean square error of all optimization objectives of 5 samples were 2.21%, 3.59%, 4.75%, 4.24%, and 3.56%, respectively. Conclusions: Slight error demonstrated good effects of optimization. The individual modeling algorithm developed in this study can effectively achieve the individualization of LPM for the blood circulatory system. LPM with individual parameters can output the individual physiological indicators after optimization, which are applicable for the numerical simulation of patient-specific hemodynamics.

Keywords: blood circulatory system, individual physiological indicators, lumped parameter model, optimization algorithm

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5388 The Evaluation of the Impact of Tobacco Heating System and Conventional Cigarette Smoking on Self Reported Oral Symptoms (Dry Mouth, Halitosis, Burning Sensation, Taste Changes) and Salivary Flow Rate: A Cross-sectional Study

Authors: Ella Sever, Irena Glažar, Ema Saltović

Abstract:

Conventional cigarette smoking is associated with an increased risk of oral diseases and oral symptoms such as dry mouth, bad breath, burning sensation, and changes in taste sensation. The harmful effects of conventional cigarette smoking on oral health have been extensively studied previously. However, there is a severe lack of studies investigating the effects of Tobacco Heating System (THS) on oral structures. As a preventive measure, a new alternative Tobacco THS has been developed, and according to the manufacturer, it has fewer potentially harmful and harmful constituents and consequently, lowers the risk of developing tobacco-related diseases. The aim is to analyze the effects of conventional cigarettes and THS on salivary flow rate (SFR), and self-reported oral symptoms.The stratified cross-sectional study included 90 subjects divided into three groups: THS smokers, conventional cigarette smokers, and nonsmokers. The subjects completed questionnaires on smoking habits, and symptoms (dry mouth, bad breath, burning sensation, and changes in taste sensation). SFR test were performed on each subject. The lifetime exposure to smoking was calculated using the Brinkman index (BI). Participants were 20-55 years old (median 31), and 66.67 % were female. The study included three groups of equal size (n = 20), and no statistically significant differences were found between the groups in terms of age (p = 0.632), sex (p = 1.0), and lifetime exposure to smoking (the BI) (p=0,129). Participants from the smoking group had an average of 10 (2-30) years of smoking experience in the conventional cigarettes group and 6 (1-20) years of smoking experience in the THS group. Daily consumption of cigarettes/heets per day was the same for both smokers’ groups (12(2-20) cigarettes/heets per day). The self-reported symptoms were present in 40 % of participants in the smokers group. There were significant differences in the presence of halitosis (p = 0.025) and taste sensation (p=0.013). There were no statistical differences in the presence of dry mouth (p =0.416) and burning sensation (0.7). The SFR differed between groups (p < 0.001) and was significantly lower in the THS and conventional cigarette smokers’ groups than the nonsmokers’ group. There were no significant differences between THS smokers and conventional cigarette smokers. The results of the study show that THS products have a similar effect to conventional cigarettes on oral cavity structures, especially in terms of SFR, self-reported halitosis, and changes in taste.

Keywords: oral health, tobacco products, halitosis, cigarette smoking

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5387 Counting Fishes in Aquaculture Ponds: Application of Imaging Sonars

Authors: Juan C. Gutierrez-Estrada, Inmaculada Pulido-Calvo, Ignacio De La Rosa, Antonio Peregrin, Fernando Gomez-Bravo, Samuel Lopez-Dominguez, Alejandro Garrocho-Cruz, Jairo Castro-Gutierrez

Abstract:

The semi-intensive aquaculture in traditional earth ponds is the main rearing system in Southern Spain. These fish rearing systems are approximately two thirds of aquatic production in this area which has made a significant contribution to the regional economy in recent years. In this type of rearing system, a crucial aspect is the correct quantification and control of the fish abundance in the ponds because the fish farmer knows how many fishes he puts in the ponds but doesn’t know how many fishes will harvest at the end of the rear period. This is a consequence of the mortality induced by different causes as pathogen agents as parasites, viruses and bacteria and other factors as predation of fish-eating birds and poaching. Track the fish abundance in these installations is very difficult because usually the ponds take up a large area of land and the management of the water flow is not automatized. Therefore, there is a very high degree of uncertainty on the abundance fishes which strongly hinders the management and planning of the sales. A novel and non-invasive procedure to count fishes in the ponds is by the means of imaging sonars, particularly fixed systems and/or linked to aquatic vehicles as Remotely Operated Vehicles (ROVs). In this work, a method based on census stations procedures is proposed to evaluate the fish abundance estimation accuracy using images obtained of multibeam sonars. The results indicate that it is possible to obtain a realistic approach about the number of fishes, sizes and therefore the biomass contained in the ponds. This research is included in the framework of the KTTSeaDrones Project (‘Conocimiento y transferencia de tecnología sobre vehículos aéreos y acuáticos para el desarrollo transfronterizo de ciencias marinas y pesqueras 0622-KTTSEADRONES-5-E’) financed by the European Regional Development Fund (ERDF) through the Interreg V-A Spain-Portugal Programme (POCTEP) 2014-2020.

Keywords: census station procedure, fish biomass, semi-intensive aquaculture, multibeam sonars

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5386 Horizontal Cooperative Game Theory in Hotel Revenue Management

Authors: Ririh Rahma Ratinghayu, Jayu Pramudya, Nur Aini Masruroh, Shi-Woei Lin

Abstract:

This research studies pricing strategy in cooperative setting of hotel duopoly selling perishable product under fixed capacity constraint by using the perspective of managers. In hotel revenue management, competitor’s average room rate and occupancy rate should be taken into manager’s consideration in determining pricing strategy to generate optimum revenue. This information is not provided by business intelligence or available in competitor’s website. Thus, Information Sharing (IS) among players might result in improved performance of pricing strategy. IS is widely adopted in the logistics industry, but IS within hospitality industry has not been well-studied. This research put IS as one of cooperative game schemes, besides Mutual Price Setting (MPS) scheme. In off-peak season, hotel manager arranges pricing strategy to offer promotion package and various kinds of discounts up to 60% of full-price to attract customers. Competitor selling homogenous product will react the same, then triggers a price war. Price war which generates lower revenue may be avoided by creating collaboration in pricing strategy to optimize payoff for both players. In MPS cooperative game, players collaborate to set a room rate applied for both players. Cooperative game may avoid unfavorable players’ payoff caused by price war. Researches on horizontal cooperative game in logistics show better performance and payoff for the players, however, horizontal cooperative game in hotel revenue management has not been demonstrated. This paper aims to develop hotel revenue management models under duopoly cooperative schemes (IS & MPS), which are compared to models under non-cooperative scheme too. Each scheme has five models, Capacity Allocation Model; Demand Model; Revenue Model; Optimal Price Model; and Equilibrium Price Model. Capacity Allocation Model and Demand Model employs self-hotel and competitor’s full and discount price as predictors under non-linear relation. Optimal price is obtained by assuming revenue maximization motive. Equilibrium price is observed by interacting self-hotel’s and competitor’s optimal price under reaction equation. Equilibrium is analyzed using game theory approach. The sequence applies for three schemes. MPS Scheme differently aims to optimize total players’ payoff. The case study in which theoretical models are applied observes two hotels offering homogenous product in Indonesia during a year. The Capacity Allocation, Demand, and Revenue Models are built using multiple regression and statistically tested for validation. Case study data confirms that price behaves within demand model in a non-linear manner. IS Models can represent the actual demand and revenue data better than Non-IS Models. Furthermore, IS enables hotels to earn significantly higher revenue. Thus, duopoly hotel players in general, might have reasonable incentives to share information horizontally. During off-peak season, MPS Models are able to predict the optimal equal price for both hotels. However, Nash equilibrium may not always exist depending on actual payoff of adhering or betraying mutual agreement. To optimize performance, horizontal cooperative game may be chosen over non-cooperative game. Mathematical models can be used to detect collusion among business players. Empirical testing can be used as policy input for market regulator in preventing unethical business practices potentially harming society welfare.

Keywords: horizontal cooperative game theory, hotel revenue management, information sharing, mutual price setting

Procedia PDF Downloads 292
5385 Technical and Economical Feasibility Analysis of Solar Water Pumping System - Case Study in Iran

Authors: A. Gharib, M. Moradi

Abstract:

The technical analysis of using solar energy and electricity for water pumping in the Khuzestan province in Iran is investigated. For this purpose, the ecological conditions such as the weather data, air clearness and sunshine hours are analyzed. The nature of groundwater in the region was examined in terms of depth, static and dynamic head, water pumping rate. Three configurations for solar water pumping system were studied in this thesis; AC solar water pumping with a storage battery, AC solar water pumping with a storage tank, and DC direct solar water pumping.

Keywords: technical and economic feasibility, solar energy, photovoltaic systems, solar water pumping system

Procedia PDF Downloads 573
5384 Heat Transfer and Trajectory Models for a Cloud of Spray over a Marine Vessel

Authors: S. R. Dehghani, G. F. Naterer, Y. S. Muzychka

Abstract:

Wave-impact sea spray creates many droplets which form a spray cloud traveling over marine objects same as marine vessels and offshore structures. In cold climates such as Arctic reigns, sea spray icing, which is ice accretion on cold substrates, is strongly dependent on the wave-impact sea spray. The rate of cooling of droplets affects the process of icing that can yield to dry or wet ice accretion. Trajectories of droplets determine the potential places for ice accretion. Combining two models of trajectories and heat transfer for droplets can predict the risk of ice accretion reasonably. The majority of the cooling of droplets is because of droplet evaporations. In this study, a combined model using trajectory and heat transfer evaluate the situation of a cloud of spray from the generation to impingement. The model uses some known geometry and initial information from the previous case studies. The 3D model is solved numerically using a standard numerical scheme. Droplets are generated in various size ranges from 7 mm to 0.07 mm which is a suggested range for sea spray icing. The initial temperature of droplets is considered to be the sea water temperature. Wind velocities are assumed same as that of the field observations. Evaluations are conducted using some important heading angles and wind velocities. The characteristic of size-velocity dependence is used to establish a relation between initial sizes and velocities of droplets. Time intervals are chosen properly to maintain a stable and fast numerical solution. A statistical process is conducted to evaluate the probability of expected occurrences. The medium size droplets can reach the highest heights. Very small and very large droplets are limited to lower heights. Results show that higher initial velocities create the most expanded cloud of spray. Wind velocities affect the extent of the spray cloud. The rate of droplet cooling at the start of spray formation is higher than the rest of the process. This is because of higher relative velocities and also higher temperature differences. The amount of water delivery and overall temperature for some sample surfaces over a marine vessel are calculated. Comparing results and some field observations show that the model works accurately. This model is suggested as a primary model for ice accretion on marine vessels.

Keywords: evaporation, sea spray, marine icing, numerical solution, trajectory

Procedia PDF Downloads 221
5383 Reaction Kinetics of Biodiesel Production from Refined Cottonseed Oil Using Calcium Oxide

Authors: Ude N. Callistus, Amulu F. Ndidi, Onukwuli D. Okechukwu, Amulu E. Patrick

Abstract:

Power law approximation was used in this study to evaluate the reaction orders of calcium oxide, CaO catalyzed transesterification of refined cottonseed oil and methanol. The kinetics study was carried out at temperatures of 45, 55 and 65 oC. The kinetic parameters such as reaction order 2.02 and rate constant 2.8 hr-1g-1cat, obtained at the temperature of 65 oC best fitted the kinetic model. The activation energy, Ea obtained was 127.744 KJ/mol. The results indicate that the transesterification reaction of the refined cottonseed oil using calcium oxide catalyst is approximately second order reaction.

Keywords: refined cottonseed oil, transesterification, CaO, heterogeneous catalysts, kinetic model

Procedia PDF Downloads 547
5382 Numerical Simulation of the Remaining Life of Ramshir Bridge over the Karoon River

Authors: M. Jalali Azizpour, V.Tavvaf, E. Akhlaghi, H. Mohammadi Majd, A. Shirani, S. M. Moravvej, M. Kazemi, A. R. Aboudi Asl, A. Jaderi

Abstract:

The static and corrosion behavior of the bridge using for pipelines in the south of country have been evaluated. The bridge was constructed more than 40 years ago on the Karoon River. Mentioned bridge is located in Khuzestan province and at a distance of 15 km east from the suburbs of Ahwaz. In order to determine the mechanical properties, the experimental tools such as measuring the thickness and static simulations based on the actual load were used. In addition, the metallurgical studies were used to achieve a rate of corrosion of pipes in the river and in the river bed. The aim of this project is to determine the remaining life of the bridge using mechanical and metallurgical studies.

Keywords: FEM, stress, corrosion, bridge

Procedia PDF Downloads 477
5381 Financial Feasibility of Clean Development Mechanism (CDM) Projects in India

Authors: Renuka H. Deshmukh, Snehal Nifadkar, Anil P. Dongre

Abstract:

The research study aims to analyze the financial performance of the companies associated with CDM projects implemented in India from 2001 to 2014 by calculating net profit with and without CDM revenue. Further the study also highlights the Year-wise and sector-wise lending to CDM projects in India as well as in the state of Maharashtra. The study further aims to examine the year-wise trend of Certified Emission Reductions (CER) issued by the CDM projects implemented in Maharashtra from 2001-2014. The study as well analyses the responses of selected corporate with respect to the challenges in implementing and obtaining finance from commercial banks.

Keywords: adaptation costs, internal rate of return, mitigation, vulnerability, CER

Procedia PDF Downloads 348
5380 Heat Transfer Enhancement via Using Al2O3/Water Nanofluid in Car Radiator

Authors: S. Movafagh, Y. Bakhshan

Abstract:

In this study, effect of adding Al2O3 nanoparticle to base fluid (water) in car radiator is investigated numerically. Radiators are compact heat exchangers optimized and evaluated by considering different working conditions. The cooling system of a car plays an important role in vehicle's performance, consists of two main parts, known as radiator and fan. Improving thermal efficiency of engine leads to increase the engine's performance, decline the fuel consumption and decrease the pollution emissions. In this study, the effects of fluid inlet flow rate and nanoparticle volume fraction on heat transfer and pressure drop of acar radiator are studied.

Keywords: forced convection, nanofluid, radiator, CFD simulation

Procedia PDF Downloads 345
5379 The Extraction of Sage Essential Oil and the Improvement of Sleeping Quality for Female Menopause by Sage Essential Oil

Authors: Bei Shan Lin, Tzu Yu Huang, Ya Ping Chen, Chun Mel Lu

Abstract:

This research is divided into two parts. The first part is to adopt the method of supercritical carbon dioxide fluid extraction to extract sage essential oil (Salvia officinalis) and to find out the differences when the procedure is under different pressure conditions. Meanwhile, this research is going to probe into the composition of the extracted sage essential oil. The second part will talk about the effect of the aromatherapy with extracted sage essential oil to improve the sleeping quality for women in menopause. The extracted sage substance is tested by inhibiting DPPH radical to identify its antioxidant capacity, and the extracted component was analyzed by gas chromatography-mass spectrometer. Under two different pressure conditions, the extracted experiment gets different results. By 3000 psi, the extracted substance is IC50 180.94mg/L, which is higher than IC50 657.43mg/L by 1800 psi. By 3000 psi, the extracted yield is 1.05%, which is higher than 0.68% by 1800 psi. Through the experimental data, the researcher also can conclude that the extracted substance with 3000psi contains more materials than the one with 1800 psi. The main overlapped materials are the compounds of cyclic ether, flavonoid, and terpenes. Cyclic ether and flavonoids have the function of soothing and calming. They can be applied to relieve cramps and to eliminate menopause disorders. The second part of the research is to apply extracted sage essential oil to aromatherapy for women who are in menopause and to discuss the effect of the improvement for the sleeping quality. This research adopts the approaching of Swedish upper back massage, evaluates the sleeping quality with the Pittsburgh Sleep Quality Index, and detects the changes with heart rate variability apparatus. The experimental group intervenes with extracted sage essential oil to the aromatherapy. The average heart beats detected by the apparatus has a better result in SDNN, low frequency, and high frequency. The performance is better than the control group. According to the statistical analysis of the Pittsburgh Sleep Quality Index, this research has reached the effect of sleep quality improvement. It proves that extracted sage essential oil has a significant effect on increasing the activities of parasympathetic nerves. It is able to improve the sleeping quality for women in menopause

Keywords: supercritical carbon dioxide fluid extraction, Salvia officinalis, aromatherapy, Swedish massage, Pittsburgh sleep quality index, heart rate variability, parasympathetic nerves

Procedia PDF Downloads 123
5378 The Evaporation Study of 1-ethyl-3-methylimidazolium chloride

Authors: Kirill D. Semavin, Norbert S. Chilingarov, Eugene.V. Skokan

Abstract:

The ionic liquids (ILs) based on imidazolium cation are well known nowadays. The changing anions and substituents in imidazolium ring may lead to different physical and chemical properties of ILs. It is important that such ILs with halogen as anion are characterized by a low thermal stability. The data about thermal stability of 1-ethyl-3-methylimidazolium chloride are ambiguous. In the works of last years, thermal stability of this IL was investigated by thermogravimetric analysis and obtained results are contradictory. Moreover, in the last study, it was shown that the observed temperature of the beginning of decomposition significantly depends on the experimental conditions, for example, the heating rate of the sample. The vapor pressure of this IL is not presented at the literature. In this study, the vapor pressure of 1-ethyl-3-methylimidazolium chloride was obtained by Knudsen effusion mass-spectrometry (KEMS). The samples of [ЕMIm]Cl (purity > 98%) were supplied by Sigma–Aldrich and were additionally dried at dynamic vacuum (T = 60 0C). Preliminary procedures with Il were derived into glove box. The evaporation studies of [ЕMIm]Cl were carried out by KEMS with using original research equipment based on commercial MI1201 magnetic mass spectrometer. The stainless steel effusion cell had an effective evaporation/effusion area ratio of more than 6000. The cell temperature, measured by a Pt/Pt−Rh (10%) thermocouple, was controlled by a Termodat 128K5 device with an accuracy of ±1 K. In first step of this study, the optimal temperature of experiment and heating rate of samples were customized: 449 K and 5 K/min, respectively. In these conditions the sample is decomposed, but the experimental measurements of the vapor pressures are possible. The thermodynamic activity of [ЕMIm]Cl is close to 1 and products of decomposition don’t affect it at firstly 50 hours of experiment. Therefore, it lets to determine the saturated vapor pressure of IL. The electronic ionization mass-spectra shows that the decomposition of [ЕMIm]Cl proceeds with two ways. Nonetheless, the MALDI mass spectra of the starting sample and residue in the cell were similar. It means that the main decomposition products are gaseous under experimental conditions. This result allows us to obtain information about the kinetics of [ЕMIm]Cl decomposition. Thus, the original KEMS-based procedure made it possible to determine the IL vapor pressure under decomposition conditions. Also, the loss of sample mass due to the evaporation was obtained.

Keywords: ionic liquids, Knudsen effusion mass spectrometry, thermal stability, vapor pressure

Procedia PDF Downloads 190
5377 Re-Evaluating the Hegemony of English Language in West Africa: A Meta-Analysis Review of the Research, 2003-2018

Authors: Oris Tom-Lawyer, Michael Thomas

Abstract:

This paper seeks to analyse the hegemony of the English language in Western Africa through the lens of educational policies and the socio-economic functions of the language. It is based on the premise that there is a positive link between the English language and development contexts. The study aims to fill a gap in the research literature by examining the usefulness of hegemony as a concept to explain the role of English language in the region, thus countering the negative connotations that often accompany it. The study identified four main research questions: i. What are the socio-economic functions of English in Francophone/lusophone countries? ii. What factors promote the hegemony of English in anglophone countries? iii. To what extent is the hegemony of English in West Africa? iv. What are the implications of the non-hegemony of English in Western Africa? Based on a meta-analysis of the research literature between 2003 and 2018, the findings of the study revealed that in francophone/lusophone countries, English functions in the following socio-economic domains; they are peace keeping missions, regional organisations, commercial and industrial sectors, as an unofficial international language and as a foreign language. The factors that promote linguistic hegemony of English in anglophone countries are English as an official language, a medium of instruction, lingua franca, cultural language, language of politics, language of commerce, channel of development and English for media and entertainment. In addition, the extent of the hegemony of English in West Africa can be viewed from the factors that contribute to the non-hegemony of English in the region; they are French language, Portuguese language, the French culture, neo-colonialism, level of poverty, and economic ties of French to its former colonies. Finally, the implications of the non-hegemony of English language in West Africa are industrial backwardness, poverty rate, lack of social mobility, drop out of school rate, growing interest in English, access to limited internet information and lack of extensive career opportunities. The paper concludes that the hegemony of English has resulted in the development of anglophone countries in Western Africa, while in the francophone/lusophone regions of the continent, industrial backwardness and low literacy rates have been consequences of English language marginalisation. In conclusion, the paper makes several recommendations, including the need for the early introduction of English into French curricula as part of a potential solution.

Keywords: developmental tool, English language, linguistic hegemony, West Africa

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5376 Effects of Fatty Acid Salts and Spices on Dermatophagoides farinae

Authors: Yumeho Obata, Mariko Era, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

Abstract:

Dermatophagoides farinae is major mite allergens in indoors. D. farinae is often swarm over powder products (e.g. wheat flour), because it feeds on starch or protein that are included in them. Eating powder products which are mixed D.farinae causes various allergic symptoms. Therefore, the creation of food additive agents with high safety and control of mite effect is required. Fatty acid salts and spices are known that have pesticidal activities. This study describes the effects of fatty acid salts and spices against Dermatophagoides farinae. Materials and Methods: Potassium salts of 9 fatty acids (C4:0, C6:0, C8:0, C10:0, C12:0, C14:0, C18:1, C18:2, C18:3) were prepared by mixing the fatty acid with the appropriate amount of KOH solution to a concentration of 175 mM and pH 10.5. C12Cu and C12Zn were selected as other fatty acid salts. Cayenne pepper, habanero, Japanese pepper, mustard, jalapeno pepper, curry aroma and cinnamon were selected as spices. D. farina, have been cultured in laboratory. To rear the mites, double-soled dishes containing of sterilized food were put on the big plastic container (30.0 × 20.0 × 20.0cm) which had 100% ammonium nitrate solution in the bottom. Plastic container was placed on incubator at 25 °C and 64 % relative humidity (RH) under dark condition. Sterilized food composed of dried bonito flakes and dried yeast (Ebios), 1:1 by weight. The antiproliferative method, sample and medium culture were mixed in double-soled dish and kept at 25 °C and 64 % RH. Decrease rates were determined 1 week and 4 week after treatment under microscope. D. farina was considered to be dead if appendages did not move when prodded with a pin. Results and Conclusions: The results show that the fatty acids potassium showed no antiproliferative effects against D. farinae. On the other hand, Japanese pepper, mustard, curry aroma and cinnamon were effective to decrease propagative rate (over 80 %) after treatment for 1 week against D. farina. Japanese pepper, curry aroma and cinnamon were effective to decrease propagative rate (approximately 100 %) after treatment for 4 weeks against D. farina. Especially, Japanese pepper and cinnamon showed the fasted and the most consecutive antiproliferative effects. These results indicate that Japanese pepper and cinnamon have high antiproliferative effects against D. farina and suggest spices will be used as a food additive agent.

Keywords: fatty acid salts, spices, antiproliferative effects, dermatophagoides farinae

Procedia PDF Downloads 236
5375 Drug Therapy Problem and Its Contributing Factors among Pediatric Patients with Infectious Diseases Admitted to Jimma University Medical Center, South West Ethiopia: Prospective Observational Study

Authors: Desalegn Feyissa Desu

Abstract:

Drug therapy problem is a significant challenge to provide high quality health care service for the patients. It is associated with morbidity, mortality, increased hospital stay, and reduced quality of life. Moreover, pediatric patients are quite susceptible to drug therapy problems. Thus this study aimed to assess drug therapy problem and its contributing factors among pediatric patients diagnosed with infectious disease admitted to pediatric ward of Jimma university medical center, from April 1 to June 30, 2018. Prospective observational study was conducted among pediatric patients with infectious disease admitted from April 01 to June 30, 2018. Drug therapy problems were identified by using Cipolle’s and strand’s drug related problem classification method. Patient’s written informed consent was obtained after explaining the purpose of the study. Patient’s specific data were collected using structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to statistical software package version 21.0 for analysis. To identify predictors of drug therapy problems occurrence, multiple stepwise backward logistic regression analysis was done. The 95% CI was used to show the accuracy of data analysis and statistical significance was considered at p-value < 0.05. A total of 304 pediatric patients were included in the study. Of these, 226(74.3%) patients had at least one drug therapy problem during their hospital stay. A total of 356 drug therapy problems were identified among two hundred twenty six patients. Non-compliance (28.65%) and dose too low (27.53%) were the most common type of drug related problems while disease comorbidity [AOR=3.39, 95% CI= (1.89-6.08)], Polypharmacy [AOR=3.16, 95% CI= (1.61-6.20)] and more than six days stay in hospital [AOR=3.37, 95% CI= (1.71-6.64) were independent predictors of drug therapy problem occurrence. Drug therapy problems were common in pediatric patients with infectious disease in the study area. Presence of comorbidity, polypharmacy and prolonged hospital stay were the predictors of drug therapy problem in study area. Therefore, to overcome the significant gaps in pediatric pharmaceutical care, clinical pharmacists, Pediatricians, and other health care professionals have to work in collaboration.

Keywords: drug therapy problem, pediatric, infectious disease, Ethiopia

Procedia PDF Downloads 155